20061228 Ver 1_Complete File_20060811

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August W AG
11, 2006
Person County
DWQ Project No. 20061228
SR 1736
State Project No. 5C.073040
APPROVAL of 401 WATER QUALITY CERTIFICATION and NEUSE BUFFER AUTHORIZATION, with
ADDITIONAL CONDITIONS
Mr. Jon G. Nance, P.E., Division Engineer
NCDOT, Division 5
2612 North Duke Street
Durham, NC 27704
Dear Mr. Nance:
You have our approval, in accordance with the conditions listed below, for the following impacts for the purpose of
paving SR 1736 in Person County:
Stream Impacts in the Nesue River Basin
Site Culvert Impact in Riprap Impact in Temporary Dewatering Total Stream
Intermittent Intermittent Stream of Intermittent Stream Impact
Stream linear ft linear ft linear ft linear ft
1 24 14 38 concurrent 38
Total 24 14 38 concurrent 38
Total Stream Impact for Project: 33 linear feet.
Neuse Riparian Buffer Impacts
Site Zone 1 minus = Zone 1 Zone 1 Buffer Zone 2 »:inus = Zone 2 Zone 2 Buffer
Impact Wetlands Buffers (not Mitigation Impact Wetlands Buffers Mitigation
(sq ft) in Zone 1 wetlands) Required (sq ft) in Zone 2 (not Required (using
(sq ft) (sq ft) (using 3:1 ratio) (sq ft) wetlands) 1.5:1 ratio)
s ft
1 2,440 0 2,440 N/A 1,581 0 1,581 N/A
Totals 2,440 0 2,440 0 1,581 0 1,581 0
* n/a = Total for Site is less than 1/3 acre and 150 linear feet of impact, no mitigation required
Total Buffer Impact for Project: 4,021 square feet.
The project shall be constructed in accordance with your application dated received August 1, 2006. After
reviewing your application, we have decided that these impacts are covered by General Water Quality Certification
Numbers 3404 and 3366. This certification corresponds to the Nationwide Permit 14 and Nationwide Permit 33
issued by the Corps of Engineers. This approval is also valid for the Neuse Riparian Buffer Rules (15A NCAC
2B.0233). In addition, you should acquire any other federal, state or local permits before you proceed with your
project including (but not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply Watershed
regulations. This approval will expire with the accompanying 404 permit.
Noe Carolina
Transportation Permitting Unit ? atimallU
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] FAX [phone] Internet: http://h2o.enr.state,nc.us/ncwetlands
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
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This approval is valid solely for the purpose and design described in your application (unless modified below).
Should your project change, you must notify the DWQ and submit a new application. If the property is sold, the
new owner must be given a copy of this Certification and approval letter, and is thereby responsible for complying
with all the conditions. If total wetland fills for this project (now or in the future) exceed one acre, or of total
impacts to streams (now or in the future) exceed 150 linear feet, compensatory mitigation may be required as
described in 15A NCAC 2H .0506 (h) (6) and (7). For this approval to remain valid, you must adhere to the
conditions listed in the attached certification as well as those listed below.
Conditions of Certification:
1. Placement of culverts and other structures in waters, streams, and wetlands shall be placed below the elevation of
the streambed by one 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 low flow passage of water and aquatic life.
Design and placement of culverts and other structures including temporary erosion control measures shall not be
conducted in a manner that may result in dis-equilibrium of wetlands or streambeds or banks, adjacent to or
upstream and down stream of the above structures. The applicant is required to provide evidence that the
equilibrium is being maintained if requested in writing by DWQ. If this condition is unable to be met due to
bedrock or other limiting features encountered during construction, please contact the NC DWQ for guidance on
how to proceed and to determine whether or not a permit modification will be required.
2. All stormwater runoff shall be directed as sheetflow through stream buffers at nonerosive velocities, unless
otherwise approved by this certification.
3. All riparian buffers impacted by the placement of temporary fill or clearing activities shall be restored to the
preconstruction contours and revegated. Maintained buffers shall be permanently revegetated with non-woody
species by the end of the growing season following completion of construction. For the purpose of this condition,
maintained buffer areas are defined as areas within the transportation corridor that will be subject to regular DOT
maintenance activities including mowing. The area with non-maintained buffers shall be permanently revegetated,
with native woody species before the next growing season following completion of construction.
4. Pursuant to NCACI5A 2B.0233(6), sediment and erosion control devices shall not be placed in Zone 1 of any
Neuse Buffer without prior approval by the NCDWQ. At this time, the NCDWQ has approved no sediment and
erosion control devices in Zone 1, outside of the approved project impacts, anywhere on this project. Moreover,
sediment and erosion control devices shall be allowed in Zone 2 of the buffers provided that Zone 1 is not
compromised and that discharge is released as diffuse flow.
5. If concrete is used during construction, a dry work area should be maintained to prevent direct contact between
curing concrete and stream water. Water that inadvertently contacts uncured concrete should not be discharged to
surface waters due to the potential for elevated pH and possible aquatic life and fish kills.
6. During the construction of the project, no staging of equipment of any kind is permitted in waters of the U.S., or
protected riparian buffers.
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. The use of rip-rap above the Normal High Water Mark shall be minimized. Any rip-rap placed for stream
stabilization shall be placed in stream channels in such a manner that it does not impede aquatic life passage.
Transportation Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone]/ FAX [phone] / Internet http://h2o.enr.state.nc.us/ncwetiands/h2oenr.statencus/ncwetiands
An Equal Opportunity/Affirmative Action Employer- 50%a Recycled/10% Post Consumer Paper

