20050569 Ver 1_Application_20050401

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STATE OF NORTH CAROLINA
1#17q
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P. O. Box 25201, Ralcigh, NC 27611-5202
G )VERN V PHONE: [phone]
March 24, 2005
Mr. John Thomas
U. S. Army Corps of Engineers
Raleigh Regulatory Field Office
6508 Falls of Neuse Road, Suite 120
Raleigh, NC 27615
LYNDO TIFF
SI:I'1t1; I mn'
050569
Subject: Nationwide Permit 43 & 933
SR 15 14, Possum Trot Valley Road, shoulder failure
Surry County, North Carolina
Project Number: 11B.208611 (No DWQ Permit Fee required)
Dear Mr. Thomas:
0
A small section of the roadway shoulder on SR 1514 has failed. This section is at the outlet of a
pipe carrying the North Prong of the South Fork of the Mitchell River (Class: C;Tr). An extension
of approximately ten (10) feet is needed in order to stabilize the shoulder at this location. Once
the pipe extension is in and buried one foot, the shoulder will be back filled and rip rap will be
placed for stabilization at the outlet.
The placement of this extension will require temporary dewatering. An impervious sandbag dike
will be constructed approximately 20 feet upstream of the existing structures to create a small
pool. Clean water will temporarily be pumped around the construction area and will be
discharged into a buffer area downstream. Any dirty water located inside the construction area
will be pumped into a silt bag. The dewatered area at this site will total approximately 0.008
acres. Once the new structure is in place, the impervious dike will be removed and
preconstruction streambed elevations will be restored.
Construction of this project will require impacts to waters of the United States in the Yadkin
Basin. This project was reviewed for the presence of threatened and endangered species on March
24, 2005. This project will have no effect on any federally listed endangered plant or animal
species.
Attached is a Preconstruction Notification Form, plan sheet, a marked county map, a marked
topography map and photographs.
11. O. 13()x2511, N. w1J.K1;SJ1(*(), NC 28659
PHONE [phone] F,tix [phone]
Mr. John Thomas
SR 1514, Possum Trot Valley Road. Surn
Page 2
March 23. 2005
By copy of this letter, it is requested that Mr. Ron Linville, Mountain Region Coordinator, with
the North Carolina Wildlife Resources Commission comment directly to you concerning the 404
Nationwide Permit application with a copy sent to me.
We would like to begin construction as soon as possible. If further information is required, please
let me know. Your early review and consideration will be appreciated.
Sincerely,
Staci Hining
Division Environmental Specialist
Enclosures
cc: John Thomas, US Army Corps of Engineers (l additional copy)
Ron Linville, Western Piedmont Region Coordinator, NCWRC
John Hennessy, Division of Water Quality (2 copies)
Mike Pettyjohn, PE, Division Engineer
Brandon Whitaker, PE, District Engineer
Mark Williams, County Maintenance Engineer
Heath Slaughter, Division Environmental Officer
Neil Trivette, Roadside Environmental Field Operations Engineer
Dennis Bennett, Bridge Maintenance Engineer
Office Use Only: Fonn version April 2001
950569
USACE Action ID No. DWQ o.
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: NW 43 & 433
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 Vlll - Mitigation), check here: ?
11. Applicant Information
1. Owner/Applicant Information
Name: North Carolina Department of Transportation
Mailing Address: P. O. Box 250, North Wilkesboro, NC 28659
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
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: Staci Hinins_ Division Environmental Specialist
Company Affiliation: North Carolina Department of Transportation
Mailing Address: P O Box 250, North Wilkesboro NC 28659
Telephone Number: X336) 903-9203 Fax Number: [phone]
E-mail Address: sshining g(dot.state. nc.us
Page 3 of 12
111. 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 1l 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 ofproject:_SR 1514 shoulder failure
2. T.I.P. Project Number (NCDOT Only): 110.20861 1
3. Property Identification Number (Tax PIN): N/A _
4. Location
County: Surry Nearest Town: Mountain Park
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): See attached SR map
5. Site coordinates, if available (UTM or Lat/Long): DD: 36.3780° N 80.9025° W
(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/Farm
7. Property size (acres): Approximately 0.01 newly disturbed acres
8. Nearest body of water (streaili/river/sound/ocean/lake): _ North Prom; of the South Fork
Mitchell River (Class: C Tr)
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 )
10. Describe the purpose of the proposed work: Repair failed roadway slope
Page 4 of 12
1 1. List the type of equipment to be used to construct the project: Track hoe/back hoe, and dump
12. Describe the land use in the vicinity of this project: Residential/Farm
IV. Prior Project History
If jurisdictional determinations and/or pert-nits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
N/A
V. Future Project Plans
Are any 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
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.
1. Wetland Impacts
Page 5 of 12
Wetland Impact
Site Number
(indicate on ma)
Type of Impact*
_ Arca of
Impact
(acres) Located within
100-year Floodplain**
(VC010) Distance to
Nearest Stream
(linear feet)
Type of Wetland***
N/A - ---

