20051439 Ver 1_Complete File_20050802

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STATE OF NORTH CAROLINA
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DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GOVERNOR
August 1, 2005
U.S. Army Corps of Engineers
Raleigh Regulatory Field Office
6508 Falls of the Neuse Road, Suite 120
Raleigh, NC 27609
Attentibn: Mr. Eric Alsmeyer
NCDOT Coordinator
X51439
LYNDO TIPPETT
SECRETARY
Subject: Proposed maintenance improvements to structure conveying Basal Creek
and to a second structure conveying an unnamed tributary to Utley Creek
on SR 1115 Avent Ferry Road in Wake County.
The North Carolina Department of Transportation (NCDOT) proposes to replace pipes
conveying Basal Creek and an unnamed tributary to Utley Creek on SR 1115 Avent Ferry
Road in Wake County (Figure 1 - 4). Information concerning this activity is provided
below:
Impacts to Waters of the United States
Site 1 - Waters of the U.S.
Maintenance activities at this site will impact an intermittent stream, Basal Creek,
[NCDENR-DWQ Index No. 27-43-15-3, Best Usage Classification B NSW, HUC 03020201]
(Figure 3) in the Neuse River Basin. The existing structure conveying the creek is an 18-inch
reinforced concrete pipe that is 40 feet long (Photograph 1). The NCDOT proposes to replace
the existing structure with an 18-inch corrugated aluminum pipe that is 40 feet long. The
NCDOT proposes to temporarily dewater the work zone during the construction of the
project. This will involve the temporary placement of sandbags in the creek 5 ft downstream
of construction. Once the stream has been dewatered, the pipe will be replaced. Permanent
impacts at the site associated with the replacement of the structure at the same length and
minimal amounts of rip rap to protect the structure involve a total of 5 linear feet (no surface
water fill and 5 ft of rip rap). The work zone will be dewatered for approximately 3 days.
Temporary concurrent impacts to the stream from this activity will result in the dewatering of
5 linear feet of stream. The sandbags used for dewatering will be removed after construction.
Fill in wetlands is also anticipated at this site. The placement of rip rap along the outlet of the
new structure will result in 12 ft'- (0.0003 ac) of fill in a fringe wetland along this stream.
(See Appendix One for USACE Wetland Delineation forms/DWQ rating sheets).
Division 5, 2612 N. Duke Street, Durham, NC 27704
Phone: [phone] Fax: [phone]
rte 2 - Waters of the U.S.
Maintenance activities at this site will impact an unnamed intermittent tributary Utley Creek
[NCDENR-DWQ Index No. 18-7-5.5, Best Usage Classification C, HUC 03030004] (Figure
4) in the Neuse River Basin. The existing structure conveying the creek is an 18-inch
reinforced concrete pipe that is 55 feet long (Photograph 2). The NCDOT proposes to replace
the existing structure with an 18-inch corrugated aluminum pipe that is 55 feet long. The
NCDOT proposes to temporarily dewater the work zone during the construction of the
project. This will involve the temporary placement of sandbags in the creek 5 ft downstream
of construction. Once the stream has been dewatered, the pipe will be replaced. Permanent
impacts at the site associated with the replacement of the structure at the same length and
minimal amounts of rip rap to protect the structure involve a total of 5 linear feet (no surface
water fill and 5 ft of rip rap). The work zone will be dewatered for approximately 3 days.
Temporary concurrent impacts to the stream from this activity will result in the dewatering of
5 linear feet of stream. The.sandbags`used for ?d " atering will be removed after construction.
Riparian Buffer
Site 1 - Buffers
The maintenance at this site involves a road crossing of a stream that is subject to the
Neuse River Buffer Rules. Basal Creek, at Site 1 is depicted on the most recent version of
the Apex (USGS 1974/1988) topographic quadrangle (Figure 1) and the Soil Survey of
Wake County (USDA-SCS, 1970) (Figure 2). Construction impacts at this site total 612
ft2 in Zone 1 and 0 ft2 in Zone 2 (totaling 5 linear feet of riparian buffer impacts). Based
on the impacts to the riparian buffer at this site, this crossing is EXEMPT.
Site 2 -.Buffers
The maintenance at this site involves a road crossing of a stream that is not subject to the
Neuse River Buffer Rules. This UT to Utley Creek, at Site 2 is not depicted on the most
recent version of the Apex (USGS 1974/1988) topographic quadrangle (Figure 1) nor the
