20051824 Ver 1_Complete File_20051010

A
W A T?R?G
r
Mr. Benton 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
o C?C?GOd??
0 CT 1 S 2005
R . WATER QUALITY
()EI?
L14 AND STORMWATER BRANCH
WETLANDS
APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear Mr. Payne:
Alan W. Klimek, P,E. Director
Division of Water Quality
October 10, 2005
DWQ# 05-1824
Stanly County
You have our approval, in accordance with the attached conditions and those listed below, to permanently
impact 49 linear feet (If) of Rock Hole Creek for the purpose of replacing a bridge with an open-bottomed
concrete culvert as described in your application received by the Division of Water Quality (DWQ) on
September 28, 2005. The location of the project is Bridge No. 135 on State Road 1147 (Polk Ford Road) in
Stanly County. After reviewing your application, we have determined that this project is covered by Water
Quality General Certification Number 3404. This certification corresponds to the Regional General Permit
Number 198200031 issued by the U.S. Army Corps of Engineers (USACE). 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 is valid solely for the purpose and design that you described in your application (unless modified
below) and will expire with the associated USACE 404 permit unless otherwise specified in the Water Quality
Certification. 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 in the attached certification and those listed below:
1. Disposal of old bridge material into surface waters is not allowed. Strict adherence to the USACE guidelines
for bridge demolition will be required.
2. Caution should be exercised to install the culvert such that the existing floodplain benches are not disturbed.
3. Riprap must not interfere with thalweg performance and aquatic life passage during low flow conditions.
4. 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.
5. Temporary dewatering sites must be restored to pre-existing conditions unless more natural geomorphic
conditions can be provided.
North Carolina Division of Water Quality 610 East Center Avenue, Suite 301
Intemet h2o.enr.state.nr-us Mooresville, NC 28115
Phone [phone]
FAX [phone]
` Carolina
rurul;
An Equal Opportunity/Affirmative Action Employer- 50% RecycleW10°/U Post Consumer Paper

Page 2
6. No live or fresh concrete shall come into contact with waters of the state until the concrete has hardened.
7. 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.
8. 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.
9. All work shall be performed during low or normal flow conditions.
10. Discharging hydroseeding mixtures and washing out hydroseeders and other equipment in or adjacent to
surface waters is strictly prohibited.
11. 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.
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).

