20020945 Ver 1_Complete File_20020617

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June 27, 2002
Rockingham County
DWQ Project No. 020945
SR 2628 (Hearth Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. J.M. Mills, P.E., Division Engineer
NCDOT Division 7
P.O. Box 14996
Greensboro, NC 27415
Dear Mr. Mills:
You have our approval, in accordance with the attached conditions and those listed below, to impact 0.02
acres of wetlands and 110 linear feet of unnamed tributaries to Rose Creek in order to improve SR 2628
(Hearth Road) in Rockingham County. The project must be constructed in accordance with your
application dated June 5, 2002 (received June 17, 2002). After reviewing your application, we have
decided that this fill is covered by General Water Quality Certification No. 3375, corresponding to the
U.S. Army Corps of Engineers Nationwide Permit Number 14. In addition, you must 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 in writing 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 be valid, you must follow the conditions listed in the attached certification and any additional
conditions listed below.
1. NCDOT shall Sedimentation and Erosion Control Guidelines for Sensitive Watersheds' (15A NCAC
4B .0024) to minimize impacts to downstream aquatic resources (the water is classified as nutrient
sensitive). Temporary or permanent herbaceous vegetation shall be planted on all bare soil within 15
days of ground-disturbing activities to provide long term erosion control.
2. Riparian vegetation must be reestablished within the construction limits of the project by the end of
the growing season following completion of construction.
3. NCDOT is encouraged to use existing on-site vegetation and materials for stream bank stabilization
and to minimize the use of rip rap.
4. The dimension, pattern, and profile of the stream and floodplain above and below the structure shall
not be modified by widening the stream channel or reducing the depth of the stream.
5. All work shall be performed during low flow conditions.
6. 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.
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
?F-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/ncwetiands/
7. All mechanized equipment operated near surface waters must be regularly inspected and maintained
to prevent contamination of stream waters from fuels, lubricants, hydraulic fluids, or other toxic
materials.
8. 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 40I/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 which 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 Ms.
Jennifer Frye of the Winston-Salem Regional Office. at 336.771.4600. .
Sincerely,
Attachment
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0a. Ii 1,P .
cc: Wilmington District Corps of Engineers
Jean Manuele, USACE Raleigh Field Office
NCDWQ Winston-Salem Regional Office
Central Files
File Copy
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0 2 0 9 4 5
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STATE OF NORTH CAROLINA
DEPARTIVfNT OF TRANSPORTATION
MICHAEL F. EASLEY
GOVERNOR
1584 YANCEYVILLE STREET, GREENSBORO, NC 27415
June 5, 2002
MEMORANDUM TO:
FROM:
SUBJECT:
Ms. Cynthia Van der Wiele
Wetlands/401 Unit
John Hunsinger
District Engineer, District 3, Division 7
LYNDO TIPPETT
SECRETARY
ti7 2002
Payment Information - Water Quality Certificate for Rockingham
County, Hearth Road (SR 2628)
In accordance with General Statute 143-215.3D(e) the following information if being provided to
facilitate payment of fees associated with the appropriate Water Quality Certificate:
• Certificate being requested: # 3375 (NWP 14)
• Work Order Number : 6.512098T
• Amount of fee: $200
Sincerely,
John Hunsinger
District Engineer, District 3, Division 7
rnz-
FILE COPY
PAYMENT
RECEIVED
PHONE [phone] FAX [phone]
8
wn
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415 LYNDo TIPPETT
GOVERNOR
SECRETARY
June 5, 2002
NC DENR Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699
ATTN.: Ms. Cynthia Van der Wiele
Wetlands/401 Unit
Dear Ms. Van der Wiele
SUBJECT: Rockingham County, Upgrade of Hearth Road (SR 2628) from an unpaved secondary
road to a paved secondary road.
Please find seven (7) copies a. Pre-Construction Notification Application package attached for you
re -view. If you have any questions or need any additional information, please contact John Hunsinger
