54963_NC DOT_20100212

t
❑ CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit # r `
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
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 15A NCAC
Rules attached.
Applicant Name Project Location: County ti"
Address; < t' Street Address/ State Road/ Lot' #(s)
City State'-1 t ZIP ?
Phone # (��`Fax # ( � 2$Z— %Z Z-- Subdivision
Authorized Agent_ 1 __ City ZIP
Affected ❑ CW ❑fW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes /' no
Phone # ( )
River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
Pier (dock) length_
Platform(s)_{-
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
- --
i
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other ri �yC.+ �
!
;
i
1
-
�
Shoreline Length
i
SAV: not sure yes no
� I
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by: j' ' , r�'. �~ ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit ** Issuing Date
Expiration Date
Application Fee(s) Check #
Local PlanningJurisdiction 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 germs 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
Iandowner(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 FNeuse
Applicable To Your Project:
r - Pamlico River Basin Buffer Rules ❑ Other:
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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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

,�' S7ATL o
UNA)
STATE OF NORTH CAROLINA" :`O'
DEPARTNEENT OF TRA?�TS,
BEVERLY EAVES PERDUE
GOVERNOR
February 9, 2010
Jim Hoadley
Division of Coastal Management
1367 U.S. 17 South
Elizabeth City, NC 27909
Dear Mr. Hoadley,
EUGENE A. CONTI, JR.
SECRETARY
This letter is requesting a general permit .2300 be issued for a pipe replacement and GP .1100 for
shoreline stabilization on SR 1122 (Hydeland Rd) in Hyde County. The stabilization will occur on an
eroded bank along SR 1122 for approximately 110'. Pipes will be replaced at 2 locations on SR 1122.
Both existing pipes are (30' x 24" CMP) and will be replaced with the proposed pipes (40' x 30" 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 -I, MP-2, MP-5 forms, location map, landowner notices,
and permit drawings depicting the proposed work. WBS element # is 1.204811. 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
a �C
�el
��' 113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

CDEI�R
North Carolina Department of Environment and Natural Resources
Division of coastai Management
Beverly Eaves Perdue James H cregson Dee Freeman
Governor Director Secretary
BUFFER AUTHORIZATION CERTIFICATE FOR SHORELINE STABILIZATION
A riparian buffer authorization is required for shoreline stabilization activities within the Tar -Pamlico & Neuse River basins
per Division of Water Quality (DWQ) regulations 15A NCAC 028.0259 & 0233. The Division of Coastal Management
(DCM) through a Memorandum of Understanding with the Division of Water Quality (DWQ) has reviewed your project
proposal and has determined that the project as proposed complies with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act (CAMA) permit have received Buffer Authorization as
long as the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to comply
with this Buffer Authorization shall subject the property owner & the party (contractor) performing the construction Wor
land clearing to a civil penalty of up to $25,000 per day per violation.
I. Impacts: Impacts to woody vegetation from clearing and filling in Zone 1 (begins at the most landward of either
the waters edge or the coastal wetland line and extends 30 feet landward) shall be minimized to what must be
impacted for the sound installation of the shoreline stabilization project, Unnecessary clearing and filling in the
buffer is a violation of the riparian buffer rules
2. Clearing & Grading: Clearing and grading of Zone 2 (begins at the landward edge of Zone 1 and extends 20 feet
landward) is allowed provided that it is re -vegetated immediately and Zone 1 is not compromised, which includes
maintaining diffused (non-channelized) flow of storm water runoff through the buffer.
s Construction Corridors: Construction corridors are allowed for shoreline stabilization projects, but they must be
satisfactorily restored as described in condition 5 below,
4. Potential 4vetwash: For vertical shoreline stabilization projects (bulkheads) only; sites where wave overwash is
expected to be severe, the first ten (10) feet landward (unless specifically authorized otherwise by DCM) from the
structure may be maintained as a stable lawn in order to provide for structural stability.
s. Site Restoration: At minimum, pre -project site conditions must be re-established. A site that was wooded prior to
this shoreline stabilization project must be restored with woody vegetation at a stem density of 320 stems per
acre. Non wooded sites may be re -vegetated with woody vegetation. Restoration must be completed by the first
subsequent planting season (November 1 through March 30) after completion of the bulkhead.
• Pre -project site conditions;
s Project Drawing: The drawing on the CAMA General Permit Is considered the project drawing of your property
indicating the location of the shoreline stabilization structure and any associated clearing, grading, and
construction corridors. This drawing will be used to aid in compliance and monitoring efforts.
By your signature below you agree to be held responsible for meeting all of the above listed conditions and verify that all
information is complete and accurate.
Age t or Applicant Printed Name
nt or Applicant Signature
CAMA GEhIERAI_ PERMIT #: 5Y�6
Permit Officer's Signature
z3
Issue Date L
Wivihmgton Othm. Ma,rnhma City Office
943 Washington !;quereMall 4?1ri,^.nmmpr¢tMeow QrhCarohnE
le
Washington, NC 27889 Morehead City, NC 28557
Phone [phone] Hf,gn4 252.898 �FOF �O
An Equal ppportunit (Affirmative Action Employr;r — 50% Recycled/10% Post Consumer Paper

