55249_NC DOT_20101019

CCAMA / ❑ DREDGE & FILL
GENERAL, PERMIT
New ❑Modification []Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
101,3nVo lu .6
Previous permit #
Date previous permit issued
Q Rules attached.
Applicant Name / v Project Location: County
Address / 1 J ' ��i�' , I Street Address/ State Road/ Lot #(s)
CiState ZIP ''' ?:)
Phone # O ' f j( Fax # ( ) Subdivision
Authorized Agent City ZIP
Affected E3'CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn�
❑ PWS: ❑ FC:
ORW: yes /` no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platfo
Finger
Groin
Bulkh
Basin,
Boat i
Boath
Beacl-
Other
Shorel
SAV:
Sandb
Morat
Photo
Waive
(Scale: )
pier(s)
length - ..
i
—
L
—
---j
--
-
I
�
lumber
,ad/ Riprap length
vg distance offshore
nax distance offshore —
channel -
ubic yards
amP - -'-
)use/ Boatlift - -
Bulldozing -
ine Length
not sure yes ho
•: _—
�+
q
— --
-
-
-
---
{
—t-
I
i
IT
ags: not sure yes no
orium: n/a yes-
s: yes no —
r Attached: yes
_
- —
—--
—
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions 4-
J✓ '
y _
Agent or Applicant Printe, ame Permit0fficer's Signature
Signature Please read compl statement on back of permit" Issuing Date Expiration Date
Application Fee(s) Check# Local Plan ningJurisdiction Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax: [phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

•
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Applicant:
Date:
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
I
Dredge ❑ Fill [Er-B—oth ❑ Other ❑
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6
d W�
Dredge ❑ Fill ©' Both ❑ Other ❑
I`
Dredge ❑ Fill ❑ Both Other ❑
d v
�O
�
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
r,..... ..._ ..... . ........ __...._ .
_" _... .._�._................... tom.

j /oo 6 (-7A /\ y r
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'� Nun �•
STATE OF NORTH CAROLINA
CQ/j 14'332_97-,-
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
October 5, 20010
John Cece
Division of Coastal Management
1367 U.S. 17 South
Elizabeth City, NC 27909
Dear Mr. Cece,
EUGENE A. CONTI, JR.
SECRETARY
RLE: CEIVED
OCT - 5 20i0
COASTAL MANAGEMENT
ELIZABETH CITY
This letter is requesting a general permit .2300 be issued for a pipe replacement on SR 1213 Herbert
Perry Rd in Dare County. The current pipe is failing and needs to be replaced to ensure safe public travel.
The existing pipe (1 @ 40' x 42" CMP) will be replaced with the proposed pipes (1 @ 40' x 48" CAP).
The road shoulder at the inlet and outlet of the pipe will be stabilized with rip -rap. The Division of Coastal
Management considers the project area to be within an AEC that requires authorization for the pipe
replacement. Included with this request are the MP-1, MP-2, MP-5 forms, location map, landowner notices,
and permit drawings depicting the proposed work. The WBS element # is 1.202811. If any additional
information is needed please contact Clay Willis at 252-482-7977.
Sincerely,
Jerry Jennings, P.E.
Division Engineer, Division One
Clay Willis
Environmental Officer, Division One
113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

i
I
i
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Information
Business Name
N.C. Department Of Transportation
Project Name (if applicable)
SR 1213 Herbert Perry Rd Pipe Replacement
Applicant 1: First Name
Clay
MI
Last Name
Willis
Applicant 2: First Name
MI
Last Name
If additional applicants, please attach an additional page(s) with names listed.
Mailing Address
113 Airport Road, Suite 100
PO Box
City
Edenton
State
NC
ZIP
27932
Country
Phone No.
252 - 482 -
7977 ext.
FAX No.
252 - 482 - 8722
Street Address (if different from above)
City
State
ZIP
Email
2. Agent/Contractor Information
Business Name
Agent/ Contractor 1: First Name
MI
Last Name
Agent/ Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box
City
State
ZIP
Phone No. 1
-
- ext.
Phone No. 2
- - ext.
FAX No.
Contractor #
Street Address (if different from above)
City
State
ZIP
Email
<Form continues on back>
252-808-2808 .. 1-888-4 COAST .. www.nccoastalmanagement.net