F W AT Michael F. Easley, Governor
F9
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OC? pG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
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CO Alan W. Klimek, P.E. Director
Division of Water Quality

9. All work in or adjacent to stream waters shall be conducted in a dry work area. Approved BMP measures from
the most current version of NCDOT Construction and Maintenance Activities manual such as sandbags, rock berms,
cofferdams and other diversion structures shall be used to prevent excavation in flowing water.
10. Heavy equipment shall be operated from the banks rather than in the stream channel in order to minimize
sedimentation and reduce the introduction of other pollutants into the stream.
11. 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.
12. No rock, sand or other materials shall be dredged from the stream channel except where authorized by this
certification.
13. Discharging hydroseed mixtures and washing out hydroseeders and other equipment in or adjacent to surface
waters is prohibited.
14. The pemmittee and its authorized agents shall conduct its activities in a manner consistent with State water
quality standards (including any requirements resulting from compliance with §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.
15. All fill slopes located in jurisdictional wetlands shall be placed at slopes no flatter than 3:1, unless otherwise
authorized by this certification..
16. A copy of this Water Quality Certification shall be posted on the construction site at all times. In addition, the
Water Quality Certification and all subsequent modifications, if any, shall be maintained with the Division Engineer
and the on-site project manager.
17. The outside buffer, wetland or water boundary located within the construction corridor approved by this
authorization shall be clearly marked by highly visible fencing prior to any land disturbing activities. Impacts to
areas within the fencing are prohibited unless otherwise authorized by this certification.
18. Upon completion of the project, the NCDOT Division Engineer shall complete and return the enclosed
"Certification of Completion Form" to notify DWQ when all work included in the 401 Certification has been
completed.
19. Native riparian vegetation must be reestablished within the construction limits of the project by the end of the
growing season following completion of construction.
20. There shall be no excavation from, or waste disposal into, jurisdictional wetlands or waters associated with this
permit without appropriate modification. Should waste or borrow sites be located in wetlands or streams,
compensatory mitigation will be required since that is a direct impact from road construction activities.
21. Sediment and erosion control measures shall not be placed in wetlands or waters unless otherwise approved by
this Certification. If placement of sediment and erosion control devices in wetlands and waters is unavoidable, they
shall be removed and the natural grade restored upon completion of the project.
- One
NvohCarolina
Transportation Permitting Unit AQlllrallly
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] FAX [phone] Internet http://h2o.enr.state.nc.us/ncwetiands
An Enual Oooortunity/Affirmative Action Emolover- 50% Recvcled110% Post Consumer Pacer
Michael F. Easley, Governor
O?OF W A7'k Q` William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
C? Alan W. Klimek, P.E. Director
DIWI Division of Water Quality
22. Erosion and sediment control practices must be in full compliance with all specifications governing
the proper design, installation and operation and maintenance of such Best Management Practices in
order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed, operated, and
maintained in accordance with the most recent version of the North Carolina Sediment and Erosion
Control Planning and Design Manual.
b. 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 sites, and waste pile (spoil) projects, including contractor-owned or leased
borrow pits associated with the project.
c. 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.
d. The reclamation measures and implementation must comply with the reclamation in accordance with
the requirements of the Sedimentation Pollution Control Act.
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. 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 contact Rob Ridings at [phone].
Sincerely,
4Y' Alan W. Klimek, P.E.
Attachments (General Certification and Certificate of Completion form)
cc: Wilmington US Army Corp District Office
Chris Murray, Division 5 Environmental Officer
Eric Alsmeyer, US Army Corps of Engineers, Raleigh Field Office
Travis Wilson, NC Wildlife Resources Commission
DWQ Raleigh Regional Office copy
File Copy
- One
Npacarolina
Transportation Permitting Unit ? atura«J
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] Internet htto://h2o.enr.state.nc.us/ncwetlands
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STATE OF NORTH CAROLINA Wfr?N?sAN?S r"W TER
DEPARTMENT OF TRANSPORTATION BRMCH
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
July 21, 2006
U.S. Army Corps of Engineers
Raleigh Regulatory Field Office
6508 Falls of the Neuse Road, Suite 120
Raleigh, NC 27609
Attention: Mr. Eric Alsmeyer
NCDOT Coordinator
061228
Subject: Secondary road improvements to SR 1736 (Rassie Crabtree Road) from
SR 1737 (Moore's Mill Road) to SR 1735 (Bowen Road) in Person
County. WBS element 5C.073040.
The North Carolina Department of Transportation (NCDOT) proposes to upgrade and
pave SR 1736 (Rassie Crabtree Road) from SR 1737 (Moore's Mill Road) to SR 1735
(Bowen Road) in Person County. (Figures 1-3). Total project length is 0.863 miles.