DETAIL SECTION CROSS SECTION
Pr-oposed Fill
Proposed (j P
Pipes to be replaced c I MFI 1.48 & 1.51
Eroded Shoulder
Lxis Hng 24" x 30' CMP
NOTE: CLASS B STONE TO BE PLACED AROUND END OF PIPES Proposed Rip Rap
NOTE: BOTTOM OF NEW PIPE TO BE PLACED
BELOW STREAM BED
SR 1122
- - - - - - -- /a - - - - - - - - - - - - - - - - - -- - - - - - - -NWL
Stream Bed
Proposed 30" x 40'
Existing 24" x 30'
DETAIL SECTION -END VIEW
Proposed 30" x 40' CAP
NWL
Pip
e to be buried below
s r e crn bed
EXISTING PIPE
0 PROPOSED PIPE
NC DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
COUNTY Hyde
QUAD
New Holland
-,n
BASIN
Tar Pam
PROJECT PIPE REPLACEMENT-o
SCALE
1 10'
DATE
1213010

Typical Plan View
SR 1122 Hydeland Rd yam=
III Juniper Bay Rd 16' - 18' Gravel Road
— /� 4' - 5' existing shoulder
I - 2' Eroded Shoulder _ _ — — — — — — — — —T.0.B
— — — — — -- -------------- NWL_
NWL----------
Hydeland Canal
Typical Cross -Section
SR 1122 Proposed 5' Shoulder
n 1'- 2'Shoulder /� _-- L
Exssn g j — N W
Eroded Shoulder'/
Proposed Shoulder Fill
Proposed Rip R.cp
Scale-. I" = 5'
Proposed Shoulder Fill
Proposed Rip Rap
Lenghts of
1) 30'
2) 20'
3) 10'
4) 15'
5) 15'
6) 10'
7) 10'
stabilization:
County: Hyde R
Road #- SR 1122 Hydeland Rd"
WBS #: 1.20A811
shoreline stablizalton�
Description:
Scale: I" = 10' c
Date: 12/30/09
Drawn bye R. Shook
GPS Coordinates- 35.41215, 76.21090

PLICAiiON fe.
Deent Pernift
(last revised 12/27.106)
North Carolina UVISION CE COASTAL MANAGEMENT
9. Primary Applicant/ Landowner Information
Business Name
Project Name (if applicable)
N.C. Department Of Transportation
SR 1122 Hydeland Rd shoreline stabilization & pipe
replacement
Applicant 1: First Name
MI
Last Name
Clay
Willis
Applicant 2: First Name
MI
Last Name
If additional applicants, please attach an additional page(s) with names listed.
Mailing Address
PO Box
City
State
113 Airport Raod
Edenton
NC
ZIP
Country
Phone No.
FAX No.
27932
252 - 482 - 7977 ext.
252 - 482 - 8722
Street Address (if different from above)
City I
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>
252-80 -2308 .. 1-8S8-4PCOAS
L_

