20061847 Ver 1_Complete File_20061201

Re: 3 PCN's
Subject: Re: 3 PCN's
From: Jamie Guerrero <[e-mail]. nc.us>
Date: Tue, 05 Dec 2006 09:53:05 -0500
To: Rob Ridings <[e-mail]>
That's correct, 1403 does not have any new impacs. I'll make it clearer in the next batches whether we
are asking for impacts or courtesy copy. Do you like courtesy copies or is it an unnecessary excercise in
paperwork?
Rob Ridings wrote:
Jamie,
OK...well if it's all the same to you, since 1427 and 1504 have no impacts, then instead of writing a
401, we can just file them away as "Courtesy Copies" and save you guys some application fee
money and (more importantly) save you some time.
I'll go ahead and write an approval for 1210.... looks like 600 sq ft of buffer from the the drawing
you're giving me.
We just got another one from y'all like this ...SR 1403 in Wilson Co. From what I see this too has
no new impacts (buffers or otherwise) and we can just file that away as a Courtesy Copy as well,
correct? Let me know...
And I'll look for your new info on NC 97 and work on it asap.
-rob
Jamie Guerrero wrote:
Rob,
No buffer impacts for SR 1427 and SR 1504. We will do all work from the
roadway for the pipe replacement. Actually we are daylighting 1504 a
few feet so we will be restoring some buffer. SR 1210 we are extending
the pipe a bit so we will have some buffer impacts. I have attached the
buffer drawings for 1210.
On another note, we have finally reworked NC 97 in Edgecombe Co. (you
had put it on hold until we figured out the buffer impacts). There are
mitigable impacts for BZ 1 (53 ft2) and BZ (3037 ft2). I will be
sending this update to you as well as our EEP request for mitigation
letter.
Jamie Guerrero
Division 4 Environmental Officer
NCDOT
[phone]
Rob Ridings wrote:
Jamie,
I've gotten three PCN applications from you for SR 1427 & SR 1504 in
Edgecombe County and SR 1210 in Halifax County.
1 of 2 12/5/2006 10:08 AM
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION 0ti
MICHAEL F. EASLEY
GOVERNOR
November 9, 2006
Mr. William Wescott
U.S. Army Corps of Engineers
Washington Regulatory Field Office
Post Office Box 1000
Washington, North Carolina 27889-1000
(One Copy)
Mr. Rob Ridings
Wetlands/401 Unit
NC DENR Division of Water Quality
2321 Crabtree Blvd. Suite 250
Raleigh, NC 27604-2260
(Seven Copies)
6?.
LYNDO TIPPETT
SECRETARY
CJ <;
Subject: NWP 3 and 33 Notification and Buffer Authorization Request, for the pipe replacement
on UT to Cokey Swamp under SR 1403, Wilson County.
WBS Element 4B209811
Dear Sirs:
Please find enclosed the Pre-Construction Notification for the above referenced project. The existing 2
lines of 60" X 42" CMP having a length of 50 foot will be replaced with 2 lines of 95" X 67" corrugated
aluminum pipe with headwalls having a length of 50 foot and will be buried to a depth of 12 inches.
The replacement of these crosslines is necessary due to current pipes failing causing road damage.
Headwalls will be used to increase shoulder width and to provide gentler and more stable vegetated side
slopes. An off-site traffic detour will be used during the crossline replacement. There are no permanent
impacts to buffers and Waters of the U.S./State associated with this project. UT to Cokey Swamp is
located in the Tar-Pamlico River Basin and discharges into Town Crcek. Cokey Swamp is classified by
the Division of Water Quality as C NSW 28-83-3.
All work will be done in the dry. Sheet pile cofferdams and pump-around measures will be used to
divert the flow of water. Best Management Practices for the Protection of Surface Waters will be strictly
adhered to during the replacement of these crosslines.
[phone] x 3532 [e-mail]
Post Office Box 3165, Wilson, North Carolina 27895-3165
FEDERALLY-PROTECTED SPECIES AND CULTURAL RESOURCES
The Fish and Wildlife Service (FWS) currently list two federally protected species for Wilson County
(Table 1).
Table I- Federally Protected Species of Wilson County
V
Federal Habitat Biological
Common Name Scientific Name Status Present Conclusion
Red-cockaded Picoides borealis E N No Effect
woodpecker
Dwarf Wedgemussel Alasmdonta heterodon E N No Effect
Michaux's Sumac Rhus michauxii E N No Effect
No element occurrences are listed on the NHP database within one mile of this crossline. During an on-
site visit, no pine trees suitable for RCW foraging or nesting are near, or adjacent to, the crossline.
Michaux's Sumac was not observed. This project is not likely to jeopardize the continued existence of