Transportation and highway laws of North Carolina (G.S. 136-44.6, 136-44.7, 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 1736 is scheduled to be paved as part of the Secondary Roads Construction Program.
Impacts to Waters of the United States
Site 1 (STA 11+52.80) - Waters of US
Construction at this site will impact an unnamed intermittent tributary to the Flat River
[NCDENR-DWQ Index No. 27-3-(1), Best Usage Classification WS-111 NSW; HUC
03020201] (Figure 3) in the Neuse River Basin. The existing structure conveying the
creek is a 36-inch reinforced concrete pipe that is 45 feet long (see Photograph 1). This
pipe will be extended 4 feet on the inlet end and 20 feet on the outlet end. Permanent
impacts at the site associated with the pipe extensions total 24 linear feet of fill in surface
water in addition to a total of 14 feet of rip rap along the stream banks. The work zone at
this site will be temporarily dewatered for approximately 3 days. This will involve the
Division 5, 2612 N. Duke Street, Durham, NC 27704
Phone: [phone] Fax: [phone]
2
temporary placement of sandbags upstream and downstream of construction. Once the
stream has been dewatered, the extensions will be set. To maintain water flow during
construction, water upstream of construction will be temporarily pumped out and
conveyed around downstream of the construction. Temporary concurrent impacts to the
stream from this activity will result in dewatering 38 linear feet of stream. The sandbags
used for dewatering will be removed after construction.
Riparian Buffer Impacts
Site 1 (STA 11+52.80) -Buffers
The construction at this site involves a road crossing of a stream that is subject to the
Neuse Riparian Buffer Rule. The unnamed intermittent tributary to the Flat River at
Site 1 is depicted on the most recent version of the Rougemont (1974/1987) topographic
quadrangle (Figure 1) as well as on the Soil Survey of Person County (USDA-SCS 1984)
(Figure 2). Erosion and sediment control devices along the project are comprised of
temporary rock . silt checks, temporary silt basins, temporary sediment dams, and
temporary silt fence: The 'NCDOT proposes to install temporary erosion and sediment
control devices in Zone 1 and Zone 2 of the riparian buffer. The temporary structures will
be removed once the vegetation has been established. Please note that the placement of
these structures are within the 60 right-of-way width and their associated impacts are
included within the site total of 2,440ft2 in Zone 1 and 1,581 ft` in Zone 2 (totaling 38
linear feet of riparian buffer impacts). Based on the impacts to the riparian buffer at this site,
this crossing is EXEMPT.
Waters of the U.S./Riparian Buffer Mitigation
Avoidance: All wetlands and surface waters not affected by the project will be protected
from unnecessary encroachment. No staging of construction equipment or storage of
construction supplies will be allowed in wetlands or near surface waters.
Minimization: The side slopes have been steepened to the extent possible at jurisdictional
sites. Strict enforcement of sedimentation and erosion control Best Management Practices
for the protection of wetlands and surface waters will be enforced during project
construction. Continued coordination will occur with maintenance forces and the
Environmental Officer during construction to minimize impacts to these sites.
Compensatory Miti agL tion: All compensatory mitigation requirements will be left to the
discretion of the regulatory review agencies.
Protected Species
Plants and animals with federal classifications of Endangered, Threatened, Proposed
Endangered and Proposed Threatened are protected under provisions of Section 7 and
Section 9 of the ESA. As of July 2006, there is one federally protected species listed for
Person County: dwarf wedgemussel (Alasmidonta heterodon). This intermittent stream is
small and within the headwaters of its system and does not provide suitable habitat for
dwarf wedgemussel. Therefore, a Biological Conclusion of No Effect has been rendered
for this species.
3
Historical Compliance
This project has been screened by all pertinent parties to ensure historic compliance.
Summary
NCDOT proposes to upgrade and pave SR 1736 (Rassie Crabtree Road) in Person
County. Pennanent impacts, associated with surface water fill and rip rap used for bank
stabilization are proposed to Waters of the United States. Additionally temporary
concurrent dewatering is proposed at Site 1. The construction at this site involves a road
crossing of a stream that is subject to the Neuse Riparian Buffer Rule. Based on the
impacts to the riparian buffer at this site, this crossing is EXEMPT. All compensatory
mitigation requirements will be left to the discretion of the regulatory review agencies.
Application is hereby made for a Department of the Army Section 404 Nationwide
Permit (NWP) 14, NWP 33, and NCDENR-DWQ Section 401 Water Quality
Certification (WQC) No. 3404 and WQC No. 3366 for above-described activities. An
automated payment procedure has been implemented between the NCDOT and
NCDWQ. This procedure will enable the Division to apply for the 401 WQC without
submitting a check for this permit application. This procedure will provide payment to
the NCDWQ by charging the permit application fee of $200.00 directly to the appropriate
NCDOT WBS element 5C.073040. A pre-construction notification is attached with this
request. If you have any questions or need additional information, please contact Ms.
Heather Montague at [phone].
nce ely, n p
Jo G. Nance, P.E.
Di ision Engineer
cc: Mr. Rob Ridings, NCDWQ Transportation Permitting Unit
Ms. Tasha Johnson, NCDOT Dist 2 Engineer
Mr. Dion Viventi, NCDOT Person County Maintenance Engineer
Ms. Katie Simmons, NCDOT Roadside Env Field Ops Technician