MP-1 (gage 2 of 5)
APPLICATION for
Major Development Permit
3. Project Location
County (can be multiple)
Street Address
State Rd. #
Hyde
SR 1122 Hydeland Rd
SR 1122
Subdivision Name
City
State
Zip
Swanquarter
NC
27885 -
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
Tar -Pam
Hydeland Canal, tributary to Juniper Bay Creek
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
Pamlico Sound
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.
4. Site Description
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
500
12500
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)
3 ❑NHW or ®NWL
e. Vegetation on tract
Various roadside grasses on maintained shoulder.
f. Man-made features and uses now on tract
SR 1122 Hydeland Rd
g. Identify and describe the existing land uses adiacent to the proposed project site.
Woodland and conservation.
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)
❑Yes ❑No ®NA
j. Is the proposed activity part of an urban waterfront redevelopment proposal? Yes InNo
k. Hasa professional archaeological assessment been done for the tract? If yes, attach a copy. E]Yes No ❑NA
If yes, by livhom?
I. Is the proposed project located in a National Registered Historic District or does it involve a []Yes 23% ONA
National Register listed or eligible property?
<Forrn continues on next page>
m. (i) Are there wetlands on the site? ❑Yes ®No
(ii) Are there coastal wetlands on the site? E]Yes ®No
(iii) If yes to either (i) or (ii) above, has a delineation been conducted? E]Yes ®No
(Attach documentation, if available)
'?>'t..:f;P; ­;eda0 1-388�4RCOAST vvwLav,aaccanst.aiManage.-mant.net

`'/'�XM MP-1 (Page 3 of 5)
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
APPLICATION for
Major Development Permit
5. Activities and Impacts
a. Will the project be for commercial, public, or private use?
[]Commercial SPublic/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 stabilize the shoulder of SR 1122 by placing rip rap and backfilling with shoulder material
and to replace 2 - 24" x 30' CMPs that are structurally failing with 2 - 30" x 40' CAPs.
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.
A tracked excavator, backhoe, and dump truck will be used during construction.
d. List all development activities you propose.
To stabilize 110' of shoulder along SR 1122 and to replace 2 - 24" x 30' CMPs.
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?
440 ®Sq.Ft or []Acres
g. Will the proposed project encroach on any public easement, public accessway or other area
❑Yes SNo ❑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 1122.
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>
S. 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.
252,80',3-28C-8 ,. 11-888- RC'CAST ..

s
,)CM NIP-1 (Page 4 of 5)
APPLICATION for
Maior Development Permit
F
copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
he appropriate application fee. Check or money order made payable to DENR.
rs and signed return receipts as proof
wne�sthave received a copy of he fapplication anddp plats by cent fed maUarSuchaandownersmust be advised that they have 30tdays in
which to submit comments on the proposed project to the Division of Coastal Management.
Name North Carolina Wildlife Resource Commission
Attn: Dale Davis
Phone No.
Address 132 Marine Drive
Edenton, NC 27932
Name Carolyn B. & Ira B. Hall Trustees
Phone No.
Address 1419 Brunseick Ave
Norfolk, VA 23508
Name
Phone No.
Address
g. A list of previous state or federal permits issued for work on
none
h. Signed consultant or agent authorization form, if applicable.
tract. Include permit numbers, permittee, and issuing dates.
i. Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
1 10), if necessary. If the
k. A statement of oo use of publichlands, attach a statemenect inv
Pdo'cumenting compliance with the North Carolina Environmental Policy Ives expenditure
c diture
of publc funds
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
and follow-up
enter on the aforementioned lands in connection with evaluating information related to this permit application
monitoring of the project.
I further certify that the information provided in this application is truthful to the best of my knowledge.
Date �/ e2 (/L 0 Print Name _Clay Willis, Environmental officer
Signature
uvurvw.A�ce�strx,aa�s,�rar�t.raet