corm DCM MP-1 (Page 2 of 5)
APPLICATION for
Major Development Permit
3. Project Location
County (can be multiple)
Street Address
State Rd. #
Dare
SR 1213, 0.3 miles from SR 1206
SR 1213
Subdivision Name
City
State
Zip
Kitty Hawk
NC
27949 -
Phone No.
Lot No.(s) (if many, attach additional page with list)
- - ext.
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
Pasquotank
UT to Kitty Hawk Bay
c. Is the water body identified in (b) above, natural or manmade?
d. Name the closest major water body to the proposed project site.
®Natural ❑Manmade ❑Unknown
Stumpy Point Bay
e. Is proposed work within city limits or planning jurisdiction?
f. If applicable, list the planning jurisdiction or city limit the proposed
❑Yes ®No
work falls within.
n/a
4.
Site Description
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
12'
2400
c.
Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
NWL (normal water level)
(If many lot sizes, please attach additional page with a list)
2 ❑NHW or ®NWL
e.
Vegetation on tract
Various roadside grasses on a maintained shoulder, sawgrass, & cattail.
f.
Man-made features and uses now on tract
SR 1213
g.
Identify and describe the existing land uses adjacent to the proposed project site.
Residential and coastal marsh.
h.
How does local government zone the tract?
I. Is the proposed project consistent with the applicable zoning?
N/A
(Attach zoning compliance certificate, if applicable)
DYes ❑No ®NA
j.
Is the proposed activity part of an urban waterfront redevelopment proposal? ❑Yes SNo
k.
Hasa professional archaeological assessment been done for the tract? If yes, attach a copy. []Yes ®No NA
If yes, by whom?
I.
Is the proposed project located in a National Registered Historic District or does it involve a []Yes ONo NA
National Register listed or eligible property?
<Form continues on next page>
m. (i) Are there wetlands on the site? OYes ❑No
(ii) Are there coastal wetlands on the site? ®Yes ❑No
(III) If yes to either (i) or (ii) above, has a delineation been conducted? ❑Yes ®No
(Attach documentation, if available)
252-808-2808 .. 1-888-41RCOAST .. wwsw,atccoastalm anagement.net

Form DCM MP-1 (Page 3 of 5)
APPLICATION for
Major Development Permit
n. Describe existing wastewater treatment facilities.
None
o. Describe existing drinking water supply source.
None
p. Describe existing storm water management or treatment systems.
None
5. Activities and Impacts
a.
Will the project be for commercial, public, or private use? []Commercial ®Public/Government
❑Private/Community
b.
Give a brief description of purpose, use, and daily operations of the project when complete.
The purpose of this project is to replace the existing pipe that is structuadly failing on SR 1213.
c.
Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored.
Methods of construction will be concurrent with NCDOT Best Management Practices for the replacement of pipes. A
tracked excavator, backhoe, and dump truck will be used during construction.
d.
List all development activities you propose.
Replace the existing pipe 1 @ 40' x 42" Corrugated Metal Pipe with 1 @ 40' x 48" Corrugated Aluminum Pipe with riprap on
both ends.
e.
Are the proposed activities maintenance of an existing project, new work, or both? Maintenance
f.
What is the approximate total disturbed land area resulting from the proposed project? 240 ®Sq.Ft or ❑Acres
g.
Will the proposed project encroach on any public easement, public accessway or other area ❑Yes ®No ❑NA
that the public has established use of?
h.
Describe location and type of existing and proposed discharges to waters of the state.
Surface runoff from SR 1213.
i.
Will wastewater or stormwater be discharged into a wetland? ❑Yes ®No ❑NA
If yes, will this discharged water be of the same salinity as the receiving water? ❑Yes ❑No ❑NA
j.
Is there any mitigation proposed? Yes ®No ❑NA
If yes, attach a mitigation proposal.
<Form continues on back>
6. Additional Information
In addition to this completed application form, (MP-1) the following items below, if applicable, must be submitted in order for the application
package to be complete. Items (a) — (0 are always applicable to any major development application. Please consult the application
instruction booklet on how to properly prepare the required items below.
a. A project narrative.
b. An accurate, dated work plat (including plan view and cross -sectional drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
252-808-2808 . 1-888-4RGOAsT . www.nccoastalmanagerrx rat=net

