54624_NC DOT_20090925

F,:!�C:AMA / ❑ DREDGE & FILL 5 V52 4
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue El 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
[D Rules attached.
Applicant Name #t' 1 Project Location: County
Address St s t Add / Sa t t
R Al L t At
� 1
City State ZIP I °'
Phone # ('' ):�- �+ :j Fax # ( )
Authorized Agent
Affected ElCW ElEW ❑ PTA ❑fS ElPTS
AEC(s):
❑ OEA ElHHF ElIH ❑ UBA ElN/A
ElPWS: ElFC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
o
)
ree rese a o s••-
Subdivision
City ZIP
Phone # () River Basin
Adj. Wtr. Body (nat + i�/unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: j''I'- )
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
f
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
t
Basin, channel
cubic yards
J
—
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
--
I
Shoreline Length
I
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a sy l
Photos: yes _
da-77
Waiver Attached: ! yes' no
/'! +
A building permit may be required by: e r' ^ ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
or Applicant Printed Name
S �
Permit Officer's Signature
r _ r
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Issuing Date Expiration Date
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 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, certifythat this project is consistentwith 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
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/ 1-888ARCOAST
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

r
SOCAMA / -,-�'6REDGE & FILL
_ I694
GENERAL PERMIT
Previous permit # —'
-N�NeW L�Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources .� J ��
and the Coastal Resources Commission in an area of environmental concern
pursuant to 15A NCAC
l
Applicant Name iv 4-,V
ales attached.
Project Location: County+' zj t
Address X ` � 7
Street Address/ State Road/ Lot #(s)
If
6-1- -
0 . 1 yr+'
City State! ZIP
Phone # ( -j�`j J 0 Fax # (_)
Subdivision
Authorized Agent �y �An.r-h
City off ��b`�1 y � C ZIP S*�
Affected u"fCW N�LW ❑ PTA eta ❑ PTS
ElOEA ❑ HHF ❑ IH El USA ❑ N/A
Phone # ( ) River Basin
Adj. Wtr. Body U � 6o>' z -S'c:, Ad
AEC(s):
(nat an�3/unkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes / Crit.Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity ,nrf ^ �'r ct 3 4
Shoreline Length
-
SAV: not sure yes ! �'
I �t_
Sandbags: not sure yes nUo r` I '— j
Moratorium: n/a-
Photos: yes I+ I L 1
Waiver Attached: G) no i
A building permit may be required by:
Notes/ Special Conditions c I n -\''/`4'-" t1✓06 k'
I A ^ C 4C
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
❑ See note on back regarding River Basin rules.
2✓e7�yn. � ��•�Y-tJr�II
I
A�'4cl a,ej:
I -71r o`i /-/—Ix
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name

A�
A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
September 28, 2009
Jay Johnson, NC DOT
Division of Environmental Officer
Division 3
PO Box 1587
Greenville, NC 27835
Dear Mr. Johnson:
Attached is General Permit #54624C to construct a 36"x40' culvert to replace a 18"x40' culvert
located at SR 1355 0.1 miles east of SR 1356, in Marshallberg, NC
In order to validate this permit, please sign the permit as indicated. Retain the white copy for
your files and return the signed yellow and pink copies to us in the enclosed, self-addressed
envelope. If the signed permit copies are not returned to this office before the initiation of
development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
Stephen Lane
Coastal Management Representative
lsb
Enclosures
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer— 50% Recycled \ 10% Post Consumer Paper

APPLICATION for y w
Major Development Perms sE�
(last revised 12127106) t " ""
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Information
Business Name
North Carolina Department Of Transportation
Project Name (if applicable)
SR 1355, Polly Hill Road,(Brown Street) Carteret County
Applicant 1: First Name
Jay
MI
B.
Last Name
Johnson
Applicant 2: First Name
MI
Last Name
If additional applicants, please attach an additional page(s) with names listed.
Mailing Address
PO Box
1587
City
Greenville
State
NC
ZIP
278351587
Country
us
Phone No.
252 - 830 -
3490 ext. 248
FAX No.
252 - 830 - 3341
Street Address (if different from above)
City
State
ZIP
Email
[e-mail]
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
<Forrn continues on back>

