20051091 Ver 1_Application_20050624

of WATF9
r
o;
Mr. Benton G. Payne, P.E.
NCDOT Division 10
716 West Main Street
Albemarle, NC 28001
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
Qr?c,[2ade
JUN 2 7 2005
DENR - WATER QUALITY
1'rERMIDSAND STORMATER LiWICH
APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear Mr. Payne:
June 24, 2005
DWQ# 05-1031
Stanly County
You have our approval, in accordance with the attached conditions and those listed below, to permanently
impact a total of 109 linear feet (If) of streams as listed in the table below:
Location/Station
Station 44+50 Stream Name
Unnamed tributary to Big Bear Creek' Length of Stream Impact
15 linear feet
Station 51+30 Unnamed tributary to Big Bear Creek* 26 linear feet
Station 79+80 Unnamed tributary to Big Bear Creek' 20 linear feet
Station 80+60 Unnamed tributary to Big Bear Creek* 12 linear feet
Station 95+20 Unnamed tributary to Big Bear Creek* 22 linear feet
Station 96+50 Unnamed tributary to Big Bear Creek* 14 linear feet
The impacts will be for the purpose of replacing, extending and/or adding culverts, and providing bank
stabilization associated with the paving of a secondary road as described in your application received by the
Division of Water Quality (DWQ) on June 10, 2005. The location of the project is State Road 1221 (Frog Pond
Road) in Stanly County. After reviewing your application, we have determined that this project is covered by
Water Quality General Certification Number 3404. Please note that you should get any other federal, state or
local permits before proceeding with your project, including those required by (but not limited to) Sediment and
Erosion Control, Non-Discharge, and Water Supply Watershed regulations. This approval will expire with the
associated 404 permit unless otherwise specified in the Water Quality Certification.
This approval is valid solely for the purpose and design that you described in your application (unless modified
below). Should your project change, you must notify the DWQ in writing and you may be required to 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 conditions. If total wetland fills for this project (now or in
the future) exceed one acre, or if 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 remain valid, you must adhere to the conditions listed in the attached certification and those listed below:
"No stream determination performed.
QQn??ett,,Carolina
,iVaturall?
North Carolina Division of Water Quality 610 East Center Avenue, Suite 301
Internet h2o.enr.state.nc.us Mooresville, NC 28115
Phone[phone]
Fax [phone]
An Equal Opportunity/Affirmative Action Employer- 50% Recycled/10% Post Consumer Paper