any of the federally protected species listed in Wilson County.
No sites eligible for listing on the National Register occur within the area of potential effect. This
project will not affect listed or eligible historic properties.
Regulatory Approvals
USACE Section 404 Permit: The project qualifies for Nationwide Permit 3 (Maintenance of previously
approved structures) and Nationwide Permit 33 (Temporary Construction, Access and Dewatering). All
permit conditions will be followed. For our files, please provide general permit verification that the
activity is authorized.
NCDW Section 401 Certification: The project qualifies for 401 General Certification number 3494
and 3366. All conditions of the general certification will be followed.
NCDW Buffer Rules: As road crossings less than 150 linear feet or 1/3 acre are an allowable use,
written authorization from the Division of Water Quality is not required. Only Buffer Rule approval is
sou,Qht in writing.
Please contact Jamie Guerrero at [phone] or Chad Coggins [phone] if you have any
questions or need additional information. Your time and effort are appreciated.
Respectfully Yours,
R.E. , Jr., PE ( ?
Division Engineer - Di sion 4
Cc: Mr. Jamie Guerrero, Division Environmental Officer
Mr. Jimmy Marler, Bridge Superintendent
Mr. Bobby Lewis, Division Maintenance Engineer
Office Use Only: Form Version March 05
USACE Action ID No. DWQ No.
fY4r ... ._...r: _..t__ ?•____ __ __ .. .. . .
-- .....7 1 -.. " "I iww is 11V1 44JJF1 CdU1C. W 11115 piVJecl, please enter Not Appmaole" 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: NWP 3 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: ?
II. Applicant Information
1. Owner/Applicant Information
Name: R. E. Greene - Division Engineer
Mailing Address: PO Box 3165
Wilson NC 27895-3165
Telephone Number: 252-237-6164x3501 Fax Number: 252-234-6174
E-mail Address: rareene(a),dot.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: Jamie Guerrero Division 4 Environmental Officeer
Company Affiliation: Division 4 - NCDOT
Mailing Address: 509 Ward Blvd.
Wilson NC 27895-3165
Telephone Number: 252 237-6164x3530 Fax Number: 252-234-6174
E-mail Address: i1?uerrero(iDdot.state. nc us
updated 11/1/2005
Page 5 of 13
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: Pipe Replacement on SR 1403 over Unnamed Tributary (UT) to Cokgy
Swamp in Wilson County
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Wilson USGS Elm City Quad map Nearest Town:_ Sharpsbura
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers/names, landmarks, etc.):
Site is between Rocky Mount and Wilson just off US301 on SR 1403 about 0.3 miles South
of SR 1146 & Sr 1403 interection.
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35.8579 ON 77.8227 °W
6. Property size (acres): N/A
7. Name of nearest receiving body of water:_ UT flows into Coke Swamp which flows into
Town Creek
8. River Basin: Tar River
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http:/ih2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: rural area forested around stream with farmland both
upstream and downstream
Updated 11/1/2005
Page 6 of 13
10. Describe the overall project in detail, including the type of equipment to be used:
Using mechanical highway equipment to replace existing 2 lines of 60" X 42" CMP 50 feet
_long with 2 lines of 95" X 67" corrurated aluminum pipe with aluminum headwalls having a
length of 50 feet. Off-site detour will be used
11. Explain the purpose of the proposed work Current pipe is failing causing cracks and holes
in pavement. The upgraded pipe with headwalls also will provide gentler and more stable
vegetated side slopes and bring this site up to current NCDOT construction and safety
standards.
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 pen-nits issued for prior segments of the same T.I.P. project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
No
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.
Updated I1/1/2005
Page 7 of 13
1. Provide a written description of the proposed impacts:
No-permanent-impacts are proposed only temporary impacts from sheet- -pilink and dewat
ennu activities.
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
separately list impacts due to both structure and flooding_
Wetland Impact
Site Number
(indicate on map) Type of Impact Type of Wetland
(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
1F10000--year lain
p
( es/no) Distance to
Stream Nearest
linear feet) Area of
Impact
(acres)

Total Wetland Impact (acres)
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 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. multinlv length X width then divide by a2 SFn
Stream Impact
Number
indicate on ma)
Stream Name
Type of Impact
Perennial or
Intermittent? Average
Stream Width
Before Impact Impact
Length
linear feet Area of
Impact
(acres)
Coke Swam
y p Temporary Sheet
Pile for dewatering
Intermittent 12
0
0

Total Stream Impact (by length and acreage) 0
Updated 11/1/2005
Page 8 of 13
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, floodin draina e 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)
6. List the cumulative impact to all Waters of the i1_S_ re,,nltinn from flip nm;,-r-t-
Stream Impact acres
Wetland Impact (acres): p
Open Water Impact (acres): p
Total Impact to Waters of the U.S. (acres) p
Total Stream Impact (linear feet): p
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. Equipment staging and work
Updated 11/1/2005
Page 9 of 13
will be performed within the existing road footprint Strict enforcement of Best Management
Practices for sedimentation and erosion control the protection of wetlands and surface waters
will be enforced. Offsite detours will be used to avoid temporary fill from an onsite detour.
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.ne.us/ncwet]ands/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.
N/A
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
Updated 11!1/2005
Page 10 of 13
website at http://h2o.enr.state.nc.us/wm/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):
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ® No ?
2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ® Meets Federal Categorical Exclusion criteria
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.
Will the project impact protected riparian buffers identified within 15A NCAC 213 .0233
(Meuse), 15A NCAC 2B.0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
213 .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify Tar River )? 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.
Zone* Impact
(square feet
Multiplier Required

Mitigation
1
2
Updated 11/1/2005
Page 11 of 13
s Zone I extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
Ri nnri n+. 0-PV n,...a,. r.... ?? rat
yu.u.. "lipid A%A aLVlall0ii Fund). Please atiach all appropriate information as identified
within 15A NCAC 2B .0242 or.0244, or.0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level.
All appropriate best management practices for sediment and erosion control will be
implemented.
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
N/A
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/ncwetlands. If no, please provide a short narrative description:
This pipe replacement and upgrade is a general maintenance project
Updated 11/1/2005
Page 12 of 13
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).
ApplicaiklAgent's-Signature `/ - Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Updated 11/1/2005
Page 13 of 13

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STATE of NORTH CAROLINA
r??On2 J
OST????Gq(J?/JO6+ O
9TF?
DEPARTMENT OF TRANSPORTATION 19
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR
November 9, 2006
Mr. William Wescott
U.S. Army Corps of Engineers
Washington Regulatory Field Office
Post Office Box 1000
Washington, North Carolina 27889-1000
(One Copy)
Mr. Rob Ridings
Wetlands/401 Unit
NC DENR Division of Water Quality
2321 Crabtree Blvd. Suite 250
Raleigh, NC 27604-2260
(Seven Copies)
SECRETARY
Subject: NWP 3 and 33 Notification and Buffer Authorization Request, for the pipe replacement
on UT to Cokey Swamp under SR 1403, Wilson County.
WBS Element 4B209811
Dear Sirs:
Please find enclosed the Pre-Construction Notification for the above referenced project. The existing 2
lines of 60" X 42" CMP having a length of 50 foot will be replaced with 2 lines of 95" X 67" corrugated
aluminum pipe with headwalls having a length of 50 foot and will be buried to a depth of 12 inches.
The replacement of these crosslines is necessary due to current pipes failing causing road damage.
Headwalls will be used to increase shoulder width and to provide gentler and more stable vegetated side
slopes. An off-site traffic detour will be used during the crossline replacement. There are no permanent
impacts to buffers and Waters of the U.S./State associated with this project. UT to Cokey Swamp is
located in the Tar-Pamlico River Basin and discharges into Town Creek. Cokey Swamp is classified by
the Division of Water Quality as C NSW 28-83-3.
All work will be done in the dry. Sheet pile cofferdams and pump-around measures will be used to
divert the flow of water. Best Management Practices for the Protection of Surface Waters will be strictly
adhered to during the replacement of these crosslines.
[phone] x 3532 [e-mail]
Post Office Box 3165, Wilson, North Carolina 27895-3165