Soil Survey of Wake County (USDA-SCS, 1970) (Figure 2). Construction at this site will
not result in impacts to protected riparian buffers.
Waters of the U.S. Mitigation
Avoidance: All wetlands and surface waters not affected by the project will be protected
from unnecessary encroachment. No staging of construction equipment or storage of
construction supplies will be allowed in wetlands or near surface waters.
Minimization: The side slopes have been steepened to the extent possible at jurisdictional
sites. Strict enforcement of sedimentation and erosion control Best Management Practices
for the protection of wetlands and surface waters will be enforced during project
construction. Continued coordination will occur with maintenance forces and the
Environmental Officer during construction to minimize impacts to these sites.
Compensatory Mitigation: Unavoidable impacts to 0.0003 acre of non-riverine wetlands
will be mitigated (at a 1:1 ratio) by providing 0.0003 acre of restoration equivalent non-
riverine wetlands within the same river basin and cataloging unit. All compensatory
mitigation requirements will be assimilated on a quarterly basis and provided to the
Ecosystem Enhancement Program (EEP) for their acceptance with a copy provided to the
USACE for verification and accounting purposes.
•
3
Protected Species ,
Plants and animals with federal classifications of Endangered, Threatened, Proposed
Endangered, and Proposed Threatened are protected under provisions of Section 7 and
Section 9 of the ESA. As of January 29, 2003, there are four federally protected species
listed for Wake County. They include bald eagle (Haliaeetus leucocephalus),
red-cockaded woodpecker (Picoides borealis), dwarf wedgemussel (Alasmidonta
heterdon), and Michaux's sumac (Rhus michauxii). SR 1115 is not adjacent to nor is it
surrounded by open water suitable of supporting foraging habitat for the bald eagle. The
dense stands of mixed hardwood surrounding this roadway do not offer suitable forging
or nesting habitat for red-cockaded woodpecker. Since these stream crossings are within
the headwaters of this drainage way and are associated with small streams with multiple
pipes segments within the project vicinities, Basal Creek and the UT to Utley Creek do
not provide suitable habitat for mussel fauna. Additionally, the roadway shoulders along
SR 1115 are heavily maintained from the pavement to the woods line, eliminating the
possibility for Michaux's sumac to exist in these areas. Therefore, based on lack of
suitable habitat observed during the 11/08/04 site visit, biological conclusions of No
Effect have been rendered for each species.
Summary
The NCDOT proposes to replace the existing concrete structures, at each site, with
aluminum structures of the same size and length. The NCDOT proposes to temporarily
dewater the work zones during the construction of the project. This will involve the
temporary use of sandbags. Once the streams have been dewatered, the pipes will be
replaced. Permanent impacts at to streams at each site total 5 linear feet for rip rap
armoring only. No surface water fill is proposed at either site. Fill in wetlands is
anticipated at Site 1. The placement of rip rap along the outlet of the new structure will
result in 12 ft2 (0.0003 ac) of fill in a fringe wetland along this stream. (See Appendix
One for USACE Wetland Delineation forms/DWQ rating sheets). Construction impacts
at Site 1 total 612 ft'- in Zone 1 and 0 ft2 in Zone 2 (totaling 5 linear feet of riparian buffer
impacts). Based on the impacts to the riparian buffer at Site 1, this crossing is EXEMPT.
No protected riparian buffer impacts will result from construction at Site 2. Construction
at Site 2 will not result in impacts to protected riparian buffers.
Application is hereby made for a Department of the Army Section 404 Nationwide
Permit (NWP) 3 and NWP 33. Additionally, this application provides notification to the
NCDWQ as Section 401 Water Quality Certification (WQC) No. 3376 and No. 3366
will be utilized for construction of this project. The NCDOT will comply with all
applicable NWP and WQC conditions. A pre-construction notification is attached with
this request. If you have any questions or need additional information, please contact
Ms. Heather Montague at [phone].
YG re
. Nance, P. .
Division Engineer
cc: Ms. Nicole Thomson, NCDWQ Mr. Brandon Jones, NCDOT
Mr. Chris McGee, NCDOT Ms. Katie Simmons, NCDOT