Page 2
1. Placement of culverts and other structures in waters, streams and wetlands must be below the elevation of
the streambed by one (1) foot for all culverts with a diameter greater than 48 inches, and 20 percent of the
culvert diameter for culverts having a diameter less than 48 inches, to allow for low flow passage of water and
aquatic life, as well as prevent headcutting of the streams. The design and placement of culverts and other
structures including temporary erosion control measures shall be installed in such a manner that the original
stream profiles are not altered (i.e., the depth of the channel must not be reduced by a widening of the
streambed). Existing stream dimensions (including pattern and profile) are to be maintained above and
below locations of each culvert. The applicant may be required to provide evidence that the equilibrium has
been maintained, if requested in writing by the DWQ.
2. Riprap must not interfere with thalweg performance and aquatic life passage during low flow conditions.
3. The presence of equipment in the channel must be minimized. Under no circumstances must rock, sand or
other materials be dredged from the wetted stream channel.
4. Erosion and sediment control practices must utilize Best Management Practices (BMP) and be in full
compliance with all specifications governing the proper design, installation, and operation and maintenance of
such BMP in order to protect surface water standards:
a. The design, installation, operation, and maintenance of the sediment and erosion control measures
must be such that they equal, or exceed, the requirements specified in the most recent version of
the North Carolina Sediment and Erosion Control Manual. The devices shall be maintained on all
construction sites, borrow pit sites, and waste pile (spoil) projects, including contractor-owned or
leased borrow pits associated with the project.
b. For borrow pit sites, the erosion and sediment control measures must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina Surface
Mining Manual.
c. The reclamation measures and implementation of these measures must be in accordance with the
requirements of the Sedimentation Pollution Control Act.
5. Heavy equipment must be operated from the banks rather than in the stream channel, when possible, in
order to minimize sedimentation and reduce the likelihood of introducing other pollutants into the stream.
6. Temporary dewatering sites must be restored to pre-existing conditions unless more natural geomorphic
conditions can be provided.
7. No live or fresh concrete shall come into contact with waters of the state until the concrete has hardened.
8. The dimension, pattern and profile of the stream above and below the crossing should not be modified.
Disturbed floodplains and streams should be restored to natural geomorphic conditions.
9. 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.
10. All work shall be performed during low or normal flow conditions.
11. Discharging hydroseed mixtures and washing out hydroseeders and other equipment in or adjacent to
surface waters is prohibited.
Page 3
12. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum extent
practicable. If placement of sediment and erosion control devices in wetlands and waters is unavoidable,
they shall be removed and the natural grade restored within 30 days after the Division of Land Resources has
released the project.
13. The North Carolina Department of Transportation (NCDOT) and its contractors and/or agents shall not
excavate, fill or perform mechanized land clearing at any time in the construction or maintenance of this
project within waters and/or wetlands, except as authorized by this Certification, or any modification to this
Certification (e.g., no work shall occur outside of the footprint of the plans provided). In addition, there shall
be no excavation from or waste disposal into jurisdictional wetlands or waters associated with this
Certification without appropriate modification. If this occurs, compensatory mitigation may be required since it
is a direct impact from road construction activities.
14. Upon completion of the project, the applicant shall complete and return the enclosed "Certificate of
Completion" form to notify DWQ when all work included in the 401 Certification has been completed. Please
include photographs upstream and downstream of the structure to document correct installation.
15. Continuing Compliance. NCDOT shall conduct its activities in a manner so as not to contravene any state
water quality standard [including any requirements for compliance with section 303(d) of the Clean Water Act]
and any other appropriate requirements of state and federal law. If DWQ determines that such standards or
laws are not being met (including the failure to sustain a designated or achieved use) or that state or federal
law is being violated, or that further conditions are necessary to assure compliance, DWQ may reevaluate
and modify this certification to include conditions appropriate to assure compliance with such standards and
requirements in accordance with 15 A NCAC 2H.0507(d): Before codifying the certification, DWQ shall notify
NCDOT and the USACE, provide public notice in accordance with 15A NCAC 2H.0503, and provide
opportunity for public hearing in accordance with 15A NCAC 21-1.0504. Any new or revised conditions shall
be provided to NCDOT in writing, shall be provided to the USACE for reference in any permit issued pursuant
to Section 404 of the Clean Water Act, and shall also become conditions of the 404 Permit for the project.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must
act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition that
conforms to Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, 6714
Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless
you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If
you have any questions, please telephone Polly Lespinasse in the Mooresville Regional Office at 704-663-
1699.
Sincerely,
for Alan W. Klimek, P.E.
Attachments
cc: Steve Lund, USACE Asheville Field Office
Rob Ridings, DWQ Wetlands Unit
Central Files
File Copy
f `V v
?SWL ?V
rs
STATE OF NORTH CAROLI-N ??sy li?y
DEPARTMENT OF TRANSPORTAT?QN
MICHAEL F. EASLEY DIVISION OF HIGHWAYS W. LYNDO TIPPETT
GOVERNOR May 25, 2005 SECRETARY
North Carolina Division of Water Quality
401 Wetlands Certification Unit i
2321 Crabtree Boulevard .i
Raleigh, NC 27604-2260 t
Subject: Secondary Road Improvements to SR 1221 (Frog Pond Road). Stanly County.
WBS Element Number 10C.084031 (DWQ Minor Permit Fee S200.00)
Dear Sir or Madam:
The North Carolina Department of Transportation (NCDOT) proposes to upgrade SR 1221 (Frog
Pond Road) in Stanly County. SR 1221 is an unpaved road%vav- that Mill be upgraded to a paved
roadway. The total project length is 1.7 miles.
Transportation and highway laws of North Carolina (G.S. 136-44.6. 1=6-14.7. 136-44.7A. 136-
44.8 and 136-44.9) require the NCDOT to develop annual work programs for construction and
maintenance of secondary roads. These general statutes specifically set forth requirements for
annual construction and paving of existing unpaved roads. Paving of these roads is performed in
priority order as established by the NCDOT for each unpaved road within a given county. This
number is based on characteristics of each road, including number of homes. schools, churches,