r
(Except for abridges :and culverts)
Attach this form to Joint Application for CANIA 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
IOther
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
Depth
NA
NA
9. 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
(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
❑WL ❑None
(ii) Describe the purpose of the excavation in these areas:
d. High -ground excavation in cubic yards.
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
(d) 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
number of square feet affected. (ii) If yes, how much water area is affected?
❑CW ❑SAV ❑SB
OWL ❑None -
(ii) Describe the purpose of disposal in these areas:
3. SHORELINE STABILIZATION
This section not applicable
(If development is a wood groin, use MP-4 — Structures)
www,;iccoas jai ra ra xrmeq-a tit r a e12/2:6/05

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Ga g 2 (i,x 2 of ;2)
ype of shoreline stabilization: b. Length: 110
❑Bulkhead ®Riprap ❑Breakwater/Sill ❑Other: Width: 3' - 5' '?
c. Average distance waterward of NHW or NWL: 3' d. Maximum distance waterward of NHW or NWL" .3..'
e. Type of stabilization material: f. (i) Has there been shoreline erosion during preceding 12
Class "B" rip rap months?
❑Yes []No ❑NA
(ii) if yes, state amount of erosion and source of erosion amount
information.
2'-4' nutria damage and wave action.
g. Number of square feet of fill to be placed below water level. h. Type of fill material.
Bulkhead backfill Riprap 330 riprap
Breakwater/Sill Other
i. Source of fill material.
quarry
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, suomergea aquatic veyeLaaun korw), o— v— .. win
other wetlands (WL)? If any boxes are checked, provide the
(ii) Amount of material to be placed in the water number of square feet affected.
(iii) Dimensions of fill area ❑CW ❑SAV ❑SB
(iv) Purpose of fill ❑WL []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? d. (i) Will wetlands be crossed in transporting equipment to project
❑Yes ®No ❑NA site? ❑Yes ®No ❑NA
(4) If yes, explain what type and how they will be implemented. (ii) If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
p
' v Date plicant Signature
SR 1122 (Hydeland Rd) shoulder stabilization & pipe replacement
Project Name
Clay Willis, Environmental Officer
plicant Name
252-808-2308 . 1-882-4RCIDAsT : �3s�±?�,�_c�®�st�3rr�.�r��s�ur�era#_.�a�� re-vised; 12/26/06

BRIDGES OPH CULVERTS
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other §actionsttr Joint
Application that relate to this proposed project. Please include all supplemental information.
1. BRIDGES ®This section not'applicable
a. Is the proposed bridge: b. Water body to be crossed by bridge:
❑Commercial ❑Public/Government ❑Private/Community
C. Type of bridge (construction material):
e. (i) Will proposed bridge replace an existing bridge? ❑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)
d. Water depth at the proposed crossing at NLW or NWL:
f. (i) Will proposed bridge replace an existing culvert? ❑Yes ONO
If yes,
(ii) Length of existing culvert:
(iii) Width of existing culvert:
(iv) Height of the top of the existing culvert above the NHW or
NWL:
(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
increasing the existing navigable opening? ❑Yes [--]No
If yes, explain:
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 This section not applicable
a. Number of culverts proposed: 2 b. Water body in which the culvert is to be placed:
Hydeland Canal, tributary to Juniper Bay Creek
< Farm continues on back>
c. Type of culvert (construction material):
2 @ 40' x 30" Corrugated Aluminum Pipe
2a a r3 1f3� 17 i - u-f d :: rm�anrs, c ga #:�3raj rt_. rr, y t net revised, tt1r ?r)