Form DCM MP-1 (Page 2 of 5)
APPLICATION for
Major Development Permit
3. Project Location
County (can be multiple)
Street Address
State Rd. #
Carteret
SR 1355, Polly Hill Road
Subdivision Name
City
State
Zip '
Phone No.
Lot No.(s) (if many, attach additional page with list)
- - ext.
I ,
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
White Oak
Great Marsh 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
Core 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.
Marshallberg
4. Site Description
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
16' (8' East and 8' West)
N/A
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)
2.1' ❑NHW or ®NWL
e. Vegetation on tract
Maintained Roadside Grasses
f. Man-made features and uses now on tract
Road
g. Identify and describe the existing land uses adjacent to the proposed project site.
Residential Property
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 ®No
k. Has a 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 ®No ❑NA
National Register listed or eligible property?
<Form continues on next page>
m. (i) Are there wetlands on the site? ®Yes ❑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)

Form DCM MP-1 (Page 3 of 5)
APPLICATION for
Major Development Permit
n. Describe existing wastewater treatment facilities.
N/A
o. Describe existing drinking water supply source.
N/A
p. Describe existing storm water management or treatment systems.
N/A
5. Activities and Impacts
a. Will the project be for commercial, public, or private use? ❑Commercial ®Public/Govemment
❑Private/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
The Existing 18" x 40' CMP Will Be Replaced By 36"x 40' CMP. The Proposed Pipe Will Keep The Roadway From
Collapsing, Thus Preventing Possible Injury and Death.
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.
The Existing Pipe Will Be Removed and the Proposed Pipe Will Be Installed. Typical Roadway Construction Equipment Will
Be Used, Including,But Not Limited To Tracked Excavators,Dump Trucks, Flat -Bed Trucks,Back-Hoes,And Boom Trucks.
d. List all development activities you propose.
Pipe Replacement and Asphalt Patching
e. Are the proposed activities maintenance of an existing project, new work, or both? Both
f. What is the approximate total disturbed land area resulting from the proposed project? 184 ®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.
N/A
i. Will wastewater or stonnwater 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.
<Fonn 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, dearly 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.

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 hat 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 Deborah and Melva Davis
Phone No. ® U_ p
Address 127 Brown Street Marshallberg, NC 28553 �i
Name Gary and Deborra Forehand cl. S
Phone No.
Address P.O. Box 129 Marshallberg, NC 28553
Name Charles D. Harris,Jr.
Phone No.
Address P.O. Box 159 Marshallberg, NC 28553
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
None
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.
FT 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 _September 1,2009 Print Name _Jay B. Johnson
Signature
Please indicate application attachments pertaining to your proposed project.
®DCM MP-2 Excavation and Fill Information ®DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
❑DCM MP-4 Structures Information
a

Form DCM MP-2
EXCAVATION and FILL
(Except for bridges and culverts)
SEP CUU�
Morehead City [)C
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
Canal
Boat Basin
Boat Ramp
Rock Groin
Rock
(excluding
(NLW or
Breakwater
shoreline
NWL)
stabilization
Length
Width
Avg. Existing
Depth
NA
NA
Final Project
NA
NA
Depth
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
OWL []None
(ii) Describe the purpose of the excavation in these areas:
2. DISPOSAL OF EXCAVATED MATERIAL
a. Location of disposal area.
c. (i) Do you claim title to disposal area?
❑Yes ❑No ❑NA
(ii) If no, attach a letter granting permission from the owner
d. High -ground excavation in cubic yards.
® This section not applicable
b. Dimensions of disposal area.
d. (i) Will a disposal area be available for future maintenance?
❑Yes ❑No ❑NA
(ii) If yes, where?
e. (i) Does the disposal area include any coastal wetlandstmarsh 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 If es, how much water area is affected?
number of square feet affected. (n) y
❑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)

