20052190 Ver 1_Complete File_20060106

Certificate of Completion
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Q Project No. OS -a 1c l O County: 1_? ,
Applicant: M C_.1 C) T ?\I
Project Name• SV- j,?? yw_(
Date of Issuance of 401 Water Quality Certification: a
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, Lc,,,rwon , hereby state that, to the best of my abilities, due care and
diligence was sed in th bservation 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: -; 2 D (o
If this proje-fvas 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:
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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
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APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear Mr. Payne:
Alan W. Klimek, P.E. Director
Division of Water Quality
January 6, 2006
DWQ# 05-2190
Stanly County
You have our approval, in accordance with the attached conditions and those listed below, to permanently
impact a total of 46 linear feet (If) of streams as listed in the table below:
Location/Station Stream Name Length of Stream Impact
Station 2+00 Unnamed tributary to Little Long Creek* 23 linear feet
Station 45+00 Unnamed tributary to Little Long Creek* 8 linear feet
Station 52+00 Unnamed tributary to Little Long Creek* 4 linear feet
Station 77+00 Unnamed tributary to Little Long Creek* 11 linear feet
The impacts will be for the purpose of replacing, extending and/or adding culverts, installing a modified cross
vane and armoring an existing scour hole associated with the minor widening and resurfacing of a road as
described in your revised application received by the Division of Water Quality (DWQ) on December 27, 2005.
The location of the project is State Road 1534 (Palestine 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.
North Carolina Division of Water Quality 610 East Center Avenue, Suite 301
Internet: h2o.enr.state.nc.us Mooresville, NC 29115
Phone [phone]
Fax [phone]
N r hCarolina
Naturally
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper
Page 2
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 21-1.0503, 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 1508 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
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WpiER
STATE OF NORTH CAROLINA N'E S7LANnENh -
AN?ST?RMQUTER?RgNCH
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GOVERNOR
U. S. Army Corps of Engineers
Asheville Regulatory Office
Attn: Mr. Steve Lund, MS, PWS
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
DIVISION OF HIGHWAYS W. LYNDO TIPPETT
SECRETARY
December 22, 2005
65---Z-1q0
Subject: Stanly County - Revised "After The Fact" Permit Request for SR 1534 (Palestine
Road).
Dear Mr. Lund:
In a application dated December 8, 2005, we advised you that we had extended four cross pipes
as part of a minor widening and resurfacing project located on SR 1534 (Palestine Road) in Stanly
County. The purpose of the application was to request an "after the fact" authorization from the
U. S. Army Corps of Engineers to construct the project under a Section 404 Nationwide 14
permit. Since that time, we have revised our stream impact estimates to include a scour hole at
one crossing and a modified cross vein at a second crossing.
Again, the project area was reviewed for the presence of federally listed threatened and
endangered species (Stanly County Listings: Haliaeetus leucocephalus and Helianthus
schweinitzii) and described in a Minimum Criteria Checklist in 2004. It was determined at that
time that the construction of this project would not likely adversely impact any listed species. It
was also noted that the proposed project was to be constructed without extending or replacing
any of the existing cross pipes. Division environmental staff were notified that four pipe were
extended by the contractor after the project had been completed. The reason that no prior notice
was given was attributed to the fact that the NCDOT project inspector was new to his position
and that he had not received any previous training in these matters.
Although there were no wetlands impacted, impacts to surface were incurred. There were 42
linear feet of permanent stream channel loss due to the pipe extensions. These impacts occurred
to unnamed tributaries of Little Long Creek, located within the Yadkin River Basin, Hydrologic
Unit 03040105. An "after the fact" permit package is attached to this letter.
The NCDOT anticipates that this application will be authorized under a Section 404 Nationwide
14 permit. We are also hereby requesting 401 Water Quality Certification GC 3404 from the
Division of Water Quality. We are providing seven copies of this application to the North
0
716 West Main Street, Albemarle, NC 28001 • [phone] 9 Fax [phone]
Carolina Department of Environment and Natural Resources, Division of Water Quality, for their
review.
Thank you for your assistance with this request. If you have any questions or need any additional
information concerning this project, please contact Mr. Larry Thompson, Environmental
Supervisor, at [phone].
Sincerely,
Benton G. Payne, P. E.
Division Engineer
LBTBGP
Enclosures
cc: Mr. John Dorney, NCDWQ
Ms. Marella Buncick, USFWS
Ms. Marla Chambers, NCWRC
Mr. Marc Morgan, DDC
Mr. Larry Thompson, DEO
Area Field Operations Unit
SR 1534 (Palestine Road)
Stanly County
Office Use Only: Form Version March 05
USACE Action ID No. DWQ No. 5 l
(If any particular item is not applicable to this project, 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: Nationwide 14
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: ?