businesses, industries, recreational facilities, traffic counts, presence of school bus routes, and
value as a thoroughfare. SR 1221 is scheduled for paving in the 2005-2006 Secondary Roads
Construction Program.
Protected Species
The subject project has been reviewed for the presence of listed threatened and endangered
species. It has been determined that the construction of this project will have no effect on any
listed plant or animal species.
Impacts to Waters of the United States
This project cannot be completed without impacts to waters of the United States. The project lies
within the Yadkin River Basin (Hydrologic Unit # 03040105); at}ecting the drainage of unnamed
tributaries to Big Bear Creek. A total of six stream impacts will be incurred due to pipe
replacement and bank stabilization activities. There will be appro-imately 109 linear feet of
impacts to the existing stream channels as a result of the proposed roadway improvements.
716 Nest Main Street, Albemarle, NC 28001 • [phone] • Fax [phone]
6
_?1
Wetland Impacts
There are no wetland impacts that will result from the construction of this project. Potential
impacts would be avoided by the proposed new location.
Stream Impacts
Table 1 includes information related to site number, stream name, existing pipe.length (ft),
existing pipe width (in), proposed replacement or extended pipe length (ft) and width (in). .
Table 1_ Stream Imnacts due to improvements to SR 1221 (Frog Pond Road)
Site Existing Existing Proposed Proposed
No. Stream Name Length Width Length Width
(feet (inches) (feet) inches
Sta. UT of Bib Bear Creek 33 30 (2) 48 (2) 30
44+50
Sta. UT of Big Bear Creek 34 18 60 42
51+30
Sta. UT of Big Bear Creek N/A N/A 20 N/A
79+80 Bank Stabilization Only - See Pictures
Sta. UT of Bib Bear Creek 40 30 (2) 52 (2) 30
80+60
Sta. UT of Big Bear Creek
1 22 18 44 30
95+20 1
Sta. UT of Big Bear Creek 30 18 44 24
96+50
Note: "UT" refers to unnamed tributary.
Avoidance/Minimization
SR 1221 has been realigned to the west side of the existing right-of-way, thereby eliminating the
need to consider relocating approximately 1600 linear feet of stream channel that parallels the
existing roadway. The new alignment also avoids impacts to one jurisdictional wetland located at
Station 68+00. The proposed road shoulders for this project have been reduced to a 2:1 slope in
an effort to further minimize unnecessary impacts.
Any wetlands or surface waters not affected by this project will be protected from unnecessary
encroachment. No staging of construction equipment or storage of construction supplies will be
allowed in or near wetlands or surface waters. Best Management Practices for the protection 'of
wetlands and surface waters will be enforced during all phases of project construction. Continued
coordination will occur between maintenance forces and the Division Environmental Supervisor
during construction in an effort to minimize impacts to jurisdictional sites.
2
Compensatory Mitigation
Based upon a May 20, 2005 conversation with Mr. Steve Lund of the US Army Corps of
Engineers, the NCDOT does not anticipate the need for compensatory nutigation for this project.
Summary
The purpose of this letter is to request authorization to construct the proposed project under a
Section 401 Water Quality Certificate (WQC) No. GC3404. We have enclosed seven copies of
the pre-construction notification package for dissemination and review.
If you have any questions or need any additional information concerning this project, please feel
free to contact Mr. Larry Thompson, Division Environmental Officer, at [phone].
Sincerely, /
Benton G. Payne, P. E.
Division Engineer
BGP/LBT
cc: Ms. Polly Lespinasse, NCDWQ
Ms. Marella Buncick, USFWS
Ms. Marla Chambers, NCWRC
Mr. Ritchie Hearne, P. E.
Ms. Ranette Davis, CME
Mr. Larry Thompson, DEO
Area Field Operations Unit
Stanly County vU ??
SR 1221 (Frog Ppnd Roads/ ?O
yFr Gti
10S O orm Version March 05
Office Use Only: 9?0 ?qr _
USACE Action ID No. D W Q N3`?
(If any particular item is not applicable to this project, please enter `%9t Applicable" or "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project:
? Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: GC3404
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 Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information
Name: N C Department of Transportation
Mailing Address: 716 W. Main Street
Albemarle NC 28001
Telephone Number: 704-982-0101 Fax Number: 704-982-3146
E-mail Address:
2. Agent/Consultant 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 Panye PE
Company Affiliation: Division Engineer
Mailing Address: N C Department of Transportation
716 W. Main Street
Albemarle NC 28001
Telephone Number: 704-982-0101 Fax Number: 704-982-3146
E-mail Address: bpaynendot state nc us
Page I of 9
Stanly County
SR 1221 (Frog Pond Road)
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 1221 (Frog Pond Road)
2. T.I.P. Project Number or State Project Number (NCDOT Only): WBS 10C.084035
3. Property Identification Number (Tax PIN): N/A
4. Location
County: STANLY Nearest Town: OAKBORO
Subdivision name (include phase/lot number):
Directions to site (include road numbers/names, landmarks, etc.): From Oakboro, travel
north on SR 1925 (St Martin Church Road) approximately 1.9 miles turn left onto SR 1221
(Frog Pond Road)
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35° 15' 24.17" ON 80° 18' 8.62" °W
6. Property size (acres):
7. Name of nearest receiving body of water: Big; Bear Creek
8. 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•/ih2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: This area is mixed use rural residential agriculture which is
open fields in areas and wooded in others There are several residences along this road but it
remains largely undeveloped -
Page 2 of 9
Stanly County
SR 1221 (Frog Pond Road)
10. Describe the overall project in detail, including the type of equipment to be used:
The existingaravel base road will be regraded sloped drainage improvements made, base
added and paved A total of 5 pipes will need to be replaced extended, or a_second line of
pipe added due to previous flooding istory and/or to establish a stable shoulder slope along
the roadway. Typical road construction equipment will be used such as: motor grader,
backhoe dump trucks and rollers.
11. Explain the purpose of the proposed work:
The purpose of the proposed work is to improve the safety and function of the existing
roadwa .
IV. Prior Project History
if jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
N/A
VI. Proposed Impacts to Waters of the United Statcs/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. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should 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
Page 3 of 9
Stanly County
SR 1221 (Frog Pond Road)
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. Provide a written description of the proposed impacts:
The proposed impacts will consist of several pipe extensions and pipe replacements on unnamed
tributaries of Big Bear Creek One request is for stream bank stabilization to prevent further
head cutting at Station 79+80 Wherever possible the new pipe will be buried to a depth equal
to 20% of the pipe diameter. - --
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
cinaratPly list impacts clue to both structure and flooding.
Vv w
Wetland Impact
Site Number
(indicate on map)