at [phone] or Len Smith at [phone]. Your time and effort are appreciated.
Sincerely,
RTMills, P.E.
Division Engineer, Division 7
cc: Mrs. Jean Manuele, USACE
Mr. Lenwood Smith, II, PWS, NCDOT 6??X/c5-L
Mr. John Hunsinger, District 3 Engineer, NCDOT
Mr. Frank Vernon, Area Roadside Field Operations Engineer, NCDOT
Nathan McKinney, Grade Crew Foreman, NCDOT
PHONE [phone] FAX [phone]
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415 LYNDo TIPPETT
GOVERNOR
SECRETARY
June 5, 2002
U.S. Army Corps of Engineers
Regulatory Field Office
6508 Falls of the Neuse Road, Suite 105
Raleigh, North Carolina 27615
ATTN: Mrs. Jean Manuele
NCDOT Coordinator
Dear Mrs. Manuele:
SUBJECT: Rockingham County, Upgrade of Hearth Road (SR 2628) from an unpaved secondary
road to a paved secondary road.
The North Carolina Department of Transportation (NCDOT) proposes to upgrade Hearth Road (SR
2628) from an unpaved to a paved secondary road to reduce future maintenance needs and increase
traffic safety. Total project length is 0.60 miles. This activity will result in the impacts to waters of
the United States including a stream and a wetland. Stream impacts will result from the replacement
and extension of a crossline pipe and the filling of a portion of modified natural stream The
replacement and stream filling are being conducted to facilitate travel lane and shoulder widening
during the upgrade. The pipe replacement, which is occurring in a US water within the Cape Fear
River Basin, is as follows:
Site Existing Pie Proposed Pie Stream type Impacts ft
1
T!'{T 40' of 24" RCP 100' of 36" RCP Intermittent 60 en , 10 tm , 10
ic-,r - remlorcea concrete pipe; CW = Corrugated metal pipe; CAVA = Corrugated metal pipe arch.
en = enclosure; tmp = temporary, rp = rip rap energy dissipaters placed above ordinary high water.
The stream filling activity is as follows:
Site Exlstin Channel(ft) I Pro osed Channel ft Stream type Impacts ft
1 30 0 Intermittent 30
PHONE [phone] FAX [phone]
Combing the stream pipe replacement impacts with the channel filling total stream impacts are 100-
feet of permanent impacts and 10-feet of temporary impacts. Permanent impacts will result from
stream enclosure, placement of rip rap energy dissipaters above the ordinary high water mark on
each side of the newly installed pipe (energy dissipaters will be included within the confines of the
temporary work area), and filling a portion of a modified natural stream. Regarding the filling of the
stream, the stream filling is necessary to prevent flooding of the road as a result of constricted flow
by the driveway pipe located downstream from the pipe being replaced. Furthermore, modification
of the stream slope is not a concern as the existing stream begins at the outlet of the existing pipe. If
the stream being impacted is perennial, temporary impacts will result from the placement of
ABC aggregate or a less intrusive dewatering device within the stream during the dewatering
operation. Dewatering devices will be placed on both sides of the pipe being replaced.
Temporary impacts will result from the placement of a rock silt screen downstream from the pipe
outlet. On-site detours will not be provided for pipe replacements in intermittent streams due to the
short duration of the activity. Temporary impacts will be minimized by entirely removing rock silt
screens, restoring natural stream contours, and seeding within 15 working days of the of the pipe
replacement activity.
Wetland impacts will result from the placement of fill material in the wetland to facilitate travel lane
and shoulder widening during the upgrade. Individual wetland impacts are as follows:
Site Wetland
Unit(s Classification* Impacts
acres Comments
1 A PFO l F 0.02 No
*Cowardin, L.M., V. Carter, F.C. Golet, and E.T. LaRoe. 1979. Classification of Wetlands and Deepwater Habitats of
the United States. US Dept. of the Interior, USFWS. FWS/OBS-79/31.
See the attached data sheets and Natural Resource Review Evaluation Sheet for additional
information on the wetland being impacted.
Stream mitigation is not anticipated, as the impacts to any individual stream do not exceed 150 feet
Wetland mitigation is not anticipated, as wetland impacts do not exceed 0.10 acres and do not occur
in a unique natural wetland. The project is not located in a High Quality Water. The project will not
impact an Essential Fisheries Habitat. No Threatened or Endangered species were observed during