FEDERALLY-PROTECTED SPECIES AND CULTURAL. RESOURCES
The Fish and Wildlife Service (FWS) currently list two federally protected species for Wilson County
(Table 1).
Table 1- Federally Protected Species of Wilson County
- r
Federal Habitat Biological
Common Name Scientific Name Status Present Conclusion
Red-cockaded Picoides borealis E N No Effect
woodpecker
Dwarf Wedgemussel Alasmidonta heterodon E N No Effect
Michaux's Sumac Rhus miehauxii E N No Effect
No element occurrences are listed on the NHP database within one mile of this crossline. During an on-
site visit, no pine trees suitable for RCW foraging or nesting are near, or adjacent to, the crossline.
Michaux's Sumac was not observed. This project is not likely to jeopardize the continued existence of
any of the federally protected species listed in Wilson County.
No sites eligible for listing on the National Register occur within the area of potential effect. This
project will not affect listed or eligible historic properties.
Regulatory Approvals
USACE Section 404 Permit: The project qualifies for Nationwide Permit 3 (Maintenance of previously
approved structures) and Nationwide Permit 33 (Temporary Construction, Access and Dewatering). All
permit conditions will be followed. For our files, please provide general permit verification that the
activity is authorized.
NCDWO Section 401 Certification: The project qualifies for 401 General Certification number 3494
and 3366. All conditions of the general certification will be followed.
NCDWO Buffer Rules: As road crossings less than 150 linear feet or 1/3 acre are an allowable use,
written authorization from the Division of Water Quality is not required. Only Buffer Rule approval is
sought in writing.
Please contact Jamie Guerrero at [phone] or Chad Coggins [phone] if you have any
questions or need additional information. Your time and effort are appreciated.
Respectfully Yours,
R.E. , Jr., PE ( ?
Division Engineer- Di sion 4
Cc: Mr. Jamie Guerrero, Division Environmental Officer
Mr. Jimmy Marler, Bridge Superintendent
Mr. Bobby Lewis, Division Maintenance Engineer
Office Use Only: Form Version March 05
USACE Action ID No. DWQ No.
fTC......._..- ..t__
\-- --w F-- "I" "I 11111113 11V1 appilcuurc w tnls project, piease 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 3 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: ?
II. Applicant Information
1. Owner/Applicant Information
Name: R. E. Greene - Division Engineer
Mailing Address: PO Box 3165
Wilson NC 27895-3165
Telephone Number: 252-237-6164x3501 Fax Number: 252-234-6174
E-mail Address: rureene(aMot.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: Jamie Guerrero Division 4 Environmental Officeer
Company Affiliation: Division 4 - NCDOT
Mailing Address: 509 Ward Blvd.
Wilson NC 27895-3165
Telephone Number: 252 237-6164x3530 Fax Number: 252-234-6174
E-mail Address: iguerrerogdot.state. nc us
updated l l/l/2005
Page 5 of 13
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 tacilities 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 fonnat;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name ofproject: _ Pine Replacement on SR 1403 over Unnamed Tributary (UT) to Cokey
Swamp in Wilson County
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Wilson USGS Elm City Quad man Nearest Town: Sharpsburg
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers/names, landmarks, etc.):
Site is between Rocky Mount and Wilson just off US301 on SR 1403 about 0.3 miles South
of SR 1146 & Sr 1403 interection.
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35.8579 ON 77.8227 °W
6. Property size (acres): N/A
7. Name of nearest receiving body of water: UT flows into Cokey Swamp which flows into
Town Creek
8. River Basin: Tar River
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: rural area forested around stream with farmland both
upstream and downstream
Updated 11/1/2005
Page 6 of 13
10. Describe the overall project in detail, including the type of equipment to be used:
Using mechanical highwav equipment to replace existing 2 lines of 60" X 42" CMP 50 feet
long with 2 lines of 95" X 67" corrurated aluminum pipe with aluminum headwalls having a
length of 50 feet. Off-site detour will be used
11. Explain the purpose of the proposed work Current pipe is failing causing cracks and holes
in pavement. The upgraded pipe with headwalls also will provide gentler and more stable
vegetated side slopes and bring this site up to current NCDOT construction and safety
standards.
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.
1t
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.
Updated 11/1/2005
Page 7 of 13
1. Provide a written description of the proposed impacts:
No permanent impacts are proposed only temporary impacts from sheet nilin and dewat
erinu activities.
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
se aratel 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
(yes/no) Distance to
Nearest
Stream
linear feet Area of
Impact
(acres)

Total Wetland Impact (acres)
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 fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original and relocated streams
must be included. To calculate acreage multi 1 length X width then divide b 43 560

Stream Impact
Number
indicate on ma)

Stream Name

Type of Impact

Perennial or
Intermittent?
Average
Stream Width
Before Impact Y
Impact
Length
linear feet)
Area of
Impact
(acres)
Coke Swam
y p Temporary Sheet
Pile for dewatering
Intermittent 12
0
0

Total Stream Impact (by length and acreage) 0
Updated 11/1/2005
Page 8 of 13
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 (lrainaaP h„llrhnarlc Pf,
Open Water Impact
Site Number
(indicate on ma) Name of Waterbody

(if applicable)
Type of Impact Type of Waterbody
(lake, pond, estuary, sound, ba
y,
ocean, etc.) Area of

p
Im act
(acres)

Total Open Water Impact (acres)
6. List the cumulative impact to all Waters of the i1_S_ recitltinn frnm t1,P nrniPrt-
Stream Impact (acres): p
Wetland Impact (acres): p
Open Water Impact (acres): p
Total Impact to Waters of the U.S. (acres) p
Total Stream Impact (linear feet): p
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 USAGE.
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. Equipment staging and work
Updated 11/1/2005
Page 9 of 13
will be performed within the existing road footprint Strict enforcement of Best Management
Practices for sedimentation and erosion control the protection of wetlands and surface waters
will be enforced. Offsite detours will be used to avoid temporary fill from an onsite detour.
VIII. Mitigation
D W Q - 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/ncwet]ands/stnngide.htm1.
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.
N/A
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
Updated 11/1/2005
Page 10 of 13
website at http://h2o.enr.state.nc.us/wry/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):
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 ® Meets Federal Categorical Exclusion criteria
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 0213.0243 (Catawba) 15A NCAC
213 .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify Tar River )? 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.
Zone* Impact
(square feet) Multiplier Required
Mitigation
1
2
Updated 11/1/2005
Page 11 of 13
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.
I 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
Ri.rnrinr D..FC .. P ....a, --,:-- T:__.. AN rat
yuauu LJU11Vi 1%. LVIaLW11 rU11U). riease attach an appropriate information as identified
within 15A NCAC 2B .0242 or.0244, or.0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level.
All appropriate best management practices for sediment and erosion control will be
implemented.
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
N/A
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 E] 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/newetlands. If no, please provide a short narrative description:
This pipe replacement and upgrade is a general maintenance project
Updated 11/1/2005
Page 12 of 13
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).
Applica><WA,gent's-Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Updated 11/1/2005
Page 13 of 13
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STATE of NORTH CAROLINA
o?
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR
November 9, 2006
Mr. William Wescott
U.S. Army Corps of Engineers
Washington Regulatory Field Office
Post Office Box 1000
Washington, North Carolina 27889-1000
(One Copy)
Mr. Rob Ridings
Wetlands/401 Unit
NC DENR Division of Water Quality
2321 Crabtree Blvd. Suite 250
Raleigh, NC 27604-2260
(Seven Copies)
SECRETARY
Subject: NWP 3 and 33 Notification and Buffer Authorization Request, for the pipe replacement
on UT to Cokey Swamp under SR 1403, Wilson County.
WBS Element 4B209811
Dear Sirs:
Please find enclosed the Pre-Construction Notification for the above referenced project. The existing 2
lines of 60" X 42" CMP having a length of 50 foot will be replaced with 2 lines of 95" X 67" corrugated
aluminum pipe with headwalls having a length of 50 foot and will be buried to a depth of 12 inches.
The replacement of these crosslines is necessary due to current pipes failing causing road damage.
Headwalls will be used to increase shoulder width and to provide gentler and more stable vegetated side
slopes. An off-site traffic detour will be used during the crossline replacement. There are no permanent
impacts to buffers and Waters of the U.S./State associated with this project. UT to Cokey Swamp is
located in the Tar-Pamlico River Basin and discharges into Town Creek. Cokey Swamp is classified by
the Division of Water Quality as C NSW 28-83-3.
All work will be done in the dry. Sheet pile cofferdams and pump-around measures will be used to
divert the flow of water. Best Management Practices for the Protection of Surface Waters will be strictly
adhered to during the replacement of these crosslines.
[phone] x 3532 [e-mail]
Post Office Box 3165, Wilson, North Carolina 27895-3165
'w;
FEDERALLY-PROTECTED SPECIES AND CULTURAL RESOURCES
The Fish and Wildlife Service (FWS) currently list two federally protected species for Wilson County
(Table 1).
Table 1- Federally Protected Species of Wilson County
Y
Federal Habitat Biological
Common Name Scientific Name Status Present Conclusion
Red-cockaded Picoides borealis E N No Effect
woodpecker
Dwarf Wedgemussel Alasmidonta heterodon E N No Effect
Michaux's Sumac Rhus miehauxii E N No Effect
No element occurrences are listed on the NHP database within one mile of this crossline. During an on-
site visit, no pine trees suitable for RCW foraging or nesting are near, or adjacent to, the crossline.
Michaux's Sumac was not observed. This project is not likely to jeopardize the continued existence of
any of the federally protected species listed in Wilson County.
No sites eligible for listing on the National Register occur within the area of potential effect. This
project will not affect listed or eligible historic properties.
Regulatory Approvals
USACE Section 404 Permit: The project qualifies for Nationwide Permit 3 (Maintenance of previously
approved structures) and Nationwide Permit 33 (Temporary Construction, Access and Dewatering). All
permit conditions will be followed. For our files, please provide general permit verification that the
activity is authorized.
NCDW Section 401 Certification: The project qualifies for 401 General Certification number 3494
and 3366. All conditions of the general certification will be followed.
NCDWO Buffer Rules: As road crossings less than 150 linear feet or 1/3 acre are an allowable use,
written authorization from the Division of Water Quality is not required. Only Buffer Rule approval is
sought in writing.
Please contact Jamie Guerrero at [phone] or Chad Coggins [phone] if you have any
questions or need additional information. Your time and effort are appreciated.
Respectfully Yours,
R.E. , Jr., PE ( ?
Division Engineer - Di sion 4
Cc: Mr. Jamie Guerrero, Division Environmental Officer
Mr. Jimmy Marler, Bridge Superintendent
Mr. Bobby Lewis, Division Maintenance Engineer
Office Use Only: Form Version March 05
USACE Action ID No. DWQ No.
?u auy }lai 111.wai ILUL11 IJ llui appucaote to tnts 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: NWP 3 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: ?
II. Applicant Information
1. Owner/Applicant Information
Name: R. E. Greene - Division Engineer
Mailing Address: PO Box 3165
Wilson NC 27895-3165
Telephone Number: 252-237-6164x3501 Fax Number: 252-234-6174
E-mail Address: rureene(a,dot.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: Jamie Guerrero Division 4 Environmental Officeer
Company Affiliation: Division 4 - NCDOT
Mailing Address: 509 Ward Blvd.
Wilson NC 27895-3165
Telephone Number: 252 237-6164x3530 Fax Number: 252-234-6174
E-mail Address:_ iguerrero(rD,dot.state. nc us
Updated 11/1/2005
Page 5 of 13
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: Pipe Replacement on SR 1403 over Unnamed Tributary (UT) to Coke
Swamp in Wilson Count
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Wilson USGS Elm City Quad map Nearest Town: Sharpsburg
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers/names, landmarks, etc.):
Site is between Rocky Mount and Wilson just off US301 on SR 1403 about 0.3 miles South
of SR 1146 & Sr 1403 interection.
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35.8579 ON 77.8227 °W
6. Property size (acres): N/A
7. Name of nearest receiving body of water: UT flows into Cokey Swamp which flows into
Town Creek
8. River Basin: Tar River
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at httl2://h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: rural area forested around stream with farmland both
upstream and downstream
updated 11/1/2005
Page 6 of 13
10. Describe the overall project in detail, including the type of equipment to be used:
Using mechanical highway equipment to replace existing 2 lines of 60" X 42" CMP 50 feet
long with 2 lines of 95" X 67" corrurated aluminum pipe with aluminum headwalls having a
length of 50 feet. Off-site detour will be used
11. Explain the purpose of the proposed work Current pipe is failing cusing cracks and holes
in pavement. The upgraded pipe with headwalls also will provide gentler and more stable
vegetated side slopes and bring this site up to current NCDOT construction and safety
standards.
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.
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.
Updated 11/1/2005
Page 7 of 13
1. Provide a written description of the proposed impacts:
No permanent impacts are-proposed-only temporary impacts from sheet piling and dewat
erinu activities.
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
separately list impacts due to both structure and flooding-
Wetland Impact
Site Number

(indicate on map)
Type of Impact Type of Wetland
(e.g., forested, marsh
,
herbaceous, bog, etc.) Located within
100-year

Flood lain (es no) Distance to
Nearest
Stream
linear feet) Area of
Impact

(acres)

Total Wetland Impact (acres)
I 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 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 acrea a multi ly length X width then divide b X1 560

Stream Impact
Number
indicate on ma)

Stream Name

Type of Impact

Perennial or
Intermittent?
Average
Stream Width
Before Impact Y
Impact
Length
linear feet)
Area of
Impact
(acres)
Coke Swam
y p Temporary Sheet
Pile for dewatering
Intermittent 12
0
0

Total Stream Impact (by length and acreage) p
Updated 11/1/2005
Page 8 of 13
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. dredeine_ flondinv drainnm, h„llrhParlc efc
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)
6. List the cumulative impact to all Waters of the I I q rPC„lt;na frnm 4t,- +.
Stream Impact (acres): p
Wetland Impact (acres): p
Open Water Impact (acres): p
Total Impact to Waters of the U.S. (acres) p
Total Stream Impact (linear feet): p
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 USAGE.
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., darn/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. Equipment staging and work
updated II/1/2005
Page 9 of 13
will be performed within the existing road footprint Strict enforcement of Best Management
Practices for sedimentation and erosion control the protection of wetlands and surface waters
will be enforced. Offslte detours will be used to avoid temporary fill from an onsite detour.
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/strrngide.htmi.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
N/A
2. Mitigation may also be made by payment into the North Carolina 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
Updated 11/1/2005
Page 10 of 13
website at httn://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):
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 ® Meets Federal Categorical Exclusion criteria
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 213 .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 0213.0243 (Catawba) 15A NCAC
213 .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify Tar River )? 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 multi liers.
P Zone* Impact
(s uare feet)
Multiplier Required
Mitigation
1
2
Updated 11/1/2005
Page 11 of 13
* 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
Rlparla:. AJIAf:;r :CStOration Fund). Please attach all appropriate information as identitied
within 15A NCAC 2B .0242 or.0244, or.0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level.
All appropriate best management practices for sediment and erosion control will be
implemented.
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
N/A
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://l12o.enr.state. nc us/newetlands. If no, please provide a short narrative description:
This pipe replacement and upgrade is a general maintenance project
Updated 11/1/2005
Page 12 of 13
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).
ApplicakAwArt s Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Updated 11/1/2005
Page 13 of 13
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? STATj
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR
November 9, 2006
Mr. William Wescott
U.S. Army Corps of Engineers
Washington Regulatory Field Office
Post Office Box 1000
Washington, North Carolina 27889-1000
(One Copy)
SECRETARY

Mr. Rob Ridings
Wetlands/401 Unit
NC DENR Division of Water Quality
2321 Crabtree Blvd. Suite 250
Raleigh, NC 27604-2260
(Seven Copies)
Subject: NWP 3 and 33 Notification and Buffer Authorization Request, for the pipe replacement
on UT to Cokey Swamp under SR 1403, Wilson County.
WBS Element 4B209811
Dear Sirs:
Please find enclosed the Pre-Construction Notification for the above referenced project. The existing 2
lines of 60" X 42" CMP having a length of 50 foot will be replaced with 2 lines of 95" X 67" corrugated
aluminum pipe with headwalls having a length of 50 foot and will be buried to a depth of 12 inches.
The replacement of these crosslines is necessary due to current pipes failing causing road damage.
Headwalls will be used to increase shoulder width and to provide gentler and more stable vegetated side
slopes. An off-site traffic detour will be used during the crossline replacement. There are no permanent
impacts to buffers and Waters of the U.S./State associated with this project. UT to Cokey Swamp is
located in the Tar-Pamlico River Basin and discharges into Town Creek. Cokey Swamp is classified by
the Division of Water Quality as C NSW 28-83-3.
All work will be done in the dry. Sheet pile cofferdams and pump-around measures will be used to
divert the flow of water. Best Management Practices for the Protection of Surface Waters will be strictly
adhered to during the replacement of these crosslines.
[phone] x 3532 [e-mail]
Post Office Box 3165, Wilson, North Carolina 27895-3165
FEDERALLY-PROTECTED SPECIES AND CULTURAL RESOURCES
The Fish and Wildlife Service (FWS) currently list two federally protected species for Wilson County
(Table 1).
Table 1- Federally Protected Species of Wilson County
Federal
Common Name
Scientific Name
Status
Habitat Biological
Present Conclusion
tcea-cocxactea Picoides borealis E N No Effect
woodpecker
Dwarf Wedgemussel Alasmidonta heterodon E N No Effect
iviicnaux's sumac Rhus michauxii E N No Effect
No element occurrences are listed on the NHP database within one mile of this crossline. During an on-
site visit, no pine trees suitable for RCW foraging or nesting are near, or adjacent to, the crossline.
Michaux's Sumac was not observed. This project is not likely to jeopardize the continued existence of
any of the federally protected species listed in Wilson County.
No sites eligible for listing on the National Register occur within the area of potential effect. This
project will not affect listed or eligible historic properties.
Regulatory Approvals
USACE Section 404 Permit: The project qualifies for Nationwide Permit 3 (Maintenance of previously
approved structures) and Nationwide Permit 33 (Temporary Construction, Access and Dewatering). All
permit conditions will be followed. For our files, please provide general permit verification that the
activity is authorized.
NCDW Section 401 Certification: The project qualifies for 401 General Certification number 3494
and 3366. All conditions of the general certification will be followed.
NCDWQ Buffer Rules: As road crossings less than 150 linear feet or 1/3 acre are an allowable use,
written authorization from the Division of Water Quality is not required. Only Buffer Rule approval is
sought in writing.
Please contact Jamie Guerrero at [phone] or Chad Coggins [phone] if you have any
questions or need additional information. Your time and effort are appreciated.
Respectfully Yours,
R.E. , Jr., PE ( ?
Division Engineer - Di sion 4
Cc: Mr. Jamie Guerrero, Division Environmental Officer
Mr. Jimmy Marler, Bridge Superintendent
Mr. Bobby Lewis, Division Maintenance Engineer
Office Use Only: Form Version March 05
USACE Action ID No. 2 6 P 4 7
DWQ No.
11 Ir
- - -
k•- ?..y r"i uvui"I ?«111 l31WL uPYiicau?c w tnls projecl, 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 3 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: ?
II. Applicant Information
Owner/Applicant Information
Name: R. E. Greene - Division Engineer
Mailing Address: PO Box 3165
Wilson NC 27895-3165
Telephone Number: 252-237-6164x3501 Fax Number: 252-234-6174
E-mail Address:_ rareeneRdot.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: Jamie Guerrero Division 4 Environmental Officeer
Company Affiliation: Division 4 - NCDOT
Mailing Address: 509 Ward Blvd.
Wilson NC 27895-3165
Telephone Number: 252 237-6164x3530 Fax Number: 252-234-6174
E-mail Address: ipztlerreroadot.state ne us
Updated 11/1/2005
Page 5 of 13
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 ofproject: pipe Replacement on SR 1403 over Unnamed Tributary (UT) to Cokey
Swamp in Wilson County
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): N/.
4. Location
County: Wilson USGS Elm City Quad map Nearest Town: Sharpsbura
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers/names, landmarks, etc.):
Site is between Rocky Mount and Wilson just off US301 on SR 1403 about 0.3 miles South
of SR 1146 & Sr 1403 interection.
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35.8579 ON 77.8227 °W
6. Property size (acres): N/A
7. Name of nearest receiving body of water: UT flows into Cokey Swamp which flows into
Town Creek
8. River Basin: Tar River
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: rural area forested around stream with farmland both
upstream and downstream
Updated 11/1/2005
Page 6 of 13
10. Describe the overall project in detail, including the type of equipment to be used:
Using mechanical highway equipment to replace existing 2 lines of 60" X 42" CMP 50 feet
long with 2 lines of 95" X 67" corrurated aluminum pipe with aluminum headwalls having a
length of 50 feet. Off-site detour will be used
11. Explain the purpose of the proposed work Current pipe is failing causing cracks and holes
in pavement. The upgraded pipe with headwalls also will provide gentler and more stable
vegetated side slopes and bring this site up to current NCDOT construction and safety
standards.
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 pen-nits 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.
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.
Updated H/1/2005
Page 7 of 13
1. Provide a written description of the proposed impacts:
No permanent impacts are proposed only temporary impacts from sheet piling and dewat
erinu activities.
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
separately list impacts due to both structure and flooding.
Wetland Impact
Site Number

(indicate on map)
Type of Impact Type of Wetland
(e.g., forested, marsh
,
herbaceous, bog, etc.) Located within
100-year
ain
Floodpl (es/no Distance to
Nearest
Stream
linear feet) Area of
Impact
(acres)

Total Wetland Impact (acres)
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 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. multinly lenoth X width then rli6di- her a2 SAO
Stream Impact
Number
indicate on map)
Stream Name
Type of Impact Perennial or

Intermittent? Average
Stream Width
Before Impact Impact
Length
linear feet) Area of
Impact
acres
Coke Swam
y p Temporary Sheet
Pile for dewatering
Intermittent 12
0
0

Total Stream Impact (by length and acreage) 0
Updated 11/1/2005
Page 8 of 13
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 floodin draina e 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)
6. List the cumulative impact to all Waters of the I IR resulting from flip rnrr%; o*-
Stream Impact (acres):
Wetland Impact (acres): p
Open Water Impact (acres): p
Total Impact to Waters of the U.S. (acres) p
Total Stream Impact (linear feet): p
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. Equipment staging and work
updated 11/1/2005
Page 9 of 13
will be performed within the existing road footprint Strict enforcement of Best Management
Practices for sedimentation and erosion control the protection of wetlands and surface waters
will be enforced. Offsite detours will be used to avoid temporary fill from an onsite detour.
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/stn-ngide.htm1.
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.
N/A
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
Updated 11/1/2005
Page 10 of 13
website at http://h2o.enr.statc.nc.us/wM/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):
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 ® Meets Federal Categorical Exclusion criteria
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 213 .0233
(Neuse), 15A NCAC 2B.0259 (Tar-Pamlico), 15A NCAC 0213.0243 (Catawba) 15A NCAC
213 .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify Tar River )? 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.
Zone* Impact
(square feet Multiplier Required
Mitigation
1
2
Updated 11/1/2005
Page 11 of 13
Total
* Zone I extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone I.
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
Rir+nri n.+ D-r'r .. n ,...a,...a:..._ n_.._ _l\ "1
•VtAA AL L.Jull\.1 1\VJtVLat1V11 ruuu). Please attach ail appropriate information as identified
within 15A NCAC 2B .0242 or.0244, or.0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level.
All appropriate best management practices for sediment and erosion control will be
implemented.
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
N/A
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/ncwetlands. If no, please provide a short narrative description:
This pipe replacement and upgrade is a general maintenance project
Updated 11/1/2005
Page 12 of 13
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).
ApplicakA.g"KSignature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Updated 11/1/2005
Page 13 of 13
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