'Form DCM MP-1 (Page 4 of 5)
APPLICATION for
Major Development Permit
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e. The appropriate application fee. Check or money order made payable to DENR.
f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name Mildred P. Foreman
Phone No.
R:ECIV:NT
Address 3857 Herbert Perry Rd
Kitty Hawk, NC 27949
O5Name Daphne J. LayPhone No. COAANETH
Address 3863 Herbert Perry Rd
Kitty Hawk, NC 27949
Name
Phone No.
Address
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
h. Signed consultant or agent authorization form, if applicable.
i. Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure
of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
7. Certification and Permission to Enter on Land
I understand that any permit issued in response to this application will allow only the development described in the application.
The project will be subject to the conditions and restrictions contained in the permit.
I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up
monitoring of the project.
I further certify that the information provided in this application is truthful to the best of my knowledge.
Date 941/1" Print Name _Clay Willis, Environmental Officer
Signature W,'l
Please indicate application attachments pertaining to your proposed project.
252-808-2808 ,. t-888-4RCOAST .. ww .nr-coastaImanagernent.net

Form DCM MP-1 (Page 5 of 5)
APPLICATION for
Major Development Permit
®DCM MP-2 Excavation and Fill Information ®DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
pDCM MP-4 Structures Information
25;�-J,8, 2808 .. 1 -8 8-4RCOA xT .. www.nccoastaImanagernent.net

Form DCM MP-2
EXCAVATION and FILL
(Except for bridges and culverts)
RECEIVED
r " T - 5 2010
COASTAL MANAGEMENT
ELIZABETH CITY
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
Describe below the purpose of proposed excavation and/or fill activities. All values should be given in feet.
Access
Other
Channel
(NLW or
Canal
Boat Basin
Boat Ramp
Rock Groin
Rock
Breakwater
(excluding
shoreline
NWL)
stabilization
Length
Width
Avg. Existing
NA
NA
Depth
Final Project
NA
NA
Depth
1.
EXCAVATION
®This section not applicable
a.
Amount of material to be excavated from below NHW or NWL in
b. Type of material to be excavated.
cubic yards.
C.
(i) Does the area to be excavated include coastal wetlands/marsh
d. High -ground excavation in cubic yards.
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
[]CW ❑SAV []SB
OWL ❑None
(ii) Describe the purpose of the excavation in these areas:
2.
DISPOSAL OF EXCAVATED MATERIAL
®This section not applicable
a.
Location of disposal area.
b. Dimensions of disposal area.
c.
(i) Do you claim title to disposal area?
d. (i) Will a disposal area be available for future maintenance?
❑Yes [:]No ❑NA
❑Yes ❑No ❑NA
(ii) If no, attach a letter granting permission from the owner.
(ii) If yes, where?
e.
(i) Does the disposal area include any coastal wetlands/marsh
f. (i) Does the disposal include any area in the water?
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
❑Yes [:]No [:]NA
or other wetlands (WL)? If any boxes are checked, provide the
(ii) If yes, how much water area is affected?
number of square feet affected.
❑CW ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of disposal in these areas:
� � - (38- Y f±3 :; 't-33 t3m # is 3i8 i" :: r v.raccrai ,t irn_ r c c t►et�t,ts t revised. '12126;06