F[Dy'31`>I DCM MP-2 (Excavation and Fill, Page 2 of 2) a
a. Type of shoreline stabilization: b. Length: 16' (8' East And 8' West?~
❑Bulkhead ®Riprap ❑Breakwater/Sill El Other: Width: 4'
c. Average distance waterward of NHW or NWL: 2 d. Maximum distance waterward,of NHW o[, NW�tjiy (MC
e. Type of stabilization material: f. (i) Has there been shoreline erosion during preceding 12
Class B Marl months?
❑Yes ®No ❑NA
(ii) If yes, state amount of erosion and source of erosion amount
information.
g. Number of square feet of fill to be placed below water level. h. Type of fill material.
Bulkhead backfill Riprap 8' East 8' West 16 Sq. Ft. Class B Marl
Total
Breakwater/Sill Other
i. Source of fill material.
Clark's Quarry
4. OTHER FILL ACTIVITIES ®This section not applicable
(Excluding Shoreline Stabilization)
a. (i) Will fill material be brought to the site? Yes EINO EINA b. (i) Will fill material be placed in coastal wetlands/marsh (CW),
it yes,
(ii) Amount of material to be placed in the water
(iii) Dimensions of fill area
(iv) Purpose of fill
suomergea aquatic vegetation (SAV), shell bottom (SB), or
other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
®CW 64 Sq. Ft. ❑SAV ❑SB
❑WL ❑None
(ii) Describe the purpose of the fill in these areas:
15. 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)?
Silt Fences and TRSC-B's Typical Road Construction Equipment
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
(ii) 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.
September 1,
Date
SR 1355, Polly Hill Road,Pipe Replacement WBS Element
Number 2C.016014
Project Name
Jay B. Johnson
plicant Signature

Pipe Replacement, SR 1355, Polly
County Replace Existing 18"x40'
36"x40' CMP
N 34A-43'-24"
W 76A-30'-46"
Erosion Control Schedule
Hill Road; Carteret
RCP With Proposed
• Install erosion/sediment control measures according to plans.
OFOP,ad City ®CM
• Grading of slopes; 1.5: 1= stabilize with Class B riprap
• Seed all disturbed areas as soon as final grading is completed.
• Clean out and/or rework all temporary sediment control measures after
significant rainfall event (or as otherwise needed). These measures should be
maintained until a permanent vegetative cover is established and project is
complete
Pipe Installation Schedule
• Install erosion/sediment control devices per plans.
• Remove material while limiting, as much as possible, material and sediment
from entering the stream and/or escaping from the project.
• Prepare pipe foundation while taking care to limit material and sediment from
entering the stream and/or escaping from the project. Where possible new
grade should be below the existing streambed. Bedding material will be washed
stone.
• Place new pipe and compact fill.
• Install slope protection on outlet and inlet ends of pipe (Class B Granite riprap)
• Establish permanent vegetation as soon as possible
• Remove sediment control devices after project has stabilized and permanent
vegetative cover is established.

%renoeMMr-s
BRIDGES and CULVERTS
S E P k 8 o�iq
Morehead City `W
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.
a. Is the proposed 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)
g. Length of proposed bridge:
b. Water body to be crossed by bridge:
d. Water depth at the proposed crossing at NLW or NWL:
f, (i) Will proposed bridge replace an existing culvert? ❑Yes []No
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)
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:
a. Number of culverts proposed: 1 b. Water body in which the culvert is to be placed:
UT to Great MarshCreek
< Form continues on back>