H. Applicant Information
716 West Main Street
Albemarle N.C. 28001
1. Owner/Applicant Information
Name: N.C
Mailing Address: 10`h
Telephone Number: (704)_ 982-0101 Fax Number:(7704) 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. Payne PE
Company Affiliation:
Mailing Address: N.C. Department Of Transportation
716 West Main Street
Albemarle N.C. 28001
SR 1534 (Palestine Road)
Stanly County
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
M. 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 1534 (Palestine Road)
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location County: Stanly County Nearest Town: Albemarle
Subdivision name (include phase/lot number):
Directions to site (include road numbers/names, landmarks, etc.): From Albemarle, travel
north on US 52 2.5 miles, turn right onto the Northeast Connector, take the second road to
the left which is SR 1534 (Palestine Road). Project begins at this intersection and ends at
the five point intersection in Palestine.
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"23'26.62"N 080010'35.11"W
6. Property size (acres):
7. Name of nearest receiving body of water: Little Long; 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
2
SR 1534 (Palestine Road)
Stanly County
Describe the existing conditions on the site and general land use in the vicinity of the
project at the time of this application: Rural residential/light commercial area with single
family homes and three small businesses located along the project.
Describe the overall project in detail, including the type of equipment to be used:
Typical construction equipment such as: track hoe dump truck boom truck and vibratory
roller.
Explain the purpose of the proposed work: Pro -ect was intended to be a safety
improvement project where Palestine road would be widened by two feet and resurfaced.
During our initial review, we were told that there would be no need for pipe extensions or
pipe replacements
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.
There are no future permit requests anticipated for this project
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.
SR 1534 (Palestine Road)
Stanly County
Provide a written description of the proposed impacts: This project was constructed by a
private contractor. The contractor informed the project inspector that several pipe would
need to be extended in order to achieve suitable road shoulder. The inspector was new to
his position and was not aware that he should have ask if the proposed work would require
permit authorizations prior to allowing the contractor to proceed. As a result, there were
42 feet of permanent impacts incurred on this project
1. 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
100-year
Floodplain
es/no Distance to
Nearest
Stream
linear feet Area of
Impact
(acres)

Total Wetland Impact (acres)
2. List the total acreage (estimated) of all existing wetlands on the property: N/A
3. 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.
Stream Impact
Perennial Average Impact Area of
Number Stream Name Type of Impact Intermittent'? Stream Width Length Impact
indicate on ma Before Impact linear feet acres
Sta. 2+00 UT to Little Long 36 inch CMP Perennial
30 inches 13 feet .0007
Creek
2+00
Sta UT to Little Long Step Down/Scour perennial 10 feet .0005
. Creek Hole 30 inches
Sta. 45+00 UT to Little Long 18 inch RCP Intermittent
12 inches 4 feet .00009
Creek
SR 1534 (Palestine Road)
Stanly County
52+00
Sta UT to Little Long 18 inch RCP Intermittent 12 inches 4 feet .00009
. Creek
77+00
Sta UT to Little Long 18 inch RCP Perennial 12 inches 8 feet .00018
. Creek
77+00
Sta UT to Little Long Modified Cross Perennial 12 inches 3 feet .00006
. Creek Vein
Total Stream Impact (by length and acreage) 0.0016
4. 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

Total Open Water Impact (acres) N/A
5.
List the cumulative im act to all Waters of the U.S. resulting from the ro.ect:
Stream Impact acres : 0.0016
Wetland Impact (acres):
Open Water Impact (acres):
Total Impact to Waters of the U.S. (acres)
Total Stream Impact (linear feet): 42 feet
6. 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.
7. 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.
SR 1534 (Palestine Road)
Stanly County
Pond to be created in (check all that apply): E] 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:
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. Streams that were not directly impacted by the project were protected
from unnecessary encroachment There was no staging of construction equipment in or
near the streams Strict enforcement of the sedimentation and erosion control best
management practices for the protection of wetlands and surface waters were enforced
during all phases of project construction, however, some sediment was lost after controls were
removed NCDOT personnel will be removing the stone that was washed into the stream
channels.
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
SR 1534 (Palestine Road)
Stanly County
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/strmgide.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.
Requests for mitigation will be routed through the NC Ecosystem Enhancement Program
for fulfillment.
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):
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 (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
SR 1534 (Palestine Road)
Stanly County
IX.