t.ast each impact separatey and identity temporary impacts. Impacts Include, but are not limited to: mechanized clearing, grading, fill,
excavation, Ilooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year Iloodplains are identified through the Federal Frilergertcy Management Agency's (FFMA) Flood Insurance late Maps
(FIRM), or FEMA-approved local Iloodplain maps. Maps are available through the FINA Map Service Ccnter at 1-800-358-9616, or
online at
*'* List a wetland lvhe that best describes wctland to be impacted (c.g., freshwater/s ltwatcr marsh, forested wedand, txaver pond,
Carolina I3av, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property:
Total area of wetland impact proposed _ _
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
Imp act
Perennial or
Intermittent'?
(please specify)

Site 1
Fill
10 feet North Prong of the
South Fork Mitchell
5 feet
Perennial
River

I,Ist each impact separately and Identity temporary impacts. hnpacts include, but are not limited to: Culverts and associated rip-rap,
darns (separately lint impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabili/alion activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linen footprint for both the original and relocated stre his must be included.
Stream names can be found on USGS topographic maps. 11'a stream has no name, list as Ul' (unnamed lributar}') 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
Several Internet sites also allow direct download and printing of USGS maps (e.g.,
.
, etc.)
Cumulative impacts (linear distance in feet) to all streams on site: 10 In. ft. of new impacts
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U. S.
Open Water Impact Area of
Name Wal Type of Waterbody
Site Number Type of Impact* Impact
)
(ifap p
plicab1cle)
(lake, pond, estuary, sound,
-(indicate on ma
) (acres) bay, ocean, etc.)
Site 1 Rip rap placement for 001 North Prong of the South

stabilization
Fork Mitchell River Perennial Stream
Site I Tent oran dewaterin
p g .008 North Prong of the South
Perennial Stream
Fork Mitchell River
,,tst cacn rrnpact sep,trtnen, and wcnuty temporary impacts. Impacts include, but are not limitLd to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
Page 6 of 12
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.):
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.
Due to the failed slope along, 1514, the culvert must be lengthened at this location to provide a
safe roadway. This extension will be the minimum amount necessary to provide for a safe
roadway width All appropriate BMPs will be used during; construction
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.
Page 7 of 12
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
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
N/A
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at 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): To be determined by the COE
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount of Non-riparian wetland mitigation requested (acres): N/A
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
Page 8 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 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
(Neuse), 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 iit [lormation:
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
l 3
2 1.5
Total
Zone I extends out 30 feet peapendiculw- from near lkink of chaluld. /,one 2 cxlends 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.
X1. 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.
Impervious surface area will not increase All appropriate best management practices for
sediment and erosion control will be implemented during culvert extension installation and slope
stabilization.
Page 9 of 12
X11. 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.
A
X111. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (I 5A NCAC 211 .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-tact 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).
Applicant/Agent's Signature ate
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell Union
US Anny Corps of Engineers Avery Clay Jackson Polk Watauga
151 Patton Avenue Buncombe Cleveland Lincoln Rowan Yancey
Room 208 Burke Gaston Macon Rutherford
Asheville. NC 28801-5006 Cabarrus Graham Madison StanleN,
Telephone: [phone] Caldwell Haywood McDowell Swain
Fax: [phone] Catawba Henderson Mecklenburg Transylvania
Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham Wilson
US Armv Corps Of Engineers Alleghany Edgecotnbe Lee Stokes Yadkin
Page 10 of 12
1332
CHELL ? Mttchell
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Rood .1
Church 1_ •'?
-f TO ROARING GAP 21 ? 1313
Pipe Location
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I Name: ROARING GAP
Date: 3/24/2005
Scale: 1 inch equals 1333 feet
1?? V
SR 1514, Possum G. I .i; _
m .? Trot Valley Road "mac -r
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036.3833298° N 080.9001272° W

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1) Outlet view with shoulder
2) Outlet view
3) Buried outlet
4) Inlet
5) View from road shoulder
i

SR 1514, pipe extension

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