Page 3
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 2H.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
S E P 2 8 2005
DENR - WATER QUALITY
STATE OF NORTH CAROLINA WETLANDS AND STQRMWATER BRANCH
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DIVISION OF HIGHWAYS W. LYNDO TIPPF,TT
GOVERNOR September 26, 2005 SECRETARY
U. S. Army Corps of Engineers
Asheville Regulatory Field Office
Attention: Mr. Steve Lund, MS, PWS
151 Patton Avenue, Room 208 r051824
Asheville, NC 28801-5006 Subject: Stanly County - Bridge No. 135 (Polk Ford Road) over Rock Hole Creek. WBS Element No.
33342 (DWQ Minor Permit Fee $200.00).
Dear Mr. Lund:
The North Carolina Department of Transportation (NCDOT) proposes to replace Bridge No. 135 on SR 1147 (Polk
Ford Road) over Rock Hole Creek in Stanly. The existing timber decked bridge measures 29 feet 7 inches long by
15 feet 9 inches wide. The proposed replacement structure will be a pre-cast open bottomed concrete culvert that
measures 30 feet long by 48 feet 6 inches feet wide.
The subject project has been reviewed for the presence of federally protected 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.
This project cannot be completed without impacts to waters of the United States. The project lies in the Yadkin
River Basin (Hydrologic Unit # 03040105), affecting the drainage of Rock Hole Creek. There will be
approximately 49 linear feet of permanent impacts to the existing stream channel as a result of the proposed
construction.
The purpose of this letter is to request authorization to construct the proposed project under Section 404 Regional
General Permit 198200031. Application is also made to the North Carolina Division of Water Quality (NCDWQ)
for the Section 401 Water Quality Certificate (WQC) No. GC3404 that is required in order to construct this project.
If you have any questions or need any additional information concerning this project, please feel free to contact Mr.
Larry Thompson, Division Environmental Supervisor, at [phone].
Sinc ely, P A
Benton G. Payne, P. E.
Division Engineer
BGP/LBT
cc: Mr. John Dorney, NCDWQ
Mrs. Polly Lespinasse, NCDWQ
Ms. Marella Buncick, USFWS
Mrs. Marla Chambers, NCWRC
Bridge Maintenance Unit
716 West Main Street, Albemarle, NC 28001 • [phone] Fax [phone]
SR 1147 (Polk Ford Road)
Stanly County
Office Use Only: Form Version March 05
20051824
USACE Action ID No. DWQ No.
rTf nnv nartirnfar item is not annlicable to this proiect, please enter "Not Applicable" or "N/A".)
1. Processing
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 General Permit No. 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 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 West Main Street
Albemarle NC 28001
Telephone Number: [phone] Fax Number: [phone]
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 Payne P E
Company Affiliation: Division Engineer
Mailing Address: I O'h Highway Division
716 W. Main Street
Albemarle NC 28001
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: bpMMe@,dot.state.nc.us
1 of 9
SR 1147 (Polk Ford Road)
Stanly County
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: Bridge No. 135 on SR 1147 (Polk Ford Road)
2.T.I.P. Project Number or State Project Number (NCDOT Only): 8.2682001
3.Property Identification Number (Tax PIN): N/A
4.Location
County: Stanly Nearest Town: Stanfield
