20021781 Ver 1_Complete File_20021107

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
j Division of Water Quality
D ?
DWQ Pro-ect No.: 2 County: JE w` ?°
Applicant: e
Project Name: IS-3,S r v
Date of Issuance of 401 Water Qua rty Certification: .ter 2 coo
Certficate of Completion
Upon completion of all uvork approved "ithin the 401 Water Quality Certification or applicable Buffer
Rules. and any subsequent modifications. the applicant is required to return this certificate to the
4011Wetland- Unit. Forth 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 projal en--in--r. It is not necessary to send certificates from all of these.
Applicanfs Certification
L . hereby state that, to the best of my abilities, due care
and diligence u•as used in the observation of the construction such that the construction was observed to
be built u-ithin substantial compliance and intent of the 401 Water Quality Certification and Buffer
Rules. the approved plans and specifications, and other supporting materials.
Siortann-e: Date:
Agent's Certificati1, L- hereby state that, to the best of my abilities, due care
and diligence vvas used in th? observation of the construction such that the construction was observed to
be built a-ithin substantial compliance and intent of the 401 Water Quality Certification and Buffer
Rules. the approved ans`ind specifications. and other supporting ateri s.
Signatur : Date: ?o ?0 3
-T
If this prOlect 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 (reriodically. full time), the construction of the project, for the Permitee hereby state
that. to the b- 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 Qualiry Certification and Buffer Rules, the approved plans and specifications, and other
supporting materials.
Sioanatur Registration No. Date
NCL
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1600 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-73;'-11786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.usfncwetiands/
o?U W ATFRQG
r
b wi_ i
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
November 8, 2002
Stanley County
DWQ Project No. 021781
Proposed Replacement of Dual Cross Pipes on SR 1535 (Mountain Creek Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. Benton G. Payne, P.E., Division Engineer
NCDOT Division 10
716 West Main Street
Albemarle, North Carolina 28001
Dear Mr. Payne:
You have our approval, in accordance with the attached conditions and those listed below, to incur 30
linear feet of permanent and 40 linear feet of temporary impacts to an unnamed tributary of Little Long
Creek in order to replace a dual cross pipe on SR 1535 (Mountain Creek Road) in Stanley County. The
project should be constructed in accordance with your application dated November 4, 2002 (received
November 7, 2002). After reviewing your application, we have decided that this fill is covered by
General Water Quality Certification Nos. 3366 and 3375 corresponding to the U.S. Army Corps of
Engineers Nationwide Permit Number 33 and General (Regional) Permit No. 198200031. In addition,
you should acquire any other federal, state or local permits before you proceed with your project
including (but not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply
Watershed regulations. This approval will expire with the accompanying §404 permit unless otherwise
specified in the Water Quality Certification.
This approval is only valid for the purpose and design that you described in your application except as
modified below.. If you change your project, you must notify us in writing, and 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
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 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. Storm water shall be directed to grassed swales, vegetated buffer areas or a storm water collection
device and not routed directly to streams where practicable.
2. Existing vegetated buffers shall not be mowed in order to utilize it for storm water sheet flow.
3. The structure 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 the pipe. The structure shall be designed and installed to allow for fish
and other wildlife movement as well as prevent headcutting of the streams.
4. Riparian vegetation must be reestablished within the construction limits of the project by the end of
the growing season following completion of construction.
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetiands/
5. 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. Please include photographs upstream and downstream of the
structure to document correct installation.
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 th6 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.
Michael Parker of the Mooresville Regional Office at 704.663.1699.
Sincerely,
Attachment
I,P.E.
Klime Pc: Wilmington District Corps of Engineers
Steve Lund, USACE Asheville Field Office
NCDWQ Mooresville Regional Office
Central Files
File Copy
dY
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DIVISION OF HIGHWAYS
GOVERNOR
0% 0% n
D
ILI uurl November 4, 2002
U. S. Army Corps of Engineers
Asheville Regulatory Office
Attn: Mr. Steve Lund, MS, PWS
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
021781
W. LYNDO TIPPETT
SECRETARY
< ?yt
7t;7
t ;
vw?
Subject: Stanly County, Proposed Replacement of Dual Cross Pipes Located on SR 1535
(Mountain Creek Road). State Work Order No. 5.6552 (DWQ Minor Permit
Fee $200.00)
Dear Mr. Lund:
The North Carolina Department of Transportation (NCDOT) proposes to replace existing dual
cross pipes on SR 1535 (Mountain Creek Road) in Stanly County. The purpose of this letter is to
request authorization from the U. S. Army Corps of Engineers to construct the project under a
Section 404 General Permit No. 198200031.
The existing two lines of 36" x 60' pipe will be replaced by two 66" x 51" x 60' corrugated metal
pipe (arched). Traffic will be maintained using an off-site detour.
The project area has been reviewed for the presence of listed threatened and endangered species
and described in a Minimum Criteria Checklist. It has been determined that the construction of
this project will have no effect on any listed plant or animal species. There are no wetlands
present, although impacts to surface waters will occur. There will be 20 linear feet of permanent
stream channel loss and approximately 30 linear feet of temporary impacts associated with this
pipe replacement. This is a perennial stream channel that flows into Little Long Creek, Yadkin
River Basin, Hydrologic Unit 03040105. A permit drawing and pre-construction notification
form are attached to this letter. 71.11,
The NCDOT anticipates that the permit application will be authorized under a Section 404
General Permit No. 198200031. We are also hereby requesting a 401 Water Quality
Certification, GC 3375, from the Division of Water Quality. We are providing seven copies of
this application to the North Carolina Department,of Environment and Natural Resources,
Division of Water Quality, for their review.
716 West Main Street, Albemarle, NC 28001 • [phone] • Fax [phone]
9