' P -. (Excavation and Fill, Page 2 of 2)
3. SHORELINE STABILIZATION ❑This section not applicable
(If development is a wood groin, use MP-4 — Structures)
a. Type of shoreline stabilization:
❑Bulkhead ERiprap ❑Breakwater/Sill []Other:
C. Average distance waterward of NHW or NWL: 2'
e. Type of stabilization material:
riprap
g. Number of square feet of fill to be placed below water level.
Bulkhead backfill Riprap 32
Breakwater/Sill Other
i. Source of fill material.
b. Lengtn: 24'
Width: 2'
d. Maximum distance waterward of NHW or NWL: 3'
f. (i) Has there been shoreline erosion during preceding 12
months?
❑Yes ®No ❑NA
(ii) If yes, state amount of erosion and source of erosion amount
information.
h. Type of fill material.
riprap
COASTAL MANAGEMENT
ELIZABETH, CITY
4. OTHER FILL ACTIVITIES ®This section not applicable
(Excluding Shoreline Stabilization)
a. (i) Will fill material be brought to the site? ❑Yes ❑No ❑NA b. (i) Will fill material be placed in coastal wetlands/marsh (CW),
If yes,
(ii) Amount of material to be placed in the water
(iii) Dimensions of fill area
(iv) Purpose of fill
submerged aquatic vegetation (SAV), shell bottom (SB), or
other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAv ❑SB
OWL []None
(ii) Describe the purpose of the fill in these areas:
5. GENERAL
a. How will excavated or fill material be kept on site and erosion b. What type of construction equipment will be used (e.g., dragline,
controlled? backhoe, or hydraulic dredge)?
Using NCDOT Best Management Practices for soil and erosion tracked excavator, backhoe, dumptruck
control.
c. (i) Will navigational aids be required as a result of the project?
[]Yes ®No ❑NA
(ii) If yes, explain what type and how they will be implemented.
d. (i) Will wetlands be crossed in transporting equipment to project
site? [-]Yes ®No ❑NA
(ii) If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
9fal�b Clay Willis, Division Environmental Officer
Date / Applicant Name
SR 1213 Herbert Perry Rd pipe replacement f
Applicant Signature
Project Name
1-88-4RCOAST :: www.nccoastalmali , crment.not

Form IN MP-5
BRIDGES and CULVERTS
RECEIVED
GCT - 5 Z010
COASTAL MANAGEMENT
'7"E3LTH CITY
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
1. BRIDGES
a. Is the proposed bridge:
❑Commercial ❑Public/Government ❑Private/Community
C. Type of bridge (construction material):
®This section not applicable
b. Water body to be crossed by bridge:
d. Water depth at the proposed crossing at NLW or NWL:
e. (i) Will proposed bridge replace an existing bridge? ❑Yes ❑No f. (i) Will proposed bridge replace an existing culvert? ❑Yes []No
If yes,
If yes,
(ii) Length of existing bridge:
(ii) Length of existing culvert:
(iii) Width of existing bridge:
(iii) Width of existing culvert:
(iv) Navigation clearance underneath existing bridge:
(iv) Height of the top of the existing culvert above the NHW or
(v) Will all, or a part of, the existing bridge be removed?
NWL:
(Explain)
(v) Will all, or a part of, the existing culvert be removed?
(Explain)
9. Length of proposed bridge:
h. Width of proposed bridge:
i. Will the proposed bridge affect existing water flow? ❑Yes ❑No
j. Will the proposed bridge affect navigation by reducing or
If yes, explain:
increasing the existing navigable opening? ❑Yes []No
If yes, explain:
k• Navigation clearance underneath proposed bridge:
I. Have you contacted the U.S. Coast Guard concerning their
approval? ❑Yes ❑No
If yes, explain:
m. Will the proposed bridge cross wetlands containing no navigable
n. Height of proposed bridge above wetlands:
waters? ❑Yes ❑No
If yes, explain:
2. CULVERTS
El This section not applicable
a. Number of culverts proposed: 1
b. Water body in which the culvert is to be placed:
Unnamed tributary to Kitty Hawk Bay.
< Form continues on back>
c. Type of culvert (construction material):
1 - 40' x 48" Corrugated Aluminum Pipe
ra< c �a a•Ar�ate tea revised. 10!2&0(3�

Form DCM MP-5 (Bridges and Culverts, Page 2 of 4)
d. (i) Will proposed culvert replace an existing bridge?
f.
h
❑Yes ®No
If yes,
(ii) Length of existing bridge:
(iii) Width of existing bridge:
(iv) Navigation clearance underneath existing bridge: _
(v) Will all, or a part of, the existing bridge be removed?
(Explain)
Length of proposed culvert: 40'
Height of the top of the proposed culvert above the NHW or NWL.
1'
Will the proposed culvert affect navigation by reducing or
increasing the existing navigable opening? ❑Yes ®No
If yes, explain:
e. (i) Will proposed culvert replace an existing culvert?
®Yes []No
If yes,
(ii) Length of existing culvert(s): 40'
(iii) Width of existing culvert(s): 42"
(iv) Height of the top of the existing culvert above the NHW or
NWL: 1'
(v) Will all, or a part of, the existing culvert be removed?
(Explain) All
9. Width of proposed culvert: 48"
i. Depth of culvert to be buried below existing bottom contour.
1'
k. Will the proposed culvert affect existing water flow?
®Yes []No
If yes, explain: Enhance hydrologic flow regimes.
3. EXCAVATION and FILL ❑This section not applicable
a. (i) Will the placement of the proposed bridge or culvert require any b. (i) Will the placement of the proposed bridge or culvert require any
excavation below the NHW or NWL? ®Yes ❑No excavation within coastal wetlands/marsh (CW), submerged
If yes, aquatic vegetation (SAV), shell bottom (SB), or other wetlands
(WL)? If any boxes are checked, provide the number of square
(ii) Avg. length of area to be excavated: 40' feet affected.
(iii) Avg. width of area to be excavated: 4' ❑CW ❑SAV ❑SB
(iv) Avg. depth of area to be excavated: 2' ❑WL ®None
(v) Amount of material to be excavated in cubic yards: 11.9
(ii) Describe the purpose of the excavation in these areas:
c. (i) Will the placement of the proposed bridge or culvert require any
high -ground excavation? ®Yes ❑No
If yes,
(ii) Avg. length of area to be excavated: 36'
(iii) Avg. width of area to be excavated: 5'
(iv) Avg. depth of area to be excavated: 2'
(v) Amount of material to be excavated in cubic yards: 13.33
252-808-2808 ;: 1-888-4RCOAST :: vrrrvwmceaastal ana_qement net revised: 10126106