field surveys conducted by Len Smith for species known to occur in Rockingham County (See the
attached Endangered Species Review Sheet for further information). Records from the NCDOT
Historic Architect indicate that no National Register, Study List, or Determination of Eligibility
properties are located within the project area. Secondary impacts will be minimized by strict
enforcement of Best Management Practices for the protection of surface waters -and wetlands,
restrictions against the staging of equipment in or adjacent to waters of the US, and coordination
with the Division Environmental Officer.
The NCDOT anticipates that the proposed filling activities will be authorized under Nationwide
Permit 14. This application is intended as a request for formal written authorization from the
USACE to place fill in the wetland and intermittent stream at Site 1 under NWP 14. This application.
is also intended as request for written authorization from the NC Division of Water Quality for filling
activities under General Water Quality Certificate # 3375 (NWT 14). Enclosed please find the Pre-
construction Notification Form and supporting documentation for the above referenced project.
Construction is anticipated to begin as soon as practicable following authorization and take 1 week
to complete.
If you have any questions or need any additional information, please contact John Hunsinger at (336)
634-5644 or Len Smith at [phone]. Your time and effort are appreciated.
Sincerely,
J.M. Mills, P.E.
Division Engineer, Division 7
cc: Ms. Cynthia Van der Wiele, NCDWQ b 61r
0/6-L
Mr. Lenwood Smith, II, PWS, NCDOT `? 1
Mr. John Hunsinger District 3 Engineer, NCDOT
Mr. Frank Vernon, Area Roadside Field Operations Engineer, NCDOT
Nathan McKinney, Grade Crew Foreman, NCDOT
Office Use Only: Form Version October 2001
USACE Action ID No. DWQ No. 020945
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
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: NWP 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:_ Mr. J.M. Mills P E Division Engineer - Division 7
Mailing Address: P.O. Box 14996
Greensboro, NC 27415
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: mmillsndot.state.nc.us
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be
attached if the Agent has signatory authority for the owner/applicant.)
Name: Not Applicable
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page 1 of 9
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: Hearth Road - SR 2628
2. T.I.P. Project Number or State Project Number (NCDOT Only):6.512098T (non-TIP)
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Rockingham Nearest Town: Reidsville
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): The project site is southeast of
Reidsville. From the US-29 Bypass exit onto Hwy-87 south. Proceed 4.1 miles and turn
right ont Hwy-150. Proceed 1.8 miles and turn right onto SR 2627 (Candy Creek Road
Proceed 1.7 miles and turn right onto SR 2628
5. Site coordinates, if available (UTM or Lat/Long): See the attached USGS map
(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:
Residential and agricultural.
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): Rose Creek
9. River Basin:_ Cane Fear
(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/ma- s/.)
Page 2 of 9
10. Describe the purpose of the proposed work: To upgrade an unpaved secondary road to a
paved secondary road. Paving and widening are being conducted to reduce future
maintenance costs, bring the road un to current construction standards and increase traffic
safety.
11. List the type of equipment to be used to construct the project: Road construction
equipment (trackhoe grader, backhoe and bulldozer)
12. Describe the land use in the vicinity of this project: Disturbed forest
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 additional permit requests anticipated for this project in the future? If so, describe the
anticipated work, and provide justification for the exclusion of this work from the current
application:
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as . appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or. stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 3 of 9
1. Wetland Impacts
Wetland Impact
Site Number
indicate on ma)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(yes/no Distance to
Nearest Stream
linear feet
Type of Wetland***
1 Placement of fill 0.02 No Headwater PFO1F

Ust each impact separamy and wenury temporary impacts. Impacts include, but are not limited to: mechanized clearing grading, fill,
excavation, flooding ditchingtdrainage, 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.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: N/A
Total area of wetland impact proposed: 0.02
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
(indicate on map)
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
(please specify)

1
Pipe replacement 60(en)
10(tmp)
10( )
UT to Rose Creek
5.5'
Intermittent
1 Placement of fill 30 UT to Rose Creek 5.5' Intermittent

*
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/gam),
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.sov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.toi)ozone.com,
www.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 60- enclosure (en),
10- temporary(tmp) 10- rip rap (r p). Total permant impact is 100-feet.
Page 4 of 9
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
Open Water Impact
Site Number
indicate on ma) *
Type of Impact* Area of
Impact
(acres) Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.
N/A _

# T _L
,.,bt CMAI uttpact separately and identity 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.): 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
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.
Pine replacement and placement of fill are necessary to increase travel lane and shoulder width
to current construction standards Impacts will be minimized by strict enforcement of Best
Management Practices for the protection of wetland and surface waters restrictions a ainst the
stag-ina of eauipment in or adjacent to waters of the US and coordination with the Division
Environmental Officer.
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.
Page 5 of 9
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.ne.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 (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.
A finding of insignificant impact is anticipated Cumulative stream impacts are less than 150
feet. The maximum amount of impact to a single stream is 100 linear feet Wetland impacts
are less than 0.10 acres with the maximum amount of impact to an individual wetland being
0.02 acres. No Outstanding Resource Waters federally protected species or their habitats or
essential fishery habitats occur in the project area The project is not located in a High
Quality Water.
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/wm/l*ndex.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): N/A
Amount of buffer'mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Page 6 of 9
Amount of Non-riparian wetland mitigation requested (acres): N/A
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
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify N/A )?
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
cone i extends out su feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 7 of 9
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 213 .0242 or.0260.
XI. Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
In accordance with the February 25, 1991 delegation agreement one copy of the sediment and
erosion control plan will be submitted to DENR - Division of Land Resources and NCDOT
Roadside Environmental Prior to construction.
XH. Sewage Disposal (DWQ Only)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
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 ?
MV. 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).
Agent's Si
z oz-
Page 8 of 9
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.
M. 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.
In accordance with the February 25, 1991 delegation agreement one copy of the sediment and
erosion control plan will be submitted to DENR - Division of Land Resources and NCDOT
Roadside Environmental Prior to construction.
MI. 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).

G /J z
hcant/Agent's Signs a Dat
(Agent's signature is valid only if an authorization letter from the applicant is provided:)
Page 8 of 8
NATURAL RESOURCE EVALUATION SHEET
State Project # SR Number Road Name County Investigator(s)
6.,4; 1 2.0`j g7' 2628 Hearth Road Rockingham Len Smith
Date: River Basin: Water Quality Designation Buffer Rules (Y/N)
08/01/01 Cape Fear C NSW No
Primary Land Use Percent Residential Percent Agricultural: Percent Unmaintained:
Residential 50 0 50
i vnPC n7 i inmaintavnari i irf in l?A Vw?vln :..?.
Community
Type Dominant Tree(s) Dominant Shrub(s) v Dominant Herb(s)
Disturbed
forest green ash, sweet gum, tree-of-
heaven tree-of-heaven pokeweed, giant ragweed,
Japanese honeysuckle

L -.J

Streams
waters of tae us
Station Stream Name Perennial or

Intermittent Ave. Wdth

(OHV*TW Ave. Dpth

OHW Ave. Wdth

OB Ave. Dpth

OB
Notes
UT to Rose Creek Intermittent 5.5' <0.5' 6.5' 3.0' Parallels road

4

i. --' vi?rvivl - 1v1caJUlcll1G116J ulauc irvm vramary rugn water marker, -m i3
=
Measurements made from the Top of the Bank
Wetlands

Station Within 100-year
Floodplain Distance to
Nearest Stream
linear feet
Cowardin Classification
Dominant Plants
No Headwater PFOl F sweet gum, red maple, winterberry,
common alder, sedge .

^- - «,
V VVIi ?v dLG¦

M.1VL Name of Waterbody
if applicable) Type of
Waterbod
M.M. Name of Waterbody
if applicable) T