Type of Impact Type of wetland

(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Floodplain
(es/no) Distance to
Nearest
Stream
(linear feet Area of
Impact
(acres)
N/A

Total Wetland Impact (acres)
3. List the total acreage (estimated) of all existing wetlands on the property:
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, 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. To calculate acreage, multi ly length X width. then divide b 43,560.
Stream Impact
Perennial Average Impact Area of
Number Stream Name Type of Impact Intermittent
Intermittent? Stream Width Length Impact
indicate on ma) . Before Impact linear feet acres

44+50
Sta
UT to Big Bear Extend existing
30" RCP and add a Perennial
Approx. 2'
15'
.0007
. Creek second 30" RCP (biological)

51+30
Sta
UT to Big Bear Replacing 18" x
34' RCP with a perennial
Approx. 1.5'
26'
.0009
. Creek 42" x 60' RCP (biological)

79+80
Sta
UT to Big Bear Proposed bank
stabilization with
Perennial
Approx. 2'
20'
.0009
. Creek (biological)
rip rap

80+60
Sta
UT to Big Bear Extend existing 30'
RCP and adding a
Perennial
Approx. 1.5'
12'
.0004
. Creek
second 30" RCP
(biological)
Page 4 of 9
Stanly County
SR 1221 (Frog Pond Road)

95+20
Sta
UT to Big Bear Replacing 18" z
22' RCP with a 30 perennial
Approx. 1.5'
22'
.0008
. Creek x 44' RCP (biological)

96+50
Sta
UT to Big Bear Replacing 18" x
30' RCP with a 24"
Perennial ,
Approx. 1
14'
.0003
. Creek x 44' RCP
Total Stream Impact (by length and acreage) 109' .004
5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fit (-yr.q.,:,tinn drerlt*inf*_ flooding. drainage. bulkheads, etc.
Open Water Impact
Site Number
indicate on ma Name of Waterbody
(if applicable)
Type of Impact Type of Waterbody
(lake, pond, estuary, sound, bay,
ocean, etc. Area
Impact
acres