&ago&
Thank you for your assistance with this project. If you have any questions or need any additional
information concerning this project, please contact Mr. Larry Thompson, Division Environmental
Officer, at [phone].
Sincerely,
Benton G. Payne, P. E.
Division Engineer
LBT/BGP
Enclosures
cc: Mr. John Dorney, NCDWQ
Ms. Marella Buncick, USFWS
Ms. Marla Chambers, NCWRC
Mr. Garland Haywood, Bridge Maintenance
Mr. Larry Thompson, DEO
Area Field Operations Unit
2
Office Use Only' 021 7 8 1 Form Version April 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.
1. Processing
Check all of the approval(s) requested for this project:
® Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: RGP 198200031
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: ?
II. Applicant Information
1. Owner/Applicant Information
Name: N C Department of Transportation
Mailing Address: 716 West Main Street
Albemarle NC 28001
Telephone Number: [phone] Fax Number: [phone]
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: Benton G Payne P E
Company Affiliation: Division Engineer
Mailing Address: 10`x' Highway Division
716 W. Main Street
Albemarle NC 28001
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: bpWena dot state nc us
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: SR 1535 ( Mountain Creek Rd.)
2. T.I.P. Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Stanly Countv Nearest Town: Albemarle
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From Intersection of 24/27 &
Hwy 52 take Hw. 52 north turn right onto Gene Rd (SR 1519) which is next to North
Stanly High School At the Intersection of Hearne Rd (SR 1518) & Gene Rd..turn right onto
Hearne Rd which ends at Mountian Creek Rd Turn rigLht Pipe sight is just ahead.
5. Site coordinates, if available (UTM or Lat/Long):
(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
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): Little Long Creek
9. River Basin: Yadkin (Hydrologic Unit 03040105)
(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 2 of 9
(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/.)
10. Describe the purpose of the proposed work: Installation of 2 lines of 66" x 51" CMPA.
- This will replace an existing 2 lines @a 36" RCP which is undersized
- 11. List the type of equipment to be used to construct the project: Heave construction equipment
( Trackhoe back hoe dump truck boom truck etc
12. Describe the land use in the vicinity of this project: Wooded on both sides of road.
Residential areas beyond wooded buffer.
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: N/A
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and 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
Page 3 of 9
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
1. Wetland Impacts
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***

_ -dine fill
• List each impact separately and identity temporary impacts. Impacts in luuc, vui ?e r t ,utuuu =__.. =•W? ?•---••-•c•
excavation. flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
100-Year floodplains are identified through the Federal Emergencv 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:/h.-%%-%v.f:_-ma.aov.
List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwatcr 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: N/A
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
(indicate on ma)
S l
Type of Impact*

Dual Culverts Length of
Impact
linear feet)
20-ft.
Stream Name**

UT to U1. Long Crk Average Width of
Stream Before
Impact
Approx. 4' Perennial or
Intermittent?
(leases specify)
Perennial
S1(a) Inlet Stabilization 5-ft. UT to Ltl. Long Crk. Approx. 4' Perennial
S I (b) Outlet Stabilization 5-ft. UT to Ltl. Long Crk. Approx. 4' Perennial

L_a _ a 1:_... ?...1 ? .... t.ru.rtn n ..it n otPlt f'Ifl-f'aT
* List each impact separately and identi fy temporary impacts. impacts mciuae, oue a,c HUL 1111liU?U L.,..,.....w ••r r>
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, 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.usss.aov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.toMone.com,
www.mapguest.com, etc.).
Page 4 of 9
Cumulative impacts (linear distance in feet) to all streams on site: Approximately 30 feet of
permanent impacts and 40 feet of temporary
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 Wat)
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.

* List each impact separately and identify temporary impacts. Impacts utciude. but are not uttutea to: nn, excavation, ureu ng
flooding. drainage, bulkheads, etc.
4. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
All wetlands or surface waters not affected by the project will be protected from unnecessary
encroachment No staying of construction equipment will be allowed in or near wetlands or
waters of the United States Strict enforcement of sedimentation and erosion Best Management
Practices for the protection of wetlands and surface waters will be enforced during.all phases of
project construction --
Page 5 of 9
VIII. Mitigation
DWQ In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
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/strm(-)-ide.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.
No mitigation is proposed for this project
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
Page 6 of 9
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/u-m/index.htm. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
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 ?
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 )?
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.
Page 7 of 9
Zone* Impact
(square feet Multiplier Required
Mitigation
1 3
2 1:5..
Total
* Zone 1 extends out 3U teet perpendicular trom near aanx or cnannei; cone z C'menus 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.
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.
There will not be an increase in impervious area as a result of these pipe replacements.
Temporary dewatering and all appropriate Best Management Practices for sediment and erosion
control will be implemented during pipe replacement/extension activities.
XII. Sewage Disposal (DWQ Only)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
N/A
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
Page 8 of 9

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).
<) -/- 02
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9
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Typical Plan and Elevation of Pipe Installation Permits Asphalt Crown
Amount of Fill over Pipe
6.0'
Creek Bed to Crown in Roadway
Typical End Elevation
Elevation 2 Lines of Corragated Metal Pipe Arch, 66" x 51
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II Rip Rap
Overall
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