Will proposed culvert replace an existing bridge? e. (1) Will proposed culvert replace an existing culvert?
❑Yes ®No ®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)
f. Length of proposed culvert: 40'
h. Height of the top of the proposed culvert above the NHW or NWL.
1.5'
j. Will the proposed culvert affect navigation by reducing or
increasing the existing navigable opening? ❑Yes ®No
If yes, explain:
3. EXCAVATION and FILL
a. (i) Will the placement of the proposed bridge or culvert require any
excavation below the NHW or NWL? ®Yes ❑No
If yes,
(ii) Avg. length of area to be excavated: 40'
(iii) Avg. width of area to be excavated: 6'
(iv) Avg. depth of area to be excavated: 2'
(v) Amount of material to be excavated in cubic yards: 17.78
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: 30'
(iii) Avg. width of area to be excavated: 8
(iv) Avg. depth of area to be excavated: 2'
(v) Amount of material to be excavated in cubic yards: '17.78
If yes,
(ii) Length of existing cuivert(s): 30'
(iii) Width of existing culvert(s): 24"
(iv) Height of the top of the existing culvert above the NHW or
NWL: 1_5'
(v) Will all, or a part of, the existing culvert be removed?
(Explain) All
g• Width of proposed culvert: 24"
i. Depth of culvert to be buried below existing bottom contour.
0.5'
k. Will the proposed culvert affect existing water flow?
[]Yes ®No
If yes, explain:
❑This section not applicable
Will the placement of the proposed bridge or culvert require any
excavation 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 ❑SAV ❑SB
OWL ®None
(ii) Describe the purpose of the excavation in these areas:
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• s any excavation, please complete the following:
the placement of the bridge or culvert involve
roved waste area site. r
(i) Location of the spoil disposal area: NCDOT approved
(ii) Dimensions of the spoil disposal area: N/A l
� Yes Ne (If no, attach a letter granting permission from the owner.) •
(iii) Do you claim title to the disposal area.
(iv) Will the disposal area be available for future maintenance? Eyes ❑No
(v) Doe
s the disposal
area include any coastal wetlands/marsh (C+>`1), submerged aquatic vegetation (SAVs), other wetlands (WL), or shell
bottom (SB)? None
❑CV+1 ❑SAV OWL ❑SB
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? ? nYes SNo
If yes, give dimensions if different from (ii) above.
osed bridge or culvert result in any
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?
No
If yes,
(ii) Avg. length of area to be filled: 40'
(iii) Avg. width of area to be filled: 3'
(iv) Purpose of fill: Rip rap for bank stabilization.
g. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item dabov❑e) to
be placed on high -ground? SYes
No
If yes,
(ii) Avg. length of area to be filled: 40'
(iii) Avg. width of area to be filled: 2'
(iv) Purpose of fill: rip rap for bank stabilization
4. GENERAL
a. Will the proposed project require the relocation of any ❑e istir
Yes
utility lines?
If yes, explain:
If this portion of the proposed project has already recof the
approval from local authorities, please attach a copy
approval or certification.
f (i) Will the placement of the prop
fill (other than excavated material described in Item d above) to
be placed within coastal wetlands/marsh (CW), submerged
aquatic vegetation (SAV), shell bottomsBhe number of square
(WL)? If any boxes are checked, provide
feet affected. ASS
j]CW ❑SAV
❑WL ENone
(ii) Describe the purpose of the excavation in these areas:
Will the proposed project require the construction of temporary
pEN
detour structures?
If yes, explain:
< Form continues on back>
work channels? d. How will excavated or fill material be kept on site and erosion
c. Will the proposed project require any Yes ENo controlled?
Using NCDOT best management practices for erosion an
If yes, complete Form DCM-MP-2, sediment control.
rievise—& 1,126106
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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.
12,
Date
SR 1122 Hydeland Rd Pipe Replacement
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.
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