ft NIL
P,ic
Form DCNI MP=5 (Bridqwu and COvertsq Page W of 4it11 7 riV*I
G. Type of culvert (construction material): 5 EN 1 8 2009
CMP
d. (i) Will proposed culvert replace an existing bridge? e. (i) 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.
1.2'
j. Will the proposed culvert affect navigation by reducing or
increasing the existing navigable opening? ❑Yes ®No
If yes, explain:
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: East 4' West 4'
(iii) Avg. width of area to be excavated: 7' North 7' South
(iv) Avg. depth of area to be excavated: 1_5'
(v) Amount of material to be excavated in cubic yards: 2 Cubic
Yards
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: 6'
(iv) Avg. depth of area to be excavated: 2_1'
(v) Amount of material to be excavated in cubic yards: 14
Cubic Yards
If yes,
(ii) Length of existing culvert(s): 40'
(iii) Width of existing culvert(s): 18"
(iv) Height of the top of the existing culvert above the NHW or
NWL: 0.4'
(v) Will all, or a part of, the existing culvert be removed?
(Explain) All of the Existing Culvert Will be Replaced
g- Width of proposed culvert: 36"
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:
b. (i) 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 64 Sq.Ft. ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of the excavation in these areas:
Pipe Bedding

Form OCM1, MI-5 (Bridges and C€dverts, Page' of 4) S P
d. If the placement of the bridge or culvert involves any excavation, please complete the following: (i) Location of the spoil disposal area: Temporary Spoil Area is in the Existing Road vreheild Cit. r1na
(ii) Dimensions of the spoil disposal area: 100' x 200'
(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 f. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to fill (other than excavated material described in Item d above) to
be placed below NHW or NWL? ®Yes []No be placed within coastal wetlands/marsh (CW), submerged
If yes, aquatic vegetation (SAV), shell bottom (S13), or other wetlands
(WL)? If any boxes are checked, provide the number of square
(ii) Avg. length of area to be filled: East 8' West 8' feet affected.
(iii) Avg. width of area to be filled: 2' ❑CW ❑SAV ❑SB
(iv) Purpose of fill: Pipe Bedding OWL ®None
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:
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.
(ii) Describe the purpose of the excavation in these areas:
b. 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?
[]Yes ®No
If yes, complete Form DCM-MP-2.
e. What type of construction equipment will be used (for example,
dragline, backhoe, or hydraulic dredge)?
Typical Bridge Construction Equipment
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.
flppirc�nt Si.gna
d. How will excavated or fill material be kept on site and erosion
controlled?
Turbidity Curtains and Silt Fences will be used to retain
sediment on -site
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.

Pipe Replacement SR 1355, Polly
County Replace Existing
8"x40'
3 d"x40' CMP
N 34'`-3'-24"
W 76A_30'-46"
Erosion Control Schedule
4 .
0. o,
HillRaad;
RCP With Pr
• Install erosion/sediment control measures according to plans.
• Grading of slopes-, LS: 1= stabilize with Class B riprap
• Seed all disturbed areas as soon as final grading is completed..
• Clean out and/or rework all temporary sediment controlmeasures after
significant rainfall event (or as otherwise needed). These measures should be
maintained until a permanent vegetative cover is established.. and project is
complete
Pipe Inst'-dIation Schedule
• Install erosion/sediment control devices per plans.
•' Remove material while limiting, as much as possible, material and sediment
from entering the stream and/or escaping from the project.
• Prepare pipe foundation while taking care to limit material and sediment from
entering the stream and/or escaping from the project. Where possible new
grade should be below the existing streambed. Bedding material will be washed
stone.
• Place new pipe and compact fill.
• Install slope protection on outlet and inlet ends of pipe (Glass B Granite riprap)
• Establish permanent vegetation as soon as possible
• Remove sediment control devices after project has stabilized and permanent
vegetative cover is established.