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Photograph 1. View of maintenance problem above pipe at Site 1.
Photograph 2. View of maintenance problem above pipe at Site 2.
SR 1115 (Avent Ferry Road) - Wake County
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Office Use Only: Form Version March 05
2805'i 438
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ® Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: 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: NCDOT Division 5 Jon G. Nance
Mailing Address: 2612 N. Duke St. Durham NC 27704
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page 1 of 9
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: Proposed replacement of structures conve ijng Basal Creek and an
unnamed tributary to Utley Creek on SR 1115 (Avent Ferry Road) in Wake County.
2. T.I.P. Project Number or State Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Wake Nearest Town: Holly Springs
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers/names, landmarks, etc.): From Holly Springs
take SR 1115 (Avent Ferry Road) south out of town to Sites 1 and 2 Site 2 is approximately
1400 feet south of the intersection of SR 1115 and Hwy 55 Site 1 is farther south on
SR 1115 (approximately 670 ft south of the intersection with SR 1101) at the Holly Springs
Fire Station.
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):
Site 1: 35.6381 ON 78.84496 11W
Site 2: 35.6479 ON 78.8353 °W
6. Property size (acres): 0.1 acre at each site
7. Name of nearest receiving body of water:- Basal Creek (Site 1) and UT to Utley Crk (Site 2)
8. River Basin: Neuse
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
Page 2 of 9
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Sites are surrounded by wooded areas agricultural land
residences, and businesses.
10. Describe the overall project in detail, including the type of equipment to be used: The
NCDOT will replace the existing structures. The NCDOT will also dewater the work zones
during construction. Equipment may include excavator, backhoe bulldozer, grader, and
crane.
11. Explain the purpose of the proposed work: The existing structures are concrete pipes which
have separated joints. These separations have resulted in the repeat loss of material from the
roadway causing the pavement to sink and break apart. Frequent maintenance is needed to
repair the roadway and the broken pavement.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules. N/A
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
N/A
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
Page 3 of 9
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description of the proposed impacts: The NCDOT will replace the
existing structures at Site 1 and Site 2 with aluminum pipes The NCDOT will also dewater
the work zone during construction
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

Floodplain
( es/no) Distance to
Nearest

Stream
(linear feet) Area of
Impact

(acres)
Site 1 Fill herbaceous No NONE 0.0003

Total Wetland Impact (acres) 0.0003
3. List the total acreage (estimated) of all existing wetlands on the property: 0.0003 ae
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 lenuth x width then divine h-11 r%A )

Stream Impact Average Impact Area of
Number Stream Name Type of Impact Perennial or Stream Width Length Impact
(indicate on map) Intermittent? Before Impact (linear (acres)
feet)
Site 1 Basal Crk Fill (piped length) Intermittent 3 0 0
Rip rap armoring

along stream bank 5 0.0003
Temporary 5 0.0003
dewatering concurrent concurrent
Site 2 UT to Utley Crk Fill (piped length) Intermittent 2 0 0
Rip rap armoring

along stream bank 5 0.0002
Temporary 5 0.0002
dewatering concurrent concurrent
Total Stream Impact (by length and acreage) 10 0.0005
Page 4 of 9
5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact
Site Number
(indicate on ma) Name of Waterbody

(if applicable)
Type of Impact Type of Waterbody
(lake, pond, estuary, sound, bay,
ocean, etc.) Area of
Impact
(acres)
N/A