Type of Waterbody

General Notes/Comments:
Division Environmental Offs r
a/ G
Date
ENDANGERED SPECIES REVIEW FOR DIVISION 7
DISTRICT 3
State Project # SR Number Road Name County
s'l 2 0 C ?g Hearth Road Rockingham
Caswell County
James sninvmimp..} (Plvarnhvmn rnlli»nl - Rnanniro t2...;,,
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
N/A
Rockingham County
Smooth Coneflnwer (Frhinaron Inovionfnl AAau hc. a„rc.n.,o.i F f'....... T....,. 0- ?t__
Habitat Survey Date Investigator(s) , Man-hours - Comments/Findings
No 08101101 Len Smith 0.5
James sninvtnussP.i (Ph urnhomn rnllinnl - Rnannva ti-
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
N/A
Potential Species (Listed in Nearby Counties)
Schweinitz's sunflower (Helianthus schweinitzii?_ Rockingham County - May be surveyed for from late
Au¢ust to Octnher
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
No 08/01/01 Len Smith 0.5
Small anthered bittercress (Cardamine micranthera) - Rockingham and Caswell Counties (Roanoke Basin)
Mav be surveved fnr in Anrii and Mau
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
N/A
General Notes/Comments:
T_57;=s?ionE?n?oK_
?talOffi?cer?_
Date
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division Seven
County Rockingham Project ID: 6.512098T
River Basin Cape Fear Bridge No: N/A
Route 2628 Stream UT to Rose Creek
Water Quality Criteria
Yes No
Stream Crossing Blueline on USGS Z ?
ORW ? Z
WSI ? Z
WS II, III, or IV Crossing Within 0.5 mi. of W.S. Critical Area ? Z
Roadway Criteria
Route Designation Yes No
Arterial Urban ? 19
Arterial Rural ? Z
Additional Site Information:
Yes No
Is a Hazardous Spill Basin Required? ?
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
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June 5, 2002
Site 1
Construction Sequence and Erosion Control Plan for Pipe
Replacement of Pipe with Pipe in an Intermittent Stream
Rockingham County - SR 2628
Work to begin as soon as practicable following authorization
Construction is anticipated to take 1 day.
1. ALL WORK WILL BE CONDUCTED IN THE DRY.
2. Prior to removing the existing pipe, install a rock silt screen downstream to prevent
incidental sediment loss due to unforeseen precipitation.
I Remove one existing line of 40' long 24" RC pipe.
4. Excavate to sufficient depth to allow 20% burial of the pipe, place base stone, and
single line of 100' long 36" RC pipe.
5. Backfill the structure.
6. Place rip rap only as needed.
7. Remove the rock silt screen and restore natural stream contours.
8. Seed and mulch remaining disturbed areas.
9. Silt fences to be placed as site conditions require.
10. Site conditions and weather may alter these plans.
5

88 P1= 6+90.64
HARDEN A=4*5
03 !co'- ?G'l (CGl

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T=11781'
PG 1476 L =235.48'

4+81.22 R = 2752.9758

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Name: REIDSVILLE Location: 17 623417 E 4013096 N
Date: 5/2412002 Caption: Location of permitted activities - SR 2628
Scale: 1 inch equals 2000 feet
Inc.

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View of the north end of wetland unit A.
View of the center of wetland unit A.

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View of wetland unit A exiting under Hearth Road.
View of the south end of wetland unit A.

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View of the northern portion of the UT to Rose Creek (This portion is being filled).
View of the southern portion of the UT to Rose Creek (This portion is not being filled).

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GOVERNOR
Mike Mills, PE
Division Engineer
1584 Yanceyville Street
Greensboro, NC 274154996
CS# 02-16-44
December 13, 2001
Dear Mr. Mills:
(Please Distribute to Division/District Maintenance Engineers and DEO):
LYNDO TIPPETT
SECRETARY
The NCDOT Historic Architecture Section has received your county commission-approved 2001-2002
Secondary Roads Rural Paving Program. We have map-checked all submitted roads at the NC State
Historic Preservation Office (SHPO) for the following currently designated historic property types:
National Register (NR), Study List (SL), and Determined Eligible (DOE) properties. Based on the map-
check reviews, we are writing (1) to inform you of the current historic compliance status for your SR Rural
Paving Program; (2) to notify you of the SR projects that definitely will require our fieldwork; (3) to
provide you with information that can be included (or attached) in your cover letter for a Pre-Construction
Notification.
If coordination is required, the NCDOT staff architectural historian will notify the Division/District
Maintenance Engineers to start a mitigation effort involving environmental commitment agreeable to all
parties. Documentation will be coordinated by the staff architectural historian with the Division
Environmental Officer.
When additional SR projects are added to a Program, individual updates will be sent to the
Division/District Maintenance Engineers and the DEO. All status updates can be tracked on the Division
Support website. If there are errors or omissions in this letter or on the website, please e-mail your NCDOT
staff architectural historian or call the Division Coordinator, Richard Silverman, 919-733-7844 x298.
Sincerely,
7?
Richard L. Silverman
Attachment
MAILING ADDRESS:
NC DEPARTMENT OF TRANSPORTATION
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS
1548 MAIL SERVICE CENTER
RALEIGH NC 27699-1548
TELEPHONE: [phone]
FAX: [phone]
WEBSIT' WWW.OOKDOT.STATE.NC.US