Zone* Impact I Multiplier I Required
(square feet) Mitigation
3 (2 for Catawba)
1.5
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.
Will the project impact protected riparian buffers
(Meuse), 15A NCAC 213 .0259 (Tar-Pamlico), I
NCAC 2B .0250 (Randleman Rules and Water
(please identify )?
2. Yes?
No
identified within 15A NCAC 2B .0233
5A NCAC 02B .0243 (Catawba) 15A
Supply Buffer Requirements), or other
3. 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.
4.
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.
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.
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. The percentage of impervious was increased
no more than 0.41 acre.
XI. Sewage Disposal (required by DWQ)
SR 1534 (Palestine Road)
Stanly County
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.
None
• Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (I5ANCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application? Yes ® No E]
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 proNide a short narrative description: The
project area is already established and the road was previously paved. The minor widening
and resurfacing should not result in additional development.
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).
o, /_7 12-7-
/L1:2 z v 5-
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
9
t o
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION lrD`I {N,? Sr0'?MwAr?k a
MICHAEL F. EASLEY
GOVERNOR
U. S. Army Corps of Engineers
Asheville Regulatory Office
Attn: Mr. Steve Lund, MS, PWS
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
DIVISION OF HIGHWAYS W. LYNDO TIPPETT
SECRETARY
December 8, 2005
05)190
Subject: Stanly County - "After The Fact" Permit Request for SR 1534 (Palestine Road).
WBS Element No. 38114 (DWQ Minor Permit Fee $200.00)
Dear Mr. Lund:
The North Carolina Department of Transportation (NCDOT) has extended four cross pipes as
part of a minor widening and resurfacing project located on SR 1534 (Palestine Road) in Stanly
County. The purpose of this letter is to request an "after the fact" authorization from the U. S.
Army Corps of Engineers to construct the project under a Section 404 Nationwide 14 permit.
The project area was reviewed for the presence of federally listed threatened and endangered
species (Stanly County Listings: Haliaeetus leucocephalus and Helianthus schweinitzii) and
described in a Minimum Criteria Checklist in 2004. It was determined at that time that the
construction of this project would not likely adversely impact any listed species. It was also noted
that the proposed project was to be constructed without extending or replacing any of the existing
cross pipes. Division environmental staff were notified that four pipe were extended by the
contractor after the project had been completed. The reason that no prior notice was given was
attributed to the fact that the NCDOT project inspector was new to his position and that he had
not received any previous training in these matters.
Although there were no wetlands impacted, impacts to surface were incurred. There were 29
linear feet of permanent stream channel loss due to the pipe extensions. The impacts occured to
unnamed tributaries of Little Long Creek, located within the Yadkin River Basin, Hydrologic Unit
03040105. An "after the fact" permit package is attached to this letter.
The NCDOT anticipates that this application will be authorized under a Section 404 Nationwide
14 permit. We are also hereby requesting 401 Water Quality Certification GC 3404 from the
Division of Water Quality. We are providing seven copies of this application to the North
Carolina Department of Environment and Natural Resources, Division of Water Quality, for their
review.
•11:111 1
r^^
N."Pt
716 West Main Street, Albemarle, NC 28001 • [phone] • Fax [phone]
Thank you for your assistance with this request. If you have any questions or need any additional
information concerning this project, please contact Mr. Larry Thompson, Environmental
Supervisor, at [phone].
Sincerely,
Benton G. Payne, P. E.
Division Engineer
LBT/BGP
Enclosures
cc: Mr. John Dorney, NCDWQ
Ms. Marella Buncick, USFWS
Ms. Marla Chambers, NCWRC
Mr. Marc Morgan, DDC
Mr. Larry Thompson, DEO
Area Field Operations Unit
SR 1534 (Palestine Road)
Stanly County
nffiea UaP Onb!
Form Version March 05
20052100
USACE Action ID No.
DW
(If any particular item is not applicable to this project, please enter "Not 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: Nationwide 14
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: 10th Highway. Division
716 West Main Street
Albemarle N.C. 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. Pa a PE
0--, Af ;llil+lnno
VVlllt.lull? [ »>aaau.av a.. -
Mailing Address: N.C. Department Of Transportation
716 West Main Street
Albemarle N.C. 28001
SR 1534 (Palestine Road)
Stanly County
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
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 1534 (Palestine Road)
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location County: Stanly County Nearest Town: Albemarle
Subdivision name (include phase/lot number):
Directions to site (include road numbers/names, landmarks, etc.): From Albemarle, travel
north on US 52 2.5 miles turn ri ht onto the Northeast Connector, take the second road to
the left which is SR 1534 Palestine Road). Project begins at this intersection and ends at
the five point intersection in Palestine.