Total Open Water Impact (acres) N/A
6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): 0.0005
Wetland Impact (acres): 0.0003
Open Water Impact (acres): NONE
Total Impact to Waters of the U.S. (acres) 0.0008
Total Stream Impact (linear feet): 10
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.
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
Page 5 of 9
techniques to be followed during construction to reduce impacts. All wetlands and surface
waters not affected by construction will be protected from unnecessary encroachment during
construction. Strict enforcement of Best Management Practices for the protection of wetlands
and surface waters will be enforced during construction. Onlv the smallest amount of fill
necessary to complete the project will be placed in waters of the United States.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15, 2002, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation 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.
NCDOT proposes to meet mitigation requirements by payment into the North Carolina
Ecosystem Enhancement Program (NCEEP). Compensatory mitigation requirements will be
assimilated on a quarterly basis and provided to the EEP for their acceptance with a copy
provided to the USACE for verification and accounting pMoses.
Page 6 of 9
2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): 0.0003 acre
Amount of Non-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
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
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 2B .0233
(Neuse), 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 )? 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.
Page 7 of 9.
Site 1
Zone* Impact
(square feet Multiplier Required
Mitigation
1 612 3 (2 for Catawba)
2 0 1.5
Total 612
T Lone i extends out .5U teet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Site 2
Zone* Impact
(square feet) Multiplier Required
Mitigation
1 0 3 (2 for Catawba)
2 0 1.5
Total 0
* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260. N/A
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. There is 0.04 acre existing impervious surface
with the 0.1 acre protect area at each site. No additional impervious surface is proposed with
these maintenance pipe replacement projects. Erosion and sediment control devices at these sites
are comprised of temporary silt fence and special stilling basin (silt bag)
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
This project will not generate wastewater.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Page 8 of 9
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 maintenance project will not result in additional development
XV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).

9//
1
Alipli(ant/Agent's Signature ' Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9
Appendix One
(USAGE Wetland Delineation forms/
DWQ rating sheets)
DATA FORM Ste. !` ,? -CGxd'
ROUTINE WETLAND DETERMINATION ,
(1987 COE Wetlands Determination Manual)
Project / Site: 1115 4,le a ?- Fr r / ; Z4) Date: 1 k o L
Applicant / Owner:_ N'C. ? -?T 7) ?? ?a r ?. Pl,s^c = County: a ke
Investigator: Heashcr /n b„ a t. State: /.C
Do normal circumstances exist on the site? Yes `?No Community ID:
Is the site significantly disturbed (Atypical situation)? Yes No Transect ID:
Is the area a potential problem area? Yes No Plot ID:
(explain on reverse if needed)
VEGETATION
Dominant Plant Species Stratum ; indicator Dominant Plant Species Stratum ' Indicator
1. a r c'va, J N f/ 03(_ ; 9.
2. 10.

4.,y?nv,sr Z"PC'L? 12.
5. J 13.
.6. - 14.......,
7. 15.
8. 16.
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-). f!?/I-
Remarks: Wetland Vegetation Present Based Upon Greater than 50% of the Plant Species arelare not
Classified as FAC-OBL in the National List of Plant Species that Occur in Wetlands. Sample plot was taken...

HYDROLOGY:. .
- Recorded Data (Describe in Remarks): Wetland Hydrology Indicators
_ Stream, Lake, or Tide Gauge
_ Aerial Photographs Primary Indicators:
_ Other _)nundated
Saturated in Upper 12"
No Recorded Data Available _ Water Marks
_ Drift Lines
Field Observations: - Sediment Deposits
_ Drainage Patterns In Wetlands
Depth of Surface Water: "' ^? (•) Secondary Indicators:
l? Oxidized Roots Channels in Upper 12"
De th to Free Water in Pit:
(in.)
p _ Water-Stained Leaves
_ Local Soil Survey Data -
Depth to Saturated Soil: (in.) _ FAC-Neutral Test
_ Other (Explain in Remarks)
Remarks:.

