51287_NC DOT_20090317

UCAMA / ❑ DREDGE & FILL
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 I SA NCAC "
_ ❑"Rules attached.
Applicant Name n`` `' ' " c Project Location: County "} r a
Address'
City State ZIP ' `1
Phone # O Fax # O �/
Authorized Agent
Affected ❑ Cw ❑ Ew ❑ PTA
AEC(s): ❑ OEA ❑ HHF ❑ IH
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no
ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s) I
Subdivision
City / t'J ZIP
Phone # O River Basin
Adj. Wtr. Body e`A' J t"/ ` (nat /man /unkn)
Closest Maj. Wtr. Body '" ` "'
Type of Project/ Activity %' r r
Pier (dock) length
Platform(s) i
Finger pier(s)
X c
X
" ' I' �:
(Scale: )
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore "
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
�e
Other
-
k
U6
f
1,
y r
1
_
_
-
Shoreline Length
SAV: not sure yes
_
Sandbags: not sure yes Cna)
i
Moratorium: n/a ye no
Photos: yes G)
Waiver Attached: yes
1
A building permit may be required by: �f' -ic,f e `' V ' Y
Notes/ Special Conditions
i
❑ See note on back regarding River Basin rules.
.
i
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
Local Planning)urisdiction 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.
Raleigh, NC 27604
919-733-2293
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

3. Primary 4ppiicantl Landowner Information
Business Name
North Caroiina Department Of Transportation
Project Name (if applicable)
SR 1333, Crow Hill Road, Carteret County
Applicant',: 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 City
1587 4 Greenville
( State
NC
ZIP
27835 1587
Country
us
Phone No.
252 - 830 -
3490 ext. 248
FAX No.
252 - 830 - 3341
Street Address (if different from above)
City
State
ZIP
i
i
Email
jbjohnson _ncdof.00v
2. Agent/Contractor Information
Business Name -
Agent/ Contractor . First Name
r
MI
Last Name
Agent/ Contractor'2 First Name
Mi
Last Name
Mailing Address
1 PO Box
I
f
City
State
ZIP
Phone No. t
ext.
Phone No. 2
ext.
FAX No,
Contractor #
Street Address (if different from above)
City
State
ZIP
Email
<Form continues on back>

5, Activities and Impacts
a. Will the project be for commercial, public, or private use? Commercial ;PubliclGovernment
❑Private/Community
b. Give a brief description Of purpose, use, and daily operations of the project when complete.
The Existing 24" x 36' CMP Will Be Replaced By 36"x 48' CMP, The Proposed Pipe Will Keep The Roadway From
Collapsing, Thus Preventing Possible In ury 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,A.nd 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? 248 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?
In. Describe location and type of existing and proposed discharges to waters of the state.
N/A
.................... .
i
i. Will wastewater or stormwater be discharged into a wetland? ❑Yes ZINo ❑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 Q No NA
If yes, attach a mitigation proposal.
<Form continues on back>
6. Additional Information
In addition to this coompleted application ,form, (MP-1) the foliotving it m )below, if p plicab!e, must be submitted in o`der for the application
package to be complete. Items a (,� are altva ys applicable to an major development application. Please consul, the application
instruction booklet on hour to propetiy 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 previousv authorized work, clearly indicate on maps, plats, drawings to distinguish i
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.

Access
Olher
Channel
(VLWor
Canal
Boat Basin
Boat Ramp
Rock Groin
Rock
Breakwater
(excluding
shoreline
j NWL)
stabilization:
Length
i
Width
Avg. Existing
j
NA
NA
Depth
Final Project
NA
NA
Depth
1,
-
(ff development is a wood groin, use MP — Structures)

Have you contacted the U.S. Coast Guard concerning their
approval? Oyes El No i
........... .
.............
n yes. explain:
He ght of proposed bridge above vvetlands:
;:2 C+'1LVER — O7his section not acp hca5ie
a. Number of culverts, proposed. 1 b. Water body in which the culvert is to be placed:
UT to South Leopard Creek
< IFaan n continues on back>

- f o1
fi
0 305 610 1,220 1,830 2,440
Feet

9fAAR 13 N09
ip
:PIPE REPI<ACEMENT
crp Y= 374507.9877
W� X-- 2 73 00 72. 70 79
N 34^-45'4 611
-' W 76^-34'-09"
N 34. 754459 DEsS`GREES
W 76. 569148 DEGREES
H
0 305 610 1,220 1,830 2,440
Feet

EXCAVATION ABOVE NWLe
6'vr x Q'L x 3.6'd = 605 CUBIC FEET 22 CUBIC YARDS
EXCAVATION 'BELOW NWL:
7',,l x ?0" x O.B'd = 5E CUBIC F-EL-T 2 CUBIC YARDS
FINISHED EARTH SLOPE AS REQUIRED
PROPOSED TRIP RAP ENO
ET[
OF PIPF

�. COMPLETE•
■ 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.
1. Article Addressed to:
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A. Sign�ture„i, 'J --��
X 1 ❑ Agent
Addressee
B. Received by ( Printed !Name) C. Date of Delivery
D. is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. S rvice Type
ertified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) 7008 1140 0002 0395 9308
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
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UNITED STATES POSTAL SEKVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZlW in thi
N.C. Divisions of Highways
P.O. Box 1587
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Greenville, NC 27835-1587
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■ 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.
1. Article Addressed to:
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❑Agent
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B. ec�ived by (Printed Name) C. Date of Delivery
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D. is delivery address different from item 1? ❑ Yes
f YES, enter delivery address below: ❑ No
3, Service Type
K&rtified Mail 0 Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(transfer from service label) 7008 1140 0002 0395 9 315
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

UNITED STATES POSTAL SERVICE
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• Sender: Please print your name, address, and
N.C. Divisions of Highways
P.O. Box 1587
Greenville, NC 27835-1587
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■ 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:
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A LD ESTY
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AtTt re
X �,\ Agent
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B. I eived Py (Printe Name) ate of Delivery
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D. Is delivery address different froth item 1 ? 0 Yes
If YES, enter delivery address below: O No
! C 3. Service Type
Z 1 Certified Mail 0 Express Mail
❑ c (� Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service kbeo 7008 1140 0002 0395 9322
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 ,

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIR14 in thi,
(D
gD 3'
N.C. Divisions of Highways
P.O. Box 1587
Greenville, NC 27835-1587 o
11111�Iif S�lttf}ti�fitiililitl ltillll5 t 11!1111�1f i1111 'lll� �

■ Complete items 1, 2, and 3. Also complete A. Signature
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse A,
so that we can return the card to you. Received by (Printed Name)
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
❑ Agent
❑ Addressee
D. Is delivery address different from ite*Kl? / V IrbE
If YES, enter delivery address below: ❑ No
3. Service Type
B&rtified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label 7008 1140 0002 0395 9346
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
i
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------------------------------------
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UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+,jgh thi:
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CD
N.C. Divisions of Highways CL
P.O. Box 1587
Greenville, NC 27835-1587
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