NO Dept, of Transportation
DIftlon of Highways4th
LOCATION:
TRANSPORTATION BUILDING
1 SOUTH WILMINGTON STREET
RALEIGH NC
HISTORIC ARCHITECTURE STATUS REVIEW SHEET
NCDOT Secondary Roads Rural Paving Projects
The county-commission approved 2001-2002 SR Rural Paving Program for Division 7 has been map-
checked at the NC Historic Preservation Office by NCDOT Architectural Historians. The results of this
map-check should be included in your Pre-Construction Notification application (by attachment of this
document with the applicable SR# circled or by inclusion in your own letter).
Historic Properties Present (NR, SL, or DOE)
Status: THE DIVISION WILL NOT PROCEED until compliance work is completed by NCDOT
Historic Architecture and Concurrence has been obtained from the NC State Historic Preservation
Office
Further Information & Scheduling: Contact your assigned Architectural Historian or go to
http://www.dot.state.nc.us/planning/pe/histarchi/divsupport/
Based on a review of USGS county survey quad maps at the SHPO, the following roads have
properties that are currently designated as historic. Please do not proceed with construction until
compliance work is completed by the Historic Architecture Section. We will be in contact with the
Division/District Maintenance Engineers and the Division Environmental Officer to coordinate this
effort. Please note: not all NR, SL, or DOE properties will necessarily require mitigation. We will
work with the Division and District Maintenance Engineers if environmental commitments are
required. At any time, if you are not in agreement with the proposed mitigation efforts, please contact
Richard Silverman, Division Coordinator at 919-733-7844 x298.
Alamance: SR 1107 (NR)
Orange: None
Guilford: None
Caswell: None
Rockingham: None
HISTORIC ARCHITECTURE STATUS REVIEW SHEET (Continued)
NCDOT Secondary Roads Rural Paving Projects
No Designated Historic Properties Present (NO NR/SL/DOE)
Status for projects with No Federal Permit: PROCEED
Status for projects with a Federal Permit anticipated: PROCEED WITH CONDITIONS
(see below)
Further Information & Scheduling: Contact your assigned Architectural Historian or go to
http•//www.dot.state.nc.us/planning/pePnistarchi/divsupportl
Based on a review of USGS county survey quad maps at the HPO, the following roads do not have
properties that are currently designated historic. The Division may proceed with construction with the
following conditions: If the Division applies for a Federal Permit, the NC State Historic Preservation
Office (SHPO) may request additional fieldwork, (usually to identify Potentially Eligible properties).
Typically this request is made for counties where historic resource surveys have not been completed or
are out-of-date. If additional historic properties are identified, further coordination, including
environmental commitments, may be required as part of the project. For SR Projects where no Federal
Permit is to be applied for, no further compliance work is anticipated by NCDOT. Those projects may
proceed unconditionally.
Alamance: SR 2384, 2333, 1191, 1565, 1502, 2012, 1758, 2013, 1584C
Orange: SR 1115, 1503, 1368, 1302, 1359, 1132, 1529, 1897
Guilford: SR 2035, 3382, 2102, 3524, 2771, 2833, 1140N, 1140S, 3105E, 2762, 3344, 3083,
2904W, 1827, 3359
Caswell: SR 1608, 1755, 1569, 1758, 1109, 1601, 1332, 1712, 1344, 1313, 1.172, 1551, 1570
Rockingham: SR 1163,f2-6-2-8)2405, 2404, 1377, 2187, 2713, 2197, 2339, 1383, 1934, 1217,
1111, 2259, 2559, 1122, 2024, 2133, 2382N, 2156, 2388, 2425, 1397