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers/names, landmarks, etc.): From the intersection of
NC 24/27 and NC 200 in the town of Locust travel south on NC 200 approximately 2 miles,
turn right onto Love Ch4XI Road and travel 0.8 miles to Polk Ford Road.
Turn right onto Polk Ford Road and continue until you reach the first bridge.
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): 035° 12' 56.08" N / 80° 26' 26.15" W
6.Property size (acres): N/A
7.Name of nearest receiving body of water: Rock Hole 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://h2o.enr.state.nc.us/admin/maps/.)
2 of 9
SR 1147 (Polk Ford Road)
Stanly County
9. Describe the existing conditions on the site and general land use in the vicinity of the
project at the time of this application: The site is located in a rural setting and is surrounded
by pastures on both sides of the road Rock Hole Creek is a perennial stream with relatively
stable banks.
10. Describe the overall project in detail, including the type of equipment to be used:
Bridge No 135 is a single lane timbered decked bridge located on a secondary road in rural
Stanly County. The existing structure will be removed using non-shattering, methods in order
to prevent debris from falling into the water. The existing bridge will be replaced with a pre-
cast three sided culvert (men bottom culvert) attached to footers that are anchored in
consolidated rock The culvert will have head and wing walls attached. The following
equipment will be used to construct the project: Track hoe, boom truck. vibrator roller, dump
trucks and various hand tools All work will take place in the dry and erosion and sediment
control devices will be installed accordingly.
-
11. Explain the purpose of the proposed work: To remove the failing single lane 29'7'
L X 15'9" W) bridge and replace it with a pre-cast three sided culvert- (30' L X 48' 6" W).
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. N/A
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
3 of 9
SR 1147 (Polk Ford Road)
Stanly County
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. 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
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: There will be 48' 6" of permanent
impacts to Rock Hole Creek due to the construction of this project. Impacts are limited
to linear impacts along the stream bank where proposed footers are to be constructed
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, separately list impacts due to both structure and flooding.
Wetland Impact
Site Number
(indicate on map)
Type of Impact Type of Wetland
(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
I00-}ear
Floodplam
(yesino Distance to
Nearest
Stream
linear feet) Area of
Impact
(acres)

Total Wetland Impact (acres)
4. List the total acreage (estimated) of all existing wetlands on the property: N/A
5. 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, multiply length X
width, then divide by 43,560.
4 of 9

SR 1147 (Polk Ford Road)
Stanly County
Stream Impact
Number
indicate on ma
Stream Name
Type of Impact
Perennial Intermittent 9
? Average
Stream Width
Before Impact Impact
Length
tin ear feet Area of
Impact
acres

Site 1
Rock Hole Creek Open Bottom
Culvert Footers
(Linear Impact)
Perennial
Var. 10-12'
49 feet
NA