s ?6 / Xh-
Project Name rfrih Nearest Road
jaunty LL'uk2 Wetland Area 0 Io?3 ages Wetland Width /O feet
Name of evaluator ifca e? IYl?•.?u NCia1- -Div S Date
Wetland Location
on pond or lake
on perennial stream
=on intermittent stream
within interstream divide
Adjacent land use
(within 1/2 mile upstream, ups-lope, or radius)
'r forested/tiatural vegetation is %
'agriculture, urban/suburban g2 %
impervious surface 5 %
other
Soil series
predominantly organic - humus, muck,
or peat -
predominantly mineral - non-sandy
?predominantly sandy .
Hydraulic factors
steep topo M 3ph1
ditched or channelized
total wetland width ? 100 feet
Dominant vegetation
(2)
3 _ US
Flooding and wetness
semipermanently to permanently
flooded or inundated
seasonally flooded or immdated
P""intermittanly flooded or temporary
surface water
no evidence of floodin¢ or surface water
Wetland type (select one)*
Bottomland hardwood forest Pine savanna
Headwater forest Freshwater marsh
Swamp forest Bog/fen
Wet flat Ephemeral wetland
Pocosin Carolina Bay
Bog forest - ?Other
*the rating system cannot be ap
_2lied to salt or brackish marshes or stream channels
weight
R Water storage f x 4.00 = Wetland
A Bank/Shoreline stabilization 2- x 4.00 Rating

T
Pollutant removal

1 * x

5.00 .$ ria::.•'v`i ,v,\' .fie`..
Wildlife habitat 1 x 2
00
N Aouatic life value 1 x .
4.00
G Recreation/Education x 1.00 =
*Add 1 point if in sensitive watershed and >10% nonpoint disturbance within 112 mile upstream,
upslo?e_ or radius

DATA FORM
ROUTINE WETLAND, DETERMINATION
(1987 COE Wetlands Determination Manual)
s1 I 1 l C
Project / Site: 12 11r5 'vp' k -, ,+ RJ Date: P
Applicant / Owner: C. Po ?r v G. c ^ County: A'
Investigator: 7;1171, State: /I C,
Do normal circumstances exist on the site? Yes "No
- Community ID:
Is the site significantly disturbed (Atypical situation)? Yes No
?
- Transect ID:
Is the area a potential problem area? Yes No
= Plot ID:
(explain on reverse if needed) - -
s VEGETATION
Dominar tPlant Species ` :..Stratum Indic r Dominant Plant species Stratum Indicator
ve. 9.
2..?? ...r.P ?" r11C 10.
3.` :.t6ccharrs `h-il)m:i'. ?n? Shr F C 11.
4. ?u?,:w r;,•t ''N SAC F 12.
5. 13.
6.: :.. 14. ...., ;. .
7. 15.
8. 16.
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-).
Remarks: Wetland Vegetation Present Based Upon Greater than 50% of the Plant Species arelare not
Classified as FAC-OBL in the National List of Plant Species that Occur in Wetlands. Sample plot was taken...

HYDROLOGY-,
_ Recorded Data (Describe In Remarks): Wetland Hydrology Indicators
- Stream, Lake, or Tide Gauge
_ Aerial Photographs Primary Indicators:
_ Other _ Inundated
_Saturated in Upper 12"
No Recorded Data Available . Water Marks
Drift Lines
Field Observations: _ Sediment Deposits
- Drainage Patterns in Wetlands
Depth of Surface Water: (?•) Secondary Indicators:
Oxidized Roots Channels in Upper 12"
Depth to Free Water in Pit: /?• _ Water-Stained Leaves
_ Local Soil Survey Data
Depth to Saturated Soil: 0n.j _ FAC-Neutral Test ..
- Other (Explain in Remarks)
Remarks:

N. C. DEPARTMENT OF TRANSPORTATION
TRANSMITTAL SLIP DATE
( O
TO:
b
l REF. NO. OR OOM, BLDG.
erg
w .
(
FROM:
1-7
/J REF. NO. OR ROOM, BLDG.
M
CTION
? NOTE AND FILE ? PER OUR CONVERSATION
? NOTE AND RETURN TO ME ? PER YOUR REQUEST
? RETURN WITH MORE DETAILS ? FOR YOUR APPROVAL
? NOTE AND SEE ME ABOUT THIS ? FOR YOUR INFORMATION
? PLEASE ANSWER ? FOR YOUR COMMENTS
? PREPARE REPLY FOR MY SIGNATURE ? SIGNATURE
? TAKE APPROPRIATE ACTION ? INVESTIGATE AND REPORT
COMMENTS:
?V W???/? l/??v'WYY(/?llX •v??'H?V?

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