fir P-5 (Bridges and Culverts, Page 3 of 4)
d. If the placement of the bridge or culvert involves any excavation, please complete the following:
(i) Location of the spoil disposal area: NCDOT approved waste area site.
(ii) Dimensions of the spoil disposal area: N/A
(iii) Do you claim title to the disposal area? ®Yes []No (If no, attach a letter granting permission from the owner.)
(iv) Will the disposal area be available for future maintenance? ®Yes ❑No
(v) Does the disposal area include any coastal wetlands/marsh (CW), submerged aquatic vegetation (SAVs), other wetlands (WL), or shell
bottom (SB)?
❑CW ❑SAV OWL ❑SB ®None
If any boxes are checked, give dimensions if different from (ii) above.
(vi) Does the disposal area include any area below the NHW or NWL? ? ❑Yes ®No
If yes, give dimensions if different from (ii) above.
e. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed below NHW or NWL? ®Yes []No
If yes,
(ii) Avg. length of area to be filled: 24
(iii) Avg. width of area to be filled: 22-T
(iv) Purpose of fill: Bank stabiliztion.
g. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed on high -ground? ❑Yes ®No
If yes,
(ii) Avg. length of area to be filled:
(iii) Avg. width of area to be filled:
(iv) Purpose of fill:
4. GENERAL
a. Will the proposed project require the relocation of any existing
utility lines? ❑Yes ®No
If yes, explain:
If this portion of the proposed project has already received
approval from local authorities, please attach a copy of the
approval or certification.
(i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed within coastal wetlands/marsh (CW), submerged
aquatic vegetation (SAV), shell bottom (SB), or other wetlands
(WL)? If any boxes are checked, provide the number of square
feet affected.
®CW 16 ®SAV ❑SB
❑WL ❑None
(ii) Describe the purpose of the excavation in these areas:
16 sq. ft of fill resulting from riprap for bank stabilization
Will the proposed project require the construction of any temporary
detour structures? ❑Yes ®No
If yes, explain:
< Form continues on back>
c. Will the proposed project require any work channels? d. How will excavated or fill material be kept on site and erosion
❑Yes ®No controlled?
If yes, complete Form DCM-MP-2. Using NCDOT best management practices for sediment
and erosion control.
252-808-2808 ;: 1-888-4RCOAST www.ncc_oastalm�nag�rxm�ar�t,net

F
Fot M DCM MP-5 (Bridges and Culverts, Page 4 of 4)
e. What type of construction equipment will be used (for example,
dragline, backhoe, or hydraulic dredge)?
tracked excavator, dumptruck, backhoe
g. Will the placement of the proposed bridge or culvert require any
shoreline stabilization? ®Yes ❑No
If yes, complete form MP-2, Section 3 for Shoreline
Stabilization only.
Date
SR 1213 Herbert Perry Rd Pipe Replacment
Project Name
Clay Willis, Environmental Officer
plicant Name
P
plicant Signature
f. Will wetlands be crossed in transporting equipment to project site?
[]Yes ®No
If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
KEGEI V ED
OCT - 5 20110
COASTAL MANAGEMENT
ELIZABETH CITY
252-808-2808 -. 1-888-4RCOAST :. wwW.nccaastalMgna_gerrrent.net
revised. 10126106

NC DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
COUNTY- DARE COUNTY
QUAD e KITTY HAWK
BASIN. PASQUOTANK
PROJECT.PIPE REPLACEMENT
"S ELEMENT: 1,20281 DRAWN BY. JGC
SCALE P-10 DATE: 0"6-2010
O DEAD END
HERBERT PERRY RD.
SR 1213
MILDRED P. FOREMAN SR
J. LAY
3857 HERBERT PERRY RD. 3863 HERBERT PERRRY RD.
KITTY HAWK, NC 2794947Q2 KITTY HAWK, NC 27949
DB 272 P 854 DB 924 P 887
CANAL
PROPOSED CLASS B
RIP RAP
45.00' C L SIR 1213
PROPOSED PIPE
1 @40'@48"CMP
PROPOSED CLASS B
RIP RAP
MILDRED P. FOREMAN
3857 HERBERT PERRY RD.
KITTY HAWK, NC 279494702
DB 272 P 854
I
I
I
TO SR 1206
I
I
I
EXISTING PIPE 1 @ 40'@42" CM
I
I
RECEIVED
I
I OCT - 5 20110
I
COASTAL MANAGEMENT
ELIZ
DAPHNE J. LAY
3863 HERBERT PERRRY RD.
KITTY HAWK, NC 27949
DB 924 P 887