�C� vE I

SR 1355 Pf LLY HILL ROAD, CARTERET COUNTY j!
PIPE REPLACEMENT ®reh��
REPLACEL�"A'.d'STING 18 "x30 CUP WITH PROPOSED 36"WO CMP '
HARICERS ISLAND USGS QUAD MAPAND SHEET 21 OF THE
SOIL SURYEYOFCARTERET COUNTY
WBS ELEMENT NUMBER 2C. 016014
rRr PANEL:7346 r ..
AL PNUMBER 3 720 734600 J SEPTEMBER 7, 2D119
m
Dr
Davis Rd
a o
R hi- 2
I PIPE
7 ASS a Y 363552.6776
X--2747300.7674
n N 34A_ 43'-24"
W76^-30! 46"
`4 N34.723275DEGREES
W 76 51.2720 DEGREES
st
Co
Rd 3
0 285 570 1,140 1,710 2,280
Feet

SUMMARY OF AFFECTED PROPERTY OjfWERS
TRACT
NUMBER
PROPERTY
O WWER
ADDRESS
3415
DEBORAH DAMS
AAD
MELVA DAVIS
127 BROFFW STREET
MARSHALLBERG, NC 28553
3335
GAR FOREHAADD
DEBORRA
FOREHAAD
P.O.BOX 129
MARSM LLBERG, NC 28553
14U6
CHARLES D.
HARRIS
P.O. BOX 159
AMRSHALLBERG, ABC 28553

ice`!,
CAMA GP APPLICATION
,•
MITTING ONLY
PIPE REPLACEMENT NOT RFOR RCONSTRUCTION
SR 1355, POLLY HILL ROAD
AREA 1
CARTERET COUNTY AREA 2
AL
SCALE:I°=20'WEDIMCS 16 Sq.Ft COASTAL
TLVA
SEPTEMBER 1, 2009 WETLAND IMPACTS
OPEN �TERFIMPACTS .'� WBS ELEMENT NUMBER:2C.016014 15 Sq,Ff.
°- OPEN WATER IMPACTS
3415 5335
DEBORAH AND MELV A DAVIS GARY AND DEBORRA FOREHAND
127 BROWN STREET P.O. BOX 129
MARSHALLBERG, NC 28553 MARSHALLBERG, NC 28553
DBK 946, P.G. 229 DBK 844, P.G. 779
EXISTING R/W
o
EXISTING DITCH
s
II
PROPOSED CLASS B STONE
PROPOSED SILT FENCE
S l5° 5l 33° W
EXISTING 18"x40' CMP
I
N 34'-43'-24° 0.3 MILES TO SR 1357,
I I
W 76°-30'-46° LUCILLE LEWIS DRIVE
366 Ft. TO SR 1556, TT--- m--PROPOSED 36x40' CUP SR 1355
GOOSE POND ROAD I I
PROPOSED SILT FENCE I I POLLY HILL ROAD
PROPOSED CLASS B STONE
EXISTING DITCH --- - --
R/W S 52° —30 —58" E EXISTING R/4
AREA 4 1406 AREA 3
16 Sq.Ft COASTAL CHARLES D. HARRIS Jr. 16 Sq.Ft COASTAL
WETLAND IMPACTS P.O. BOX 159 WETLAND IMPACTS
30 Sq. Ft. MARSHALLBERG, NC 28553 30 Sq. Ft.
OPEN WATER IMPACTS NO DEED REFERENCE OPEN WATER IMPACTS
TOTAL:64 Sq.Ft.COASTAL WETLAND IMPACTS MAP NUMBER 3720734600J
TOTAL:120 Sq. Ft.OPEN WATER IMPACTS FIRM PANEL 7546 J