Total Stream Impact (by length and acreage) 49 feet
6. 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 fill, excavation, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact
Site Number
indicate on ma Nam
e applicable) Wat e)
(if ap
Type of Impact Type of Waterbody
(lake, pond, estuary, sound, bay,
ocean. etc. Area of
Impact
(acres)

Total Open Water Impact (acres)
7. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): N/A
Wetland Impact (acres): N/A
Open Water Impact (acres): N/A
Total Impact to Waters of the U.S. (acres) N/A
Total Stream Impact (linear feet): 49 feet
8. 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.
9. 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.
5 of 9
SR 1147 (Polk Ford Road)
Stanly County
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:
VII. Impact Justification (Avoidance and Minimization)
Expected pond surface area:
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.
While there are impacts associated with this project impacts will be limited to an area that has
been previously impacted due to the construction of bridge headwalls. It is anticipated that the
footers required for the proposed open bottom culvert will extend slightly beyond the limits of
the existing headwalls hence the need for a PCN.
Surface waters not affected by the construction of this project will be protected from
unnecessary encroachment The staging of construction equipment will not be allowed in or near
the Rock Hole Creek. Strict enforcement of the sediment and erosion control BMP's for the
protection of wetlands and surface waters will be enforced during all phases of project
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 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.
6 of 9
SR 1147 (Polk Ford Road)
Stanly County
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://h2o.enr.state.nc.us/ncwetlands/stnngide.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.
If mitigation is required for this project the NCDOT will request that the EEP consider
accepting payment in lieu.
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 (919)
715-0476 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/yn/index.htm. 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):
• Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federaUstate) land? Yes ® No El
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
7 of 9
SR 1147 (Polk Ford Road)
Stanly County
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
IX. 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.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 213 .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes ? No ?
2. 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.
Zones mpact
(square feet Multiplier Required
Mitigation
1 3 (2 for Catawba)
2 1.5
Total
* Zone 1 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 discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 213 .0242 or .0244, or .0260. N/A
X. 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.
All appropriate best management practices for sediment and erosion control will be implemented
during work activities There will not be a net increase in storm water runoff as a result of this
project being constructed
8 of 9
SR 1147 (Polk Ford Road)
Stanly County
XI. 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
• Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No 0
Is this an after-the-fact permit application? Yes ? No
XII. 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//h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description:
XIII. 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).
7/05
Applicant/AgentYs Sign ure v /Date/
(Agent's signature is valid only f an authorization letter from the applicant is provided.)
9 of 9
LO U ST\,
J r'? ? f
5
0 s 00?011 Q_.
y \
RO row/ ;?? i
\ I? "? oe oQO ??
F ?
?Lj I ?oo?? J6-
107
o G
Cl-
aov , (0A S
SI .u ?
`AHP r?
i JrII w? I e?
STANFIELD
RIVER I
(SR 11151
? I
MILL
I
2 77.7)
,? (1 no_? Loves
o Unitell
q 9`?O
GB i
DoF Sy
R?\??jl? O9 09 s ? I 9/ '3l /
O
d
co
f ?
® -
O QP
4k?
i
Wv w r.
71
Chipol-
wff?
Alk
Lee
L` f \
r __.,• ,,1 •: ?"? 1,; \ ?? ter' ,.??? \$ _ ? ?/ -
1 N-2
y
1lie r + .
_? )
7* W
Stanly County Bridge 135
Polk Ford Road over Rock Hole Creek
i" I % I If . ?k ., - - "
1 4 4
?/ o ? 1 kt , r; `? ? 1S ,? r `• r ti t r ? r. • ?fiw k , ?
???`?k?s } p 1 f ?? ?` i ? fi I+ i p• ??7'????1Jg?`' ? ? `.?,a,•. ? J?# ?' ?i
?, wB J1
1r
R f
TbB' ! ~- mar s. ??i
)Bayi r + 1 aD ?. ,. 4 -',..,.r+ F}?,r3 ?t• ji .'
r d` L ?r
r. ?V-7-
Ile,
'OG
1 r
17' ,. , vex- Ch;tpell(
CJO .a
D B
TbM
--
,?
Legend
,a, a -? ?•.'? T?D,? sa[? 0 permit site
? ?:?? f/ 'Y 1 4I r ?r ILI
? ll
??? • 1 ?y\ }}???f t?``?1 i { •; ?? +1 +l Z-;°C?? ;y, 'a +.'r ;-w ? .k ji °'.4?
TcB2
+ +. J ' Prepared by:
14
if f{,? . ?„ y •-!.•? t `f' A'1. 4' `'`? ;'4 •-? North Carolina
4 .' ?' j-,', Ce. 'yrFU ,I ` l r 74 "` . ?r } i `+ k ?•r Sj? Dqmrt soira
t. B. hompsoe tloe
f k .., "a +^?ti? y7 '• i _ Emtroameotal UnK DWm 10
Date: September 26, 2005
1 j
Thla map b YAeedad for Internal DOT we any.
+ ^? ., ,.? ,; w .rte j` ?'r?1 :: ^? y •_!? ; err
?? Inds accaac7,ft or mr-dw biota Ily
aceompony this pmdart.
T6B2
f Feet
0 370 740 1,480 2,220 2,960
' I i i
? .
? t
I
f
t ? ? ?, I
j i
? r I
?, ? ? -:
1_
n
0
C1
x
..