HERBERT PERRY RD.
SR 1213
NOTE: BOTTOM OF NEW PIPE TO BE PLACED
6" TO 1' BELOW SILT LINE
NOTE: CLASS B STONE TO BE PLACED AROUND END OF PIPES
99.1
100.39
EXISTING PIPE @ 40'@ 42"CMP
DETAIL SECTION -CROSS SECTION
PROPOSED CLASS B
RIP RAP
PROPOSED PIPE 1@40'@48" CMP
CL SR 1213 ELEV. 100.39
LL
100.39 100.42
TOP OF PIPE 99.55
NC DEPARTMENT OF TRANSPORTATION -
DIVISION OF HIGHWAYS
COUNTY: DARE COUNTY
QUAD KITTY HAWK
BASIN z PASQUOTANK
PROJECT Plpg REpL,4CEMENT
WBS ELEMENT. 1.102811 DRAWN BY; IGC
SCALE 11.5' — - DATR- 04-264cio
PROPOSED PIPE 1@40'@48" CMP
NWL 98.57
SILT 97.57
XISTING PIPE @ 40'@ 42"CMP
INVERT ELEV. 96.00
DETAIL SECTION -END VIEW
TOP OF PIPE 99.55
NWL 98.57
I
I
PROPOSED CLASS B
RIP RAP
FINISHED EARTH SLOPE AS REQUIRED
��PROPOSED RIP RAP FOR SHORELINE
� STABLIZATION
C)
CD
D
O
mD
m
D r
C )
W
D
m

Dare County SR 1213 Herbert Perry Rd
pipe replacement, 0.3 miles from SR 1206
RECEIVED
2 -
;` is COASTAL. MANAGEMENT
ELIZABETH UTY
� h
S ,n
_ � 7 S, -' .� `k - t",��• ((° "4. t >��. , 1. 1 v �T 1 i
einl ' �iY Lj
57Kitty
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,x
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i
A
' Hog •�----
Stoveir
�1 j ,� '✓
USGS Quad - Kitty Hawk N
Pasquotank River Basin 0 I0.110.21 1 10.4 Miles W E
s

RECEIVED
STATE OF NORTH CAROLINA
CCASTAL MANAGEMENT
DEPARTMENT OF TRANSPORTA ON ^ ELIZABETH CITY
Y _
BEVERLY EAVES PERDUE
GOVERNOR
September 16, 2010
Daphne J. Lay
3863 Herbert Perry Rd
Kitty Hawk, NC 27949
To Whom It May Concern:
EUGENE A. CONTI, JR.
SECRETARY
CERTIFIED MAIL
The NC Department of Transportation is proposing to replace 1 metal pipe on SR
1213 Herbert Perry Rd. The site is located approximately 0.3 miles from the intersection
of SR1206 ( Kitty Hawk Rd). The existing pipe is 40' x 42" and the proposed pipe is 40'
x 48" with the inlet and outlet ends of the pipe stabilized with riprap. All work will be
conducted within NCDOT right-of-way.
The Division of Coastal Management (DCM) considers the adjacent waters to be
estuarine waters under their regulations. Therefore, it is provided protection under state
law. For this reason the NCDOT will apply for a permit from the DCM to perform the
described work. Part of the permit process is notifying the adjacent landowners of the
proposed work. A map depicting the project area, along with a design plat is included
with this letter. If you have any questions concerning the proposed work you can contact
Clay Willis at 252-482-7977.
113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

ADJACENT RIPARIAN LANDOWNER STATEMENT
( Dare County: SR 1213, 0.3 miles from SR 1206)
I, , am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on SR 1213. I am further aware that this work will occur in an AEC and
therefore will require authorization from the Division of Coastal Management in
accordance with the Coastal Area Management Act (CAMA).
I have no objection to the project as presently proposed and hereby waive
that right of objection as provided in General Statute 113-229.
are attached.
I have objections to the project as presently proposed and my comments
Signature of Adjacent Landowner
Date:

Ic
■ Complete iterls 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Daphne J. Lay
3863 Herbert Perry Road
Kitty Hawk, NC 27949
A. Signature
X Ct ❑ Agent
❑ Addressee
B. R e ed by (Pn ed Name) 16D.1
too Deliv(eery
ii
D. Is delivery address different from Rem 1? \❑ Y6s
If YES, enter delivery address below: ❑ No
3. Service Type
16 Certified Mail ❑ Express Mail
❑ Registered ❑ Retum Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) 7009 2820 0003 3738 2633
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1W

-
UNITED
U
° Sender: Please print your name, address, and Z|P+4inthis box °
,cDEPTOFTRAN3PORTAl|bw
DIVISION OFFICE
113AIRPORT DRIVE, SUITE 1A0
EDENTON,N
rlOUW0

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
Mildred P. Foreman
3857 Herbert Perry Road
Kitty Hawk, NC 27949
A. Signature
X 'Y7% ",
B. Received by( Printed Name)
❑ Agent
❑ Addressee
ite of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
9 Certified Mail ❑ Express Mail
Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(rransfer from service label) 7009 2820 0003 3738 2640
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

'4.P -sr
UNITED STATES POSTAL SERVICE
psgag6 -i
• Sender: Please print your name, address,� and ZIP441'nihis box •
NG DEPT OF TRANSPORTA11u,
DIVISION OFFICE
113 AIRPORT DRIVE, SUITE 10b
EDENTON, NO 27932
(IMIRIFIlt 10-51-02

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
September 16, 2010
Mildred P. Foremean
3857 Herbert Perry Rd
Kitty Hawk, NC 27949
To Whom It May Concern:
RECEIVED
OCT — 2010
COASTAL MANAGEMENT
ELIZABETH CTY
EUGENE A. CONTI, JR.
SECRETARY
CERTIFIED MAIL
The NC Department of Transportation is proposing to replace 1 metal pipe on SR
1213 Herbert Perry Rd. The site is located approximately 0.3 miles from the intersection
of SR1206 ( Kitty Hawk Rd). The existing pipe is 40' x 42" and the proposed pipe is 40'
x 48" with the inlet and outlet ends of the pipe stabilized with riprap. All work will be
conducted within NCDOT right-of-way.
The Division of Coastal Management (DCM) considers the adjacent waters to be
estuarine waters under their regulations. Therefore, it is provided protection under state
law. For this reason the NCDOT will apply for a permit from the DCM to perform the
described work. Part of the permit process is notifying the adjacent landowners of the
proposed work. A map depicting the project area, along with a design plat is included
with this letter. If you have any questions concerning the proposed work you can contact
Clay Willis at 252-482-7977.
113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

The attached form is submitted to insure that you have an opportunity to comment
on the proposal. The work is depicted on the attached drawings. If you have no objects to
the proposal, please return the form with your response within ten (10) days to this office.
If you do have objections to the project, please forward your comments to:
John Cece
NC Division of Coastal Management
1367 U.S. 17 South
Elizabeth City, N.C. 27909
No response within ten (10) days will be construed to mean you have no objections.
Thank you for your cooperation.
Sincerely,
Jerry Jennings, P.E.
Division Engineer, Division One
Clay Willis
` �
Environmental fficer�/, D�ivision One

ADJACENT RIPARIAN LANDOWNER STATEMENT
( Dare County: SR 1213, 0.3 miles from SR 1206)
I, , am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on SR 1213. 1 am further aware that this work will occur in an AEC and
therefore will require authorization from the Division of Coastal Management in
accordance with the Coastal Area Management Act (CAMA).
I have no objection to the project as presently proposed and hereby waive
that right of objection as provided in General Statute 113-229.
are attached.
I have objections to the project as presently proposed and my comments
Signature of Adjacent Landowner
Date:

The attached form is submitted to insure that you have an opportunity to comment
on the proposal. The work is depicted on the attached drawings. If you have no objects to
the proposal, please return the form with your response within ten (10) days to this office.
If you do have objections to the project, please forward your comments to:
John Cece
NC Division of Coastal Management
1367 U.S. 17 South
Elizabeth City, N.C. 27909
No response within ten (10) days will be construed to mean you have no objections.
Thank you for your cooperation.
Sincerely,
Jerry Jennings, P.E.
Division Engineer, Division One
Clay Willis
Environmental Officer, ivision One