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): 035023'26.62"N 080010'35.11".W
6. Property size (acres):
7. Name of nearest receiving body of water: Little Long Creek
8. River Basin: Yadkin (Hydrologic Unit 03040105)
(Note - this must be one of North Carolina's seventeen designated mayor river basins. The
River Basin map is available
SR 1534 (Palestine Road)
Stanly County
Describe the existing conditions on the site and general land use in the vicinity of the
project at the time of this application: Rural residential/light commercial area with single
family homes and three small businesses located along the project.
Describe the overall project in detail, including the type of equipment to be used:
Typical construction equipment equipment such as: track hoe dump truck boom truck,
vibrato roller.
Explain the purpose of the proposed work: Project was intended to be a safety
improvement project where Palestine road would be widened by two feet and resurfaced.
During our initial review, we were told that there would be no need for pipe extensions or
pipe replacements.
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.
There are no future permit requests anticipated for this project.
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.
SR 1534 (Palestine Road)
Stanly County
Provide a written description of the proposed impacts: This project was constructed by a
private contractor. The contractor informed the project inspector that several nine would
need to be extended in order to achieve suitable road shoulder. The inspector was new to
his position and was not aware that he should have ask if the proposed work would require-
per mit authorizations prior to allowing the contractor to proceed. As a result there were
29 feet of permanent im acts incurred on this project.
1. 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.
Type of Wetland Located within :Nearest istano Area of
Wetland Impact 100-year Impact
Site Number Type of Impact (e.g., forested, marsh, Floodplain Stream: (acres)
(indicate on map) herbaceous, bog, etc.) es/no near t
Total Wetland Impact (acres)
2. List the total acreage (estimated) of all existing wetlands on the property: N/A
3. 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.
act
Im Area of
Average p
Stream Impact
Number Stream Name Type of Impact Pereqia
Inter Stream
l g Impact
eforem
B
a t feet
linea
te on ma
di
i
ca
n
2+00
Sta UT to Little Long 36 inch CMP Perennial 30 inches 13 feet .0007
. Creek

45+00
Sta UT to Little Long 18 inch RCP Intermittent 12 inches 4 feet .00009
. Creek

52+00
Sta UT to Little Long 18 inch RCP Intermittent 12 inches 4 feet .00009
. Creek
4
SR 1534 (Palestine Road)
Stanly County
77+00
Sta UT to Little Long 18 inch RCP Perennial [12 inches 8 feet .00018
. Creek
Total Stream Impact (by length and acreage) 0.0010
4. 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

Total Open Water Impact (acres) N/A
5.
List the cumulative impact to all Waters of the U.S. resulting from the ro'ect:
Stream Impact acres). 0.0010
Wetland Impact (acres):
Open Water Impact (acres):
Total Impact to Waters of the U.S. acres)
Total Stream Im act (linear feet): 29 feet
6. 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 USAGE.
7. 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:
SR 1534 (Palestine Road)
Stanly County
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. Streams that were not directly impacted b the project .were protected
from unnecessary encroachment. There was no staging of construction equipment in or
near the streams. Strict enforcement of the sedimentation and erosion control best
management practices for the protection of wetlands and surface waters were enforced
Burin all phases of project construction however, some sediment was lost after controls were
removed. NCDOT personnel will be removing the stone that was washed into the stream
channels.
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://h2o.enr.state.nc.us/ncwetlands/strmgide.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
SR 1534 (Palestine Road)
Stanly County
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.
Requests for mitigation will be routed through the NC Ecosystem Enhancement Program
for fulfillment.
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):
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 (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
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
SR 1534 (Palestine Road)
Stanly County
3.
4
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 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A
NCAC 2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other
(please identify )?
2. 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 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.
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.
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. The percentage of iWervious was increased _
no more than 0.41 acre.
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.
None
SR 1534 (Palestine Road)
Stanly County
• 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 ?
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 N
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: The
project area is already established and the road was previously paved. The minor widening,
and resurfacing should not result in additional development.
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).
/2 U? 05
Applicant/Agent's Signa re Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
t
Legend
Q permit site
Stanly County
Prepared by:
North Carolina
Department or Transportation
1. B. Thompson
Enrtron.mal Unit, Dhislan 10
Data: December 2, 2005
This map Is Intended for Internal DOT an eoly.
For all other mos, nowarrantles of atty sort,
brcW lag accuracy, fitness, or merchantability
accompany this product
I I I f I I. i
Feet
0 800 1,600 3,200 4,800 6,400
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