PROJECT NO. 2C.016014 CROSS SECTION OF
CULVERT CROSSING
DATE SEPTEMBER 1, 2008
ROAD SR 1355
ROAD NAME POLLY HILL ROAD
REPLACE 18RX40' RCP WITH J 40' CMP
COUNTY CARTERET' IX
ROAD
SR 1355 '",r;
EXISTING /8'x 4YRGP
61 '�
NAL
2.1' 1.7' � ° ��9
EXISTING I6'x 40'P�
UNDEm r a
eACMLL NOT To SCALE
PROPOSED 3V x 4a CNP
ROAD
SR 13,55
7'
2 a l' 1. 7' WIL
PROPOSED 36' x 40' CAlP
I. 0 EDGE OF PAVEMENT EDGE OF PAVEMENT
E
EXISTING SHOULDER
PROPOSED RIP RAP c END TOP VIEW ( EXISTING
OF PIPE OF
utmeKctFF a
sACKFtLL NOT TO SCALE 4,
DITCH rearoSFO Pff DITCH
4'
EXCAVATION ABOVE NWL° FINISHED EARTH SLOPE AS REQUIRED
6'w x 39 L x ?-I'd = 378 CUBIC FEET 14 CUBIC YARDS
EXCAVATION BELOW NWL: PROPOSED RIP RAP 0 END
OF
I
7'w x 4'L x ISd = 42 CUBIC FEET 2 CUBIC YARDS I

6i1.T mn rm 'E'
H+!
LEGEND SHEET
WETLANDS
DIFFUSE FLOW THROUGH
VEGETATED UPLANDS BEFORE ENTERING WETL
I
SA EROSION CONTROL LEW40
W
TYPICAL EACH S Ei
TEMPORARY ROCK SILT CHECK
I
w
w
a
SILT BASIN TYPE B
TYPE -A UPLANDS
z
w I
a
w
TE)PORARY ROCK SILT CHECK ME•A
> I
°
TEORARY ROCK SILT CHECK TYPE-8
WP
2 1
+
U
0
tea_ w— 1E1,PORuiY SlT PENCE
SILT BASIN TYPE-B
IL
w I
w
GRADE BREAK
d
�I
oNEcraN of PLor
I
I I I • ------ WOODSLINE
DIFFUSE FLOW
DIFFUSE
FLOW
DETAIL
/l
NTS
-------- 404 WETLANDS FILL AREA
TOPPORARY WX WELT Gii M TYPE V
V
., .:.,. ®OE OF PAYEEINT
rRMAAL BORE — .
6.1 l0 --- NEUSE RIVER RIPARIAN BUFFER
—------- 404 WETLANDS
\� -- COASTAL WETLANDS
10 GL 3*GL �'fT'fl'1 ---- GRASS LINED CHANNEL
�----OPEN WATER IMPACTS
K 1
N
a. Rr KRx., Ir •u.
�w
!E10I1 A•A
RAL TEMPORARY ROCK SILT CHECK TYPE -A
PROPOSED SILT FENCE
WETLAND I VAR. 0'-6'
EDGE OF EXIST. ROAD
UTILITIES LEGEND,
TYPICAL EACH SHEET
y
POWER POLE
r
AG
TELEPHONE PEDESTAL
©
CABLE TV PEDESTAL
Q+
SEWER CLEAN OUT
®
WATER VALVE
FIRE HYDRANT
Q
WATER METER
EIP 0
EXISTING IRON PIPE
+
PROPERTY CORNER
—EL—
PROPERTY LINE
GRASS -LINED CHANNEL
TRAPEZOIDAL DITCH SECTION
Z-
X-SECTION AREA !AI - BD +ZD
TOP WIDTH !T! - B + 2DZ
EXISTING FILL ,
AREA TO BE
FILLED OR
DISTURBED
UNDISTURBED AREA
FABRIC BURIED BELOW
EXISTING
AW4
SILT `fENC�
DETAI -
`
%� NTS
1 PROPOSED SILT FENCE
;VAR.O'°6' I
LEDGE OF EXIST, ROAD

VAI
DIM.
LEGEND SHEET
SPECIAL SEDIMENT CONTROL FENCE
1.06 3 FT.
CONTROL STONE
VIN.
I,
SEDIMENT CONTRO
I FT, MIN.
WATER FLOW
N,_af ccL POST - 2 FT. DEEP
WOOD POST - 3 FT. DEEP
GENERAL NOTES:
USE NO.3 OR NO.57 STONE FOR SEDIMENT
CONTROL AND PAY FOR AT THE CONTRACT UNIT
PRICE PER TON SEDIMENT CONTROL STONE
USE HARDWARE CLOTH 24 GAUGE WIRE MESH
WITH %4 INCH MESH OPENINGS
INSTALL 5 FT. SELF FASTENER ANGLE STEEL
POST 2 FT. DEEP MINIMUM
INSTALL 6 FT. LONG, 3 IN. DIA. WOOD POSTS
3 FT. DEEP MINIMUM
SPACE POSTS A MAXIMUM OF 3 FT.
TURBIDITY CURTAIN
PUMP
03
G ` SILT BAG

■ 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 maiipiece,
or on the front if space permits.
1. Article Addressed to:
Gary Forehand and Deborra
Forehand
PO Box 129
Marshallberg, NC 28553
2. Article Number
(Ransfer from service label)
PS Form 3811, February 2004
A. �ig re
Agent
Addre
A. feceived by,(Printed.Namf) C. Daye of Qei
D. Is delivery address different from item 1? ❑ Yes
If YES�Ifiod'm below: 15(No
3. ice Type
ertified Mail ❑
❑ R um Receipt for Merchandise
❑ in
4. Restricted Delivery? (Extra Fee) ❑ Yes
7008 1140 0002 0397 4400
Domestic Return Receipt
■ 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 maiipiece,
or on the front if space permits.
1. Article Addressed to:
Deborah Davis and Melva Davis
127 Brown St.
Marshallberg, NC 28533
2. Article Number
(transfer from service label)
PS Form 3811, February 2004
102595-02-M-1540
A. Nnate `
❑ ent
X Addressee
B. 3ceived by ( Printed Name) CVate of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, err Rress below: ❑ No
�S
3. S5\1ce Type
`Z Chrtified Mail ❑
❑ insured -Ma —7--El'-e:O.D•
4. Restricted Delivery? (Extra Fee) ❑ Yes
7008 1140 0002 0397 4417
Domestic Return Receipt
■ 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 maiipiece,
or on the front if space permits.
1. Article Addressed to:
Charles D. Harris, Jr.
PO Box 159
Marshellberg, NC 28533
102595-02-M-1540
A. Signature
gent
X
Wv w Addressee
B. Received b (Pri to Name) C ate f Deliv ry
lyA X4 � V --I/-0
D. Is delivery address different from Rem 1? ❑ Yes
If YES, enntt� ress below: 51�o
--
3. S ice Type ie
ified Mail ❑ Expr.WIJ '
❑ Insured'1aef-:-K b.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
0
2. Article Number
(transfer from service labeO 7008 1140 0002 0397 4394
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1W

CERTIFIED MAIL
RETURN RECEIPT REQUESTED
September 1, 2009
Gary Forehand and Deborra Forehand
P.O. Box 129
Marshallberg, NC 28553
To Whom It May Concern:
440'ehead City 1)(;IU
This correspondence is to notify you as an adjacent riparian landowner that the North Carolina Department of Transportation
plans to replace pipes on -site of his/her property, Parcel 3335. located on SR 1355, Polly Hill Road in Carteret County. The
sketch attached accurately depicts the proposed construction.
Should you have objections to the proposed construction. please check the appropriate statement below. sign. date, and
return as soon as possible to:
Mr. Stephen Lane, Field Representative
N.C. Dept. of Environment and Natural Resources
Division of Coastal Management
Morehead City District
400 Commerce Avenue
Morehead City, N.C. 28557
Written comments must be received by the Division of Coastal Management within 10 days of receipt of this notice.
NO RESPONSE WITHIN 10 DAYS of receipt of the correspondence will be INTERPRETED AS NO OBJECTION.
Sincerelv.
I have no objection to the proposed project as described in this correspondence.
I have objection to the ject as presently propose and have enclosed comments.
__�/Jtoww
ature)
O/zoo 9 (Date)
6J,r wELCaME AIVY Ef`QgrS t° ^OflO VE Ov2 ROAD!✓AY.I AnJO ORA1,1VAG-C