? i

Photograph 1. View downstream of outlet.
SR 1736 (Bessie Crabtree Road) in Person County.

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Project Study Area
SR 1736 Rassie Crabtree Road
Person County
Rougemont
USGS Topo Map (1974/1987)
Figure 1 1:24,000
SHEET NUMBER 15
SOIL SURVEY OF PERSON COUNTY, NORTH CAROLINA
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Project Study Area
SR 1736 Rassie Crabtree Road
Person County
USDA-SCS (1984)
Figure 2 1:24,000

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Office Use Only: Form Version March 05
USACE Action ID No. DWQ N0.2 0 0 6 1 2 2 8
tru any parncuiar item is not appucau?e to this prglect, please enter "Not Applicable" or "N/A".)
1. 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: NWP 14 and NWP 33
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: ?
11. Applicant Information
1. Owner/Applicant Information
Name: NCDOT Division 5, Jon G. Nance
Mailing Address: 2612 N. Duke St., Durham NC 27704
Telephone Number:[phone] Fax Number: [phone]
E-mail Address: JNanceOwdot.state. nc.us
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:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page I of 8
III. Project Information
Attach a Oi"i
?n 1(Qrq showing the location of the property with respect to local
i#Y
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
USAGE 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: Proposed extension of a structure conveying an unnamed tributary to the
Flat River on SR 1736 (Rassie Crabtree Road) in Person County.
2. T.I.P. Project Number or State Project Number (NCDOT Only): WBS Element 5C.073040
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Person Nearest Town: Rougemont in Durham Co.
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From US Hwy 501 at
Rougemont, take a right onto SR 1471 (Red Mountain Road) and travel East for
approximately 1.4 miles. Then make a left onto [SR 1601 (Moore's Mill Road)/which
changes to SR 1737 across the Person County line] and travel North for approximately
1.5 miles. Make a right onto SR 1736 (Rassie Crabtree Road) and travel approximately
300 feet to Site 1.
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): 36.2445 "N 78.9072 "W
6. Property size (acres): 6.28 acre (0.863 mile long project with 60ft right-of-way)
7. Name of nearest receiving body of water: Flat River
8. River Basin: Neuse
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enE.state.nc.us/adniin/maps/.)
Page 2 of 8
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Site is surrounded by agricultural and wooded land.
10. Describe the overall project in detail, including the type of equipment to be used: The
NCDOT will extend the existing 36-inch concrete structure 4ft on the inlet and 20ft on the
outlet end. The NCDOT will also dewater the work zone during construction. Equipment
may include excavator, backhoe, bulldozer, grader, and crane.
11. Explain the purpose of the proposed work: The existing structure is only 45 ft long and
does not allow for adequate shoulder widths.
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
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.
Page 3 of 8
1. Provide a written description of the proposed impacts: The NCDOT will extend the
existing structure. The NCDOT will also dewater the work zone during construction
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 Type of Wetland Located within Distance to Area of
Site Number Type of Impact (e.g., forested, marsh, 100-year Nearest Impact
(indicate on map) herbaceous, bog, etc.) Floodplain Stream (acres)
(yes/no) linear feet)
N/A N/A N/A N/A N/A N/A

Total Wetland Impact (acres) N/A
3. List the total acreage (estimated) of all existing wetlands on the property: N/A
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 till 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.
Stream Impact Perennial or Average Impact Area of
Number Stream Name Type of Impact ' Stream Width Length Impact
indicate on ma intermittent
? Before Impact linear feet) (acres)
Site 1 UT Castle Creek Fill (piped length) Intermittent 2.0 24 0.0001
Rip rap armoring 14 0.0006
Along stream bank
Temporary 38 0.0007
dewatering concurrent concurrent
Total Stream Impact (by length and acreage) 38 0.0007
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
fill, excavation, dredging, 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 of
Impact
(acres)
N/A _

Total Open Water Impact (acres) N/A
Page 4 of 8
6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): 0.0007
Wetland Impact (acres): NONE
Open Water Impact (acres): NONE
Total Impact to Waters of the U.S. (acres) 0.0007
Total Stream Impact (linear feet): 38
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.
N/A
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.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Current land use in the vicinity of the pond: N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts. All wetlands and surface
waters not affected by construction will be protected from unnecessarv encroachment during
construction. Strict enforcement of Best Management Practices for the protection of wetlands
and surface waters will be enforced during construction. Only the smallest amount of till
necessary to complete the project will be placed in waters of the United States.
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
Page 5 of 8
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 detennining 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 USAGE 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/ncwetiands/strmt;i(ic.litml.
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 oftsite), 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.
All compensatory mitigation requirements will be left to the discretion of the re Tu?? latory
review agencies.
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/wrp/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): N/A
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
Page 6 of 8
IX. Environmental Documentation (required by DWQ)
1. 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.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 213 .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
213 .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.
Site 1

Zone* Impact
(square feet

Multiplier Required

Mitigation
1 2,440 3 (2 for Catawba) N/A
2 1,581 1.5 N/A
Total 4,021 N/A
* 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 2B .0242 or .0244, or .0260. N/A
Page 7 of 8
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. Existing: 2.7 acre impervious surface (avg 26 foot
wide gravel road) of 6.28 acre total project size. Proposed: 2.1 acre impervious surface (proposed
20 foot wide asphalt paved road) of 6.28 acre total project size Erosion and sediment control devices
along the proiect are comprised of temporary rock silt checks temporary sediment dams temporary
silt basins, and temporary silt fence The NCDOT proposes to install temporary erosion and sediment
control devices in Zone I and Zone 2 of the riparian buffer. The temporary structures will be
removed once the vegetation has been established. Please note that the placement of these
structures are within the 60 right-of-way width and their associated impacts are included
within the site totals listed above.
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.
This project will not generate wastewater.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application? Yes ? No
XIV. 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/ncwetIands. If no, please provide a short narrative description:
This secondary road project will not result in additional development.
XV. 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).
L _ _ D' ?.G Z4???a
Appl cant/Agent's Signature Date
(Agent's si ature is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8