Total Open Water Impact (acres) N/A
6
List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): .004
Wetland Impact (acres): -
Open Water Impact (acres): -
Total Impact to Waters of the U.S. (acres) .004
Total Stream Impact (linear feet): 109'
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ® No
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
8. 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.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond: Expected pond surface area:
Page 5 of 9
Stanly County
SR 1221 (Frog Pond Road)
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.
The proposed road improvements have been planned to avoid unnecessary impacts to the streams
and wetlands located along SR 1221 The existing roadway will be shifted to the west side of the
right of wav and road shoulders will be limited to a 2:1 slope where possible. Wherever
possible new pipe installations will be buried to a depth equal to 20% of the pipe diameter.
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 January 15, 2002, 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 NCEEP 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:/ih2o.enr.state.nc.tis/ncwet]ands/strmgide.htmi.
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,
Page 6 of 9
Stanly County
SR 1221 (Frog Pond Road)
Based upon a previous conversation with Mr Lund, USACE mitigation will not be required
for the proposed impacts.
2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http•//h2o enr state nc.us/wvMhndex.litm. If use of the NCEEP is proposed, please
check the appropriate box on page five 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 (required by DWQ)
Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ® No ?
2. 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
3. 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 (required by DWQ)
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.
Page 7 of 9
Stanly County
SR 1221 (Frog Pond Road)
2
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify N/A )? Yes ? No ?
If "yes", 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 for Catawba)
2 1.5
Total
* Zone I extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please
Donation of Property, Riparian Buffer
Riparian Buffer Restoration Fund). Ple
within 15A NCAC 2B .0242 or .0244, or
discuss what type of mitigation is proposed (i.e.,
Restoration / Enhancement, or Payment into the
ase attach all appropriate information as identified
.0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (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. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level.
The average width of the existing gravel base is 20 feet and the proposed paved roadway width is
20 feet There will not be an increase in impervious surface area as a result of this road being
XII. Sewage Disposal (required by DWQ)
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
Page 8 of 9
Stanly County
SR 1221 (Frog Pond Road)
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (I 5A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application? Yes ? No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ? No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http:Hh2o enr state. nc us/ncwetlands. If no, please provide a short narrative description:
It is not anticipated that the12roposed road improvements will result in additional development
which could impact nearby downstream water quality. However Stanly County's long ranee
land use plan does identify the area of SR 1221 from SR 1968 to SR 1970 as a primary growth
area while the remainder of SR 1221 is identified as a secondary growth area and a agricultural
conservation area.
XV. Othcr Circumstanccs (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).
?4 - 6- G5
Applicant/Agent's Sign ture Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9
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1960
Name: FROG POND Location: 035° 15' 29.73" N 080° 18'04.51" W
Date: 6/6/2005 Caption: Stanly County
Scale: 1 inch equals 1000 feet SR 1221 (Frog Pond Road)
1998, Maptech, Inc.
Stanly County
SR 1221 (Frog Pond Road)

Legend
p permit site
90
Prepared by:
North Carolina
Department of Tramportatlon
Ir U. Thompson
Environmental Unit. Division 10
Date: April 21, 2005
This map Is intended for internal DOT use only.
For all other met, no warranties of any sort,
Including accuracy, fitness, or merchantability
accompany this product.
Feet
0 500 1,000 2,000 3,000 4,000
T ? i j

SR 1221 (Frog Pond Road)
Sta. 44+50 facing north

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STATE'OF NORTH CAROLINA SUBJECT
EPARTMENT OF TRANSPORTATION COUNTY
DIVISION OF HKiHWAYS PREPARED BY STATION
716 WEST MAIN STREET
ALBERMARLE, NORTH CAROLINA 28001 CHECKED BY DATE STR NO SHEET! or, --L
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Certificate of Completion
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DWQ Project No. 05- IV'31 County:
Applicant: NC?D-i" Z -X\l- \ D 3
Project Name•
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Date of Issuance of 401 Water Quality Certification: (-e 2 oo 5
Upon completion of all work approved within the 401 Water Quality Certification and Buffer Rules,
and any subsequent modifications, the applicant is required to return this certificate to the
401 /Wetlands Unit, North Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh,
NC, 27699-1621. This form may be returned to DWQ by the applicant, the applicant's authorized
agent, or the project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
I, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to
built within substantial compliance and intent of the 401 Water Quality Certification and Buffer
Rules, the approved plans and specifications, and other supporting materials.
Signature:
Date:
Agent's Certification
I, A , hereby state that, to the best of my abilities, due care and
diligence was used in the servation of the construction such that the construction was observed to
built within substantial compliance and intent of the 401 Water Quality Certification and Buffer
Rules, the approved plans and specifications, and other supporting materials.
Signature: 2???-,i?1 ?-? Date: I C>/.:--\ /-0 G
If this proje
,?l was designed by a Certified Professional
I, , as a duly registered Professional
(i.e., Engineer, Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been
authorized to observe (periodically, weekly, full time) the construction of the project, for the
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that the construction was observed to built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans
and specifications, and other supporting materials.
Signature: Registration No.: Date: