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HomeMy WebLinkAbout20051436 Ver 1_Complete File_20050818`(DUJGL,'r inwitaet r. nastey, vovemor P40 C+^ William G. Ross Jr., Secretary 4 j`(v'll?O North Carolina Department of Environment and Natural Resources Alan W. Klimek, P.E. Director Division of Water Quality 1I 10s44 osTOe?ct?q O August 18, 2005 i RMwA Jackson County BR?'?H DWQ Project No. 051436 Bridge No. 208 NCSR 1160 APPROVAL of 401 Water Quality Certification with Additional Conditions Mr. J. B. Setzer, P.E. Division Engineer N C Department of Transportation 253 Webster Road Sylva, North Carolina 28779 Dear Mr. Setzer: You have our approval, in accordance with the attached conditions and those listed below, for temporary impacts of 70 linear feet of Little Pine Creek (temporary impacts of 70 linear feet for removal of existing bridge end bents) in order to construct a new bridge (No. 208) on NCSR 1160 in Jackson County. The project must be constructed in accordance with the application dated July 26, 2005 (received August 1, 2005), including the environmental commitments made in the application letter. After reviewing your application, we have decided that this fill is covered by General Water Quality Certification Nos. 3404 and 3366, corresponding to the U.S. Army Corps of Engineers General Permit No. 31. In addition, you must acquire any other federal, state.or local permits before you proceed with your project including (but not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This approval will expire with the accompanying 404 Permit unless otherwise specified in the Water Quality Certification. This approval is valid solely for the purpose and design described in your application (unless modified below). Should your project change, you must notify the DWQ in writing and submit a new application. If the property is sold, the new owner must be given a copy of this Certification and approval letter, and is thereby responsible for complying with all the conditions. If total wetland fills for this project (now or in the future) exceed one acre, or if total impacts to streams (now or in the future) exceed 150 linear feet, compensatory mitigation may be required as described in 15A NCAC 211 .0506 (h) (6) and (7). For this approval to be valid, you must follow the conditions listed in the attached certification and any additional conditions listed below. Erosion and sediment control practices must be in full compliance with all specifications governing the proper design, installation and operation and maintenance of such Best Management Practices in order to protect surface waters standards: a. The erosion and sediment control measures for the project must be designed, installed, operated, and maintained in accordance with the most recent version of the North Carolina Sediment and Erosion Control Planning and Design Manual. b. The design, installation, operation, and maintenance of the sediment and erosion control measures must be such that they equal, or exceed, the requirements specified in the most recent version of the North Carolina Sediment and Erosion Control Manual. The devices shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects, including contractor-owned or leased borrow pits associated with the project. c. For borrow pit sites, the erosion and sediment control measures must be designed, installed, operated and maintained in accordance with the most recent version of the North Carolina Surface Mining Manual. e NthCarolina Noaturally North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, NC 28778 Phone (828) 296-4500 Customer Service Internet: h2o.enr.state.nc.us FAX (828) 299-7043 1-877-623-6748 An Equal Opportunity/Affirmative Action Employer 1V11. J. D. artzer, r.r. August 18, 2005 Page Two d. The reclamation measures and implementation must comply with the reclamation in accordance with the requirements of the Sedimentation Pollution Control Act. 2. No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond the footprint of the impacts depicted in the Preconstruction Notice Application. All construction activities, including the design, installation, operation, and maintenance of sediment and erosion control Best Management Practices, shall be performed so that no violations of state water quality standards, statutes, or rules occur. 3. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum extent practicable. If placement of sediment and erosion control devices in wetlands and waters is unavoidable, they shall be removed and the natural grade restored within six months of the date that the Division of Land Quality has released the project. 4. In-stream work and land disturbance within the 25-foot wide buffer zone are prohibited during the rainbow trout- spawning season of January 1 through April 15 to protect the egg and fry stages of trout from off-site sedimentation during construction of the bridge. 5. Adequate sedimentation and erosion control measures must be maintained on the project site to minimize sediment transport to downstream aquatic resources. Temporary or permanent herbaceous vegetation should be planted on all bare soil within 15 days of ground disturbing activities to provide long-term erosion control. Erosion control matting should be used in conjunction with appropriate seeding on disturbed soils in steep slope and riparian areas. Matting should be secured in place with staples, stakes or, wherever possible, live stakes and native trees. Tall fescue and straw should not be used in riparian areas. 6. Stormwater shall be directed to vegetated buffer areas, grass lined ditches or other means appropriate to the site for the purpose of pre-treating stormwater runoff, and must not be routed directly into streams. There shall be no bridge deck drains that discharge directly to surface waters. Mowing of existing vegetated buffers is strongly discouraged, so that they may be utilized for stormwater diffuse flow. 7. Removal of vegetation at the stream crossing and adjacent to streams should be minimized. Native trees and shrubs (e.g. Rhododendron, dog hobble, willows, alders, sycamores, dogwoods, black walnut and red maple) should be planted along the streambank to reestablish the riparian zone and to provide long-term erosion control in the vicinity of the new bridge. Riparian vegetation must be reestablished within the construction limits of the project by the end of the growing season following completion of construction. 8. Rock should not be placed in the stream channel in a manner that constricts stream flow or that will impede aquatic life movement during low flow conditions. Riprap placed for bank stabilization should be limited to the streambank below the high water mark, and vegetation should be used for stabilization above the high water elevation. 9. The dimension, pattern and profile of the stream, above and below the bridge, should not be, modified by widening the stream channel or reducing the stream depth. Any over widened areas at the bridge site should be restored and the width/depth ratio typical of reaches upstream and downstream of the site should be maintained through the bridge project. 10. Heavy equipment must be operated from the banks rather than in the stream channel in order to minimize sedimentation and to reduce the likelihood of introducing other pollutants into the stream. 11. All mechanized equipment operated near surface waters must be regularly inspected and maintained to prevent contamination of stream waters from fuels, lubricants, hydraulic fluids, or other toxic materials. 12. Excavation in the stream associated with the new bridge construction and old bridge removal should be conducted in the dry, if possible. Sandbags, cofferdams, flexible pipe or other diversion structures should be used to minimize excavation in flowing water. 13. If concrete is used during bridge installation (e.g., headwalls), a dry work area should be maintained to prevent direct contact between curing concrete and stream water. Water that inadvertently contacts uncured concrete should not be discharged to surface waters due to the potential for a change in water chemistry and possible aquatic life and fish kills. 14. Discharging hydroseed mixtures and washing out hydroseeders and other equipment in or adjacent to surface waters is strictly prohibited. 15. The presence of equipment in the channels must be minimized. Under no circumstances must rock, sand or other materials be dredged from the wetted stream channel under authorization of this permit, except in the immediate vicinity of the bridge construction. In stream dredging has catastrophic effects on aquatic life, and disturbance of the natural form of the stream channel will likely cause downstream erosion problems, possibly affecting other landowners. The natural streambed contours must be reestablished, if necessary, following removal of the cofferdam structures. Mr. J. B. Setzer, P.E. August 18, 2005 r Page Three 16. This certification does not authorize the discharge of waste rock and dirt into the stream or riparian zone except for permitted areas associated with the bridge construction. 17. Grading and backfilling should be minimized and tree and shrub growth should be retained where possible to ensure long-term availability of riparian cover for fish and wildlife. Backfill materials should be obtained from upland sites. 18. Discharge of materials into surface waters from demolition of the old bridge should be avoided as much as possible. Any material that reaches surface waters should be removed. Waste materials should not be disposed of in the stream or riparian areas. 19. All work shall be performed during low flow conditions (below bankfull). 20. Upon completion of the project, the NCDOT shall complete and return the enclosed "Certificate of Completion" form to notify the NCDWQ when all work included in the §401 Certification has been completed. The responsible party shall complete the attached form and return it to the Transportation Permitting Unit of the NC Division of Water Quality upon completion of the project. The NCDOT is strongly advised to send in photographs upstream and downstream of each structure to document correct installation. If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a hearing. This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If you have any questions, please telephone or Mr. Mike Parker of the Asheville Regional Office at 828.296.4500. Sincerely, Alan W. Klimek, P.E., Director Division of Water Quality Attachment cc: Mark Davis, Division 14, DEO Ed Ingle, Roadside Environmental Angie Pennock, USACE Asheville Field Office Transportation Permitting Unit Mike Parker, Asheville Regional Office x51436 M.a STATE OF NORTH CAROLINA o? 400 0 , 1. ?0 D DEPARTMENT OF TRANSPORTATION MICHAEL F. EASLEY GOVERNOR July 26, 2005 Ms. Angie Pennock, NCDOT Regulatory Project Manager U.S. Army Corps of Engineers 151 Patton Avenue, Room 208 Asheville, NC 28801-2714 LYNDO TIPPETT SECRETARY Subject: GP 31 Permit Application Bridge Number 208 on SR 1160 over Little Pine Creek Jackson County State Project: WBS No: 14B.205011 (DWQ Minor Permit Fee $200.00) Dear Ms. Pennock, The North Carolina Department of Transportation (NCDOT) is proposing to replace Bridge Number 208 on SR 1160 over Little Pine Creek (WS III), in Jackson County. The existing bridge is a 15' single span structure with timber abutments and timber joists. The new bridge will span the creek using timber joists on timber abutments at a length of 20'. The footings will be constructed of 12" x 12" timber mudsills. All work will be performed in a dry environment. Sandbag cofferdams will be used if necessary to ensure a clean, dry area, and to minimize impacts to aquatic habitats and allow the existing stream gradients to remain as unchanged as physically possible. The North Carolina Natural Heritage Database was checked for records of threatened and endangered species. There are no records of threatened or endangered species for the Little Pine Creek watershed. Additionally, there are no records of threatened and endangered species for the adjacent watersheds, Gem Creek and Pine Creek. Thorpe Reservoir fragments the riverine habitat approximately 0.75 miles downstream of the project site. The existing bridge will be replaced with another spanning structure; therefore, impacts from construction will be very minimal. For these reasons, the project will have "no effect" on threatened and endangered species. Impacts to historic or cultural resources are not anticipated. If the State Historic Preservation Office (SHPO) and the Office of State Archaeology determines that further investigations are Whittier Bridge Maintenance, 178 Henry Bird Rd, Whittier, NC 28789Telephone(828)497-7953 Fax(828)497-6544 PAI required; NCDOT will conduct the appropriate site investigations and obtain compliance from SHPO prior to project construction. The best management practices will be used to minimize and control sedimentation and erosion on this project. The construction foreman will review all erosion control`mea'sure daily to' ; ensure sedimentation and erosion is being effectively controlled. If the planned devices"are not functioning as intended, they will be immediately replaced with better devices. Impacts to Waters of the United States In order to construct the project in accordance with our current Bridge Maintenance standards, it will be necessary to impact waters of the United States in the Little Tennessee River Basin. Specifically, NCDOT is requesting to widen Jackson County Bridge No. 208. Listed below is a summary of the proposed impacts. Site No. Station Existing Condition Proposed Condition Net Impacts Site 1 West - Existing 35 L.F. (175 sq. ft.) Existing End Structure Bent Removal And Replacement Site 2 East - Existing Existing 35 L.F. (175 sq. ft.) End Bent Structure Removal. And Replacement Total =70 L.F Temp 0 L.F. Permanent Permits Requested NCDOT is hereby requesting authorization under Section 404 of the Clean Water Act to proceed with the construction project outlined above. By copy of this letter, I am asking the North Carolina Wildlife Resources Commission (NCWRC) to comment directly to you concerning the 404 Nationwide Permit request. Also by copy of this letter, I am requesting authorization to proceed under Section 401 of the Clean Water Act from Division of Water Quality. In addition, I am asking the Mr. David McHenry (NCWRC) and Mr. Ed Ingle, (NCDOT) to comment directly to me concerning this permit request. Whittier Bridge Maintenance, 178 Henry Bird Rd, Whittier, NC 28789Telephone(828)497-7953 Fax(828)497-6544 T d 9 R+s1" If you have any questions or need additional information, please contact me at (828) 497-7953. Your early review-and consideration will be greatly appreciated. Sincerely, B.T. Williams, PE Division 14 Bridge Maintenance Engineer cc: Mr. John Hennessy, DWQ, DENR Raleigh (seven copies) Mr. Mike Parker, DWQ, DENR, Asheville Mr. David McHenry, Mountain Region Coordinator, NCWRC, Waynesville Ms. Marella Buncick, NCDOT Coordinator, USF&WS, Asheville Mr. Mike Goodson, Acting Regional Engineer, LQS, DENR, Asheville Mr. Joel Setzer, P.E., Division Engineer, NCDOT, Sylva Mr. Mark Davis, Division Environmental Officer, NCDOT Mr. E. L. Ingle, Roadside Environmental Field Operations Engineer, NCDOT Whittier Bridge Maintenance, 178 Henry Bird Rd, Whittier, NC 28789Telephone(828)497-7953 Fax(828)497-6544 Office Use Only: 2 o O 5 1 436 Form Version May 2002 USACE Action ID No. DWQ No. kir any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".) 1. Processing 1. Check all of the approval(s) requested for this project: ® Section 404 Permit ? Riparian or Watershed Buffer Rules ? Section 10 Permit ? Isolated Wetland Permit from DWQ N 401 Water Quality Certification 2. Nationwide, Regional or General Permit Number(s) Requested: GP 31 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 (verify availability with NCEEP prior to submittal of PCN), complete section VIII and check here: N 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: North Carolina Department of Transportation Mailing Address: 178 Henry Bird Rd. _Whittier, NC 28789 Attn. Ben Williams Division Bridge ngineer Telephone Number: (828) 497-7953 Fax Number: (828) 497-6095 E-mail Address:_ btwilliams(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: NA Company Affiliation: NA Mailing Address: NA Telephone Number: NA E-mail Address: NA Fax Number: NA Page 1 of 8 III. Project Information Attach a vicinity map clearly showing the location of the property with respect to local landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property boundaries and development plans in relation to surrounding properties. Both the vicinity map and site plan must include a scale and north arrow. The specific footprints of all buildings, impervious surfaces, or other facilities must be included. If possible, the maps and plans should include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion, so long as the property is clearly defined. For administrative and distribution purposes, the USACE requires information to be submitted on sheets no larger than 11 by 17-inch format; however, DWQ may accept paperwork of any size. DWQ prefers full-size construction drawings rather than a sequential sheet version of the full-size plans. If full-size plans are reduced to a small scale such that the final version is illegible, the applicant will be informed that the project has been placed on hold until decipherable maps are provided. 1. Name of project: Bridge # 208 over Little Pine Creek on SR 1160 in Jackson County 2. T.I.P. Project Number or State Project Number (NCDOT Only): WBS # 14B.205011 3. Property Identification Number (Tax PIN): NA 4. Location County: Jackson Nearest Town: Glenville, NC Subdivision name (include phase/lot number): NA Directions to site (include road numbers, landmarks, etc.): From Cashiers NC, follow NC 107 North towards Sylva, NC for approx. 6.0 miles to with SR 1157 on the left. Turn left and follow for approx. 3.3 miles to SR 1160. Turn and follow 0.2 miles to Jackson Co. Bridge 208. 5. Site coordinates, if available (UTM or Lat/Long): 35.19041660 N 83.1843055° W (Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the coordinates for each crossing of a distinct waterbody.) 6. Property size (acres): 7. Nearest body of water (stream/river/sound/ocean/lake): Little Pine Creek (WS-III) 8. River Basin: Little Tennessee (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 residential with surrounding forest and agriculture land Page 2 of 8 10. Describe the overall project in detail, including the type of equipment to be used: Replace existing 15' single span timber bridge. New bridge will be a single span timber joist and abutment structure approx. 20' in length. New footings will be constructed of concrete. Traffic will be detoured during construction. 11. Explain the purpose of the proposed work: Repair Jackson bridge 208. 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. NA 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. NA 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. The applicant must also provide justification for these impacts in Section VII below. All proposed impacts, permanent and temporary, must be listed herein, and must be clearly identifiable on an accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a delineation map, whether or not impacts are proposed to these systems. Wetland and stream evaluation and delineation forms should be included as appropriate. Photographs may be included at the applicant's discretion. If this proposed impact is strictly for wetland or stream mitigation, list and describe the impact in Section VIII below. If additional space is needed for listing or description, please attach a separate sheet. Page 3 of 8 1. Provide a written description of the proposed impacts: There will be no new impacts to the site. 2. Individually list wetland impacts below: Wetland Impact Site Number (indicate on ma) Type of Impact* Area of Impact (acres) Located within 100-year Floodplain** (yes/no) Distance to Nearest Stream (linear feet) Type of Wetland*** NA NA NA NA NA NA * List each impact separately and identify temporary impacts. 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. ** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps (FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or online athitp://www.fema.g . *** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond, Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only). List the total acreage (estimated) of all existing wetlands on the property: NA Total area of wetland impact proposed: NA 3. Individually list all intermittent and perennial stream impacts below: Stream Impact Site Number indicate on ma Type of Impact* Length of Impact (linear feet) Stream Name** Average Width of Stream Before Im act Perennial or Intermittent? lease specify) Existing Site 1 structure 35 L.F. Little Pine Creek 6' P removal and Temp. replacement Existing Site 2 structure 35 LX Little Pine Creek 6' P removal and Temp. replacement * List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap, dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain), stabilization activities (cement wall, rip-rap, crib wall, 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. ** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at www.usgs.eov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.tgpozone.com, www.mgpguest.com, etc.). Page 4 of 8 Cumulative impacts (linear distance in feet) to all streams on site: Temp: 70 LIT O' Permanent Impacts. 4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic Ocean and any other water of the U.S.) below: Open Water Impact Site Number (indicate on map) Type of Impact* Area of Impact (acres) (if Name p Waterbody applicable) Type of Waterbody (lake, pond, estuary, sound, bay, ocean, etc.) NA NA NA NA NA i tst each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging, flooding, drainage, bulkheads, etc. 5. 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.): NA Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond, local stormwater requirement, etc.): NA Size of watershed draining to pond: NA Expected pond surface area: NA 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. Sandbag cofferdams will be used to temporarily divert the channel and provide a dry working environment. Concrete will not be allowed into live water during construction VIII. Mitigation DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC Division of Water Quality for projects involving greater than or equal to one acre of impacts to Page 5 of 8 freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial streams. USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide Permits, published in the Federal Register on March 9, 2000, 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 hitp://h2o.enr.state.nc.us/ncwetlands/stnngide.html. 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. NA 2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at (919) 715-0476 to determine availability and to request written approval of mitigation prior to submittal of a PCN. For additional information regarding the application process for the NCEEP, check the NCEEP website at http://www.nceo.net. If use of the NCEEP is proposed, please check the appropriate box on page three and provide the following information: Amount of stream mitigation requested (linear feet): 0' Amount of buffer mitigation requested (square feet): NA Amount of Riparian wetland mitigation requested (acres): NA Amount of Non-riparian wetland mitigation requested (acres): NA Amount of Coastal wetland mitigation requested (acres): NA Page 6 of 8 IX. Environmental Documentation (required by DWQ) Does the project involve an expenditure of public (federal/state) funds or the use of public (federal/state) land? Yes ® No ? 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 (919) 733-5083 to review current thresholds for environmental documentation. Yes ? No 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 2B .0233 (Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please identify )? Yes ? No ® If you answered "yes", provide the following information: Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer mitigation is required calculate the required amount of mitigation by applying the buffer multipliers. Zone* Impact (square feet) Multiplier Required Mitigation 1 3 2 1.5 Total cone i extenas out 3u teet perpenatcular trom near bank of channel; Zone 2 extends an additional 20 feet from the edge of Zone 1. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or Payment Page 7 of 8 into the Riparian Buffer Restoration Fund). Please attach all appropriate information as identified within 15A NCAC 2B .0242 or .0260. XI. Stormwater (required by DWQ) Describe impervious acreage (both 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. The best management practices will be used to minimize and control sedimentation and erosion on this project. The construction foreman will review all erosion control measures daily to ensure sedimentation and erosion is being effectively controlled. If the planned devices are not functioning as intended, they will be immediately Mlaced with better devices. 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. No wastewater will be generated from theproject. 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. 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). NA _/3 gFiy' j re _//ms 65r 7 4,/0 --'5- Applicant/Agent's Signature Date (Agent's signature is valid only if an authorization letter from the applicant is provided.) Page 8 of 8 STATE OF NORTH CAROLINA &0649 Zoe PR ME ? ??I Q F SUBJECT PROJECT I PL + + DEPARTMENT OF TRANSPORTATION pL/V _ / lJ/ &,0,rAl?L ?j}ekS?lll DIVISION OF HIGHWAYS COUNTY , HIGHWAY BUILDING ,?? PREPARED BY GIA?? DATE STATION P. 0. BOX 25201 L RALEIGH. NORTH CAROLINA 27611 CHECKED BY DAVE STR NO SHEET OF.? iO-V ) STATE OF NORTH CAROLINA SUBJECT PROJECT 17 R1DC7-' REP i?lkf1 DEPARTMENT OF TRANSPORTATION ?L C,S l? p< z& <b J x /` DIVISION OF HIGHWAYS '1-1 -64 - COUNTY HIGHWAY BUILDING PREPARED BY 41)14K 1, DATE STATION P. O. BOX 25201 NO SHEET OF RALEIGH. NORTH CAROLINA 27611 CHECKED BY DATE STR I ; I I i SO-O 1 DONNN,STREAM RRInc-F 1-40-Iffm JACKSON 12-1.1-03 0 ? i I t P ? 1 E ? i ;08$ 11 ? OEQO? ?( F P r I f 4 ?. ? ? I ! 10 °F1?'? OcQO; ?V? f E 83° 0?" ? : ? X08 °}09'? QQO'< F ? 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