s
a

3
?o
N
I
!l
1rT

Q
1

ir
S
W
F-
O
Z
Z Z
J H H
W r N a
W J Z a
r DO U
N NHOH
J Otr il,
- r r m X
r3V7WMW
O H U- W LL
[rw JJO
rQ
J
O"ZM2<
U-! W->
zHvWZO
H 2 LL H w
In ZOMFQ-q'
HOF OZ•
WFHWOU2
Wz--,00
Fx-~HNQw
ZQW(L W ¢F-I
O N -M J rW a`
MLOaQ oO
W O¢ U O
rral"1 H
N U O J O m m
>-QZaOw+
NCr I- -
O Z 21
Z N S H Z
H U W h J H 0
Q SF+O H
axr3a°Q
WhLLW2Wh
= O U O
Z N
H O
N W I H h U Q
QJ OCL Z"W
SN?MHww
U Z W O Z m D
DHJUH r
M Q U Q J U
NF-Hmr JO
QZF-0M<X
ZO[m(rWx)-
HUQW(LNN
x
?I
XI
I
X
3
cr
U 2
Z F -
H U (D
V) W '
H J C-
W (r N
I U 11
?x
W I
J
0o I X
za I
H
rx
H3
W CL I X
C7
Z
H
m
W
r
1Q
x
N
O1 W
2w
Cr;
O
?w
Z Ix-
a
00
Z Z
H H
a J
NQ
N LL
mr
O
W Z
> J
O
J
W H
W 3
W N
m1)
m
J W
ap
2
N h
W =
U H
O
H x
U
M=)
=)
UN
Z V)
H O
r O
V7M
HF-
X W
Wm
Cr
O
r [r
r p
1 Wr
N
?m
O u.
IQ
iW
-? W
J m
W Z
U V) m0 Ix_O = ZW
z W- Z
Q H r F a O Q J Q WO H
3 3 v H°Z z L)
Mm0>-?
°r h N Va WIHi r° LLrw
JI-F fL
=mC7? Q H (r Ir/1H?V QpHJZW
dB,.
B Z QLLxLLW W"3aaU
N C LW H
WH ~U U HOQ"V) /-I"'I D..p O(m -I z H> O J N Q N O Z Q a
o z
LLXFI
o2 O? HO KZO>-6Q mLUJJ U.,Wxr
O Q QHMro aHrH
Za o JmHr z
Hw w aQ J UFO"Q HN(r(m6z
Om QSp ?x W Ix_.a HVWj? i=WU(Wjr
a Q Q N Z A z m Q m 0 0 LL H Y O O
mTJ Hm =H r Qa aHO 2(rN z
r r w UNUI N o -0"00
O h y.H WF-IQ H 3UZU
ZJ F ? Z 2
Q NO LLr "') mCLOJr>' Qa mH
"N QU oW Q a°am(r aQO(rxw
O U W "M -'r, Swx
?-a r rO vz)O W (L Hh
CDO Q m r ° z m NZ ma a z w
(r H -t ..r 0 z U 2 M W Z Q H W F-1 3 F-
Wa ZU Q= ?? NH QI--(m0 OSUO°Q
JO OH al` P7 W33 1-N WQW W(r
H
V) 2 11
00 LL
N Q O WW U W H H OM W U H J 0 7 2 N Z H H 0
Y ?J I mQ MF-U CLQQ3xH
"H NO Z 0 M
Q W F..I J JZD H JO WQ
WF- KF- CmW CHy CHi O F-CLOJWX MUF
mW 0U am Q OC>_Q2h rZ
O rU W Z O rU 21-N 1I SWH(rW
J UfY mJ 36 J My wx OUJWww
JF- Qr J Wag a0 Qamx
xW HZ WS WW > JZHOWQ hWO>-pJ
N?(r ZO SN WW H JHrHO HCUm H
WO OU H 00 J U <F- N r0 (rte
J U U p(N7 S ° rWH ZQ QNmW°a
QOQ WW WZ » W NWLL(r"O iW-mv)<
34.(r Sm XH 21 QZHF-JCr O0 OWK
OZF- r F- HH UHUNO rONJ
QHZ >- WE XZ N WUWZCr(r W F-000L
WWO F-Q SO ,% F4 N KZa OQo SLLZWUH
x(rU QM F-LL : 1 7 a (L WNVULL F-O">Om
fl
0.09
O
O
-
V)
0
H
I
J lf)
O
In O
Z N Z N Z
O Z O O Q 3
H QHO mo
Zh JI--F'• S
SOa LLQQ 0-,•.
hHH =(r L.,W
z aQOH ~2z,s--r
Q Ot- Z WCL 0H"Z"W
J M 7
H
O W U S O ~ x~ CL N m a
(r
M ?iF a C)ujow°:w
Or O "WOO NS
LO ?(r aQ HOZUWQWF-
U W WLL h z H Q x Z U r
Z a r N N H N r O "H<
N W Jx -JOOHmZ
JJHaLL "QwHOZIO-I
W = HO mHHGaIH-H
w NIO_,?N U> a3N2
N U H N NO H Q O W N 'a
N O v N Z W> r W U
[r mJZW XHZIO-J-
LLJ
~FS-
VO) mLLQU WQHrO
H
IHr°a roz3a3w_
O NN(r LLZO? r
(r -I(rmr O -IUF-I O W)--
Z W w= H W(r N= J W m O
O W°r ?WF-UZwQ
U M
W" U Z O Z N
F-
Z O>Z HWO F'-WZ
O LL JOQ XXLLw a[m X
J r F
Q LLi -j
O aJ 0 0 m 3= 0 LL a
W >h U M00 CLLLW
J NCm2JNHS
O J Q LLN J Z O r
O W O x Z x N N M 2 Z Z
LL (rZNH hHHNF-00
W
H
N
a
a
J O
00 O
0 cr
ao o W
t- + W
+Q
3 I
W
r
.. W
X33210 31011 X0021_
/

i
V
tD
N
+
N F
D
a
wr
S N
r I 1
Y Jm V
a
O i D
v p +
N (?
Z ~
H S O r, F
YCrm v
H?,Q
0-
O 11
V)
)(rvJ
•[rMW
F W U
J ?
O ?
O [C
ti X
+ v + W U X
z
3 HW
rU
Non
\I
m W 11
IHH? 1

W

U I
I
I
(m " I

o
E - X

W
r J
N U O

Q
J
z a
I
CL H
I
r (m
N
N W
k
t- H (L
N ><O

tD '
wa

Q
h

N I I
Cr '
W
N
H

(r

W
N m /
FA
I FA
> m N
\
Q
Z
H
I p Q
W
Qaz:1 >-
C) V) (r X
Sti
m
X
O
QQ

W N ° h m

• JwmJ
D U m m

1 Z M
O m /
z
I .N.NrZ[m

P
h
?O

X
X
3
X o
Z
H
F
X
X W
CL
w
a W
H (r
(r ZD
U N
z Q
H a
F-
X
W
z
H C
Q c
r a
W
Ix i
3
J
O
O ?
T J
O r)
+ N
N.. " o Cn Ln
? O M N ?
t y O N N
F N M N
LI)
n u
H
CL QO J (r
r
J
or
lD J
t_
+ q rn
+ a} M
O ?0 N N P
v
F MN? co
N
N
a Q O J h m
N
1.4
Z
It
O
z
U
Z
a
L'i
O
N :3
Z J
O U
H z
r H
Q z
O
J W O
W N
-1 0
° z a
W
W N N
(r H 2
O 3
co w z
W
w x x W
J U h
a W O J
) ~ N H
W N tr
U W O
D (r
N a
w J
r 1 U
O
Z Z W
W p I'
° O
7 Z
N
co
Ui)
O
O
H N
V7
(r ?U
UQ O
10 TN0
O N W M m
N V V .. V
1
O Z
p H O
O Q r
J >
W W >
J
Z
W
U
O W
W VH) W x
c?Wr I WW
[rOQ Uh
Q 3Q(ra
S W W Q 3
V Ox(rx
v) U a"z
F-/ >- H N U
pz <1-4 =
Z W 7_
(•7=UZUU
h/O"HIHH
V) W NQNV)
WMW2aa
MWoomm
a
r
0
U
H
IL
UU
O
CC
N
x
LL)
1
z
Q `
J •
V
W
U
Z ,.•
H a
r >-
H
W` 3
xlklI ~
O O
[r O
cl:j
1 3
X + W + v
I\
r J
z I
I I
00
0
N
+
XI l'i
NJ N
U D O
W ? 3
J ~
M
N
U u
1
/ O X Z
N U O
M Q ?
w a
h U ~
O N
O v
C;,!
N M
+V

QW
h J
N W
Q N
H R
a?
°
(D
O Ulm
O
Q 1
I (r J
U 1
O D
O_
0N
N ?
+ Q
N
Q W
J
N lJ
F-
. 1 z
O J
O O O
w O
N
Lr)
N
e.y
J
O Z
Z Q
F-
F- N
U
W
O
a-
Z
O
H
F-
Q
H
V)
LLJ

a
Z

M
CC
W

J
a
(r o
Na
W H
u
V> M
0+ O
O O N
tD o(T
M N V
r
0
01
O Z
IJy O
H
U h
I Z Q
WCLW
d U(L J
H (r OW
d <)-
0 MMO
U W O
O N>O
p H0J
0 0 W
w Z O z
u ">-"
Z MUCL
H CLzn-
a 0wC)
M rDF-
o (r 0 (r
)- W WW
(r > (r >
w OLLo
0
W
F-
z W
z
O a W
~ U F- W d
Z
W °-°

z

s

N
Q Zfr ?.r
-O
Z OWZF-
?
O H J
m
Z q- WU,T 4W
3
?
N
w
?3?
N w
~WOxO m
Ww
D2S
LL -J, LLpNU
z
o o QOzH o0 H P ?
z W-MHV)XLLJ •
W W W _J .-1
W
u Z
w z W woor,
H :E W WZa:
m Nz=YN
N ° Q~ O
a o W
m
a L
IL °z P

'......
.,No
a
W
?
rm 3 9

?d• odd ?CCt

W
F- a ^)
w
Cr O Q

Cr
z r W N
I O
-
U>
J
h J
QU
O
w° (r
W
m
w I
+ao Qv
?aH Cr3,
T N r x v
Q
r X W p N J
d
N , (r
(40h x
L_; i

1
Fr1T)lintlrlTgTrrr1mrir))rlimPn1
OI O O O O
N O D) 00 N
N Q [T V
r I D
W Z
>
Cr e
2 V
N Q
`B'IZ
.9- 8b
. - i - h£-6
r (D:
r r'
N
~ 1'

• I ), w

O
O
+
lD
1 0
Lt!
lf)
+
O
T 'Q
W
v M
J O
w ,?
V;0
3 O
+I
tD
z Q
H
r L no
0wr
OLLa:+1
LL <-:
O N
a > `r
O J J
rww
O
O
.N.
Z ..
OW
_J a
a V)
W
J
LL-
0
M N
O p
w W
H H
d d
00
z z
? o
J ?
J ?
d J
m ()
? ru
m
2
U
Q W
? S
O U
?Op'CO-07-OS"l06CB\••?^)pn?16\106C-a\20'06L\Z002\I?aIp?O\"J ryY IC'B S'9 SO^2/62/9