HomeMy WebLinkAbout50453_NC DOT_20080513❑DREDGE & FILL NTH' A 51)4 ¢3 7
6-�& 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
Applicant Name
Address
City ----._..-----.--.-.-- State ZIP
Phone # () Fax # ( ) i
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
Previous permit #
Date previous permit issued
❑ Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit **
Application Fee(s)
Check #
Issuing Date
Local Planningf urisdiction
Expiration Date
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, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules
❑ Neuse River Basin Buffer Rules
❑ Other:
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: 252-247-3330
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
(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: 252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06
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WATER LEVEL
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1_ a NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
D
n IVISION
\ 113 AIRPORT (25
h Urc h 1\(� S� \ EDENTON, NC 27932 (2E2) 4E2-7977
111 � ��,►e � C �\
ell. '� h J � I •` L I � N � ¢ COUNTY: PASOUOTANK WBS#: N/A
\\ QUAD: WEEKSVILLE DATE: MARCH 17, 20
BASIN: PASOUOTANK SHEET #: 1 OF 2
SUBJECT: PIPE REPLACEMENT ON SR 111E DOUBLE BRIDGE RD.
LAT. - 38.1893237 N LONG. +• 7E.177B361 W
DRAWN SY: A.L. MULDER SCALE: 1" - 30
DETAIL SECTION --
M-0„
PROPOSED RIP
0.02 Fr/FT
PROPOSED HEADWALL�n C-17- —
EXISTING STREAM BED
PROPOSED
1 @ 73" X 55" X 40' CAAPA W/HEADWALL
CROSS SECTION
PROPOSED RIP RAP
PROPOSED HEADWALL
WATER LEVEL
(u EXIST. PIPE BED
PROPOSED PIPE BED
EXISTING
1 @ 48" X 40' CMP
NOTE: PROPOSED 1 @ 73" x 55" x 40' CAAPA TO BE BURIED
1.0' BELOW EXISTING STREAM BED
NOTE:
PROPOSED PIPE WILL BE OF PAVEMENT
BURIED 1.0' BELOW EXISTING 50.49'
STREAM BED
EXISTIVG
PROPOSED RIP RAP_— — — — — — — — 1 Qa 48- X 40' CMP
— — — — — — — — — —
�— — _ WATER LEVEL
EXISTING STREAM SE ELV. 48.28'
ELV. 45.00' PROPOSED PIPE BED
PROPOSE ELV. 44.00'
1 @ 73" X 66" X 40' CAAPA W/HEADWALL EXELVIN44.60' BED
DETAIL SECTION - END VIEW
SYMBOLS
PROPOSED CROSS SECTION
- - - - EXISTING CROSS SECTION
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
DIVISION 1
113 AIRPORT DR.
EDENTON, NO 27932 (252) 462-7977
COUNTY: PASQUOTANK WBS#: NIA
QUAD WEEKSVILLE DATE: MARCH 17, 2008
BASIN: PASQUOTANK SHEET#: 2 OF 2
SUBJECT PIPE REPLACEMENT ON SR 1115`DOUBLE �BRIDGE 4RD,
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LAT. = 35.1893237 N LONG. = 78.1776351 Al
DRAWN BY: A.L.wMULDER�*yww* s SCALE: 1" = 10'
ON MP-1
APPLICATION for
Major Development Permit
(last revised 12127/06)
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant Landowner Information
Business Name
N.C. Department Of Transportation
Project Name (if applicable)
SR 1115 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
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. AgentContractor 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>
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Form DCM MP-1 (Page 2 of 5)
APPLICATION for
Major Development Permit
3. Project Location e
County (can be multiple)
Street Address
State Rd. #
Pasquotank
SR 1115 Double Bridge Road
1115
Subdivision Name
City
State
Zip
Elizabeth City
NC
27909 -
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
Unnamed tributary (modified stream channel) to Chapel
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
Chapel Creek
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 fails within.
4. Site Description
a.
Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
35'
800
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)
2.5 ❑NHW or ®NWL
e.
Vegetation on tract
Various roadside grasses, bermuda, fescue, and centipede.
f.
Man-made features and uses now on tract
SR 1115 Double Bridge Road
g.
Identify and describe the existing land uses adiacent to the proposed project site.
Residential and agricultural.
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 El 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)
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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/Comm unity
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 pipes that are structuarlly failing on SR 1115 Double Bridge Road.
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 existing pipe 1 @ 40' x 48" Corrugated Metal Pipe with 1 @ 40' x 73" x 55" Corrugated Aluminum Alloy Pipe Arch.
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? 400 ®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 1115.
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 DNA
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) — (f) 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.
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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 instrunlent 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 Charles R Gray
Phone No.
Address 1119 Salem Church Road
Elizabeth City, NC 27909
Name George O. Gray
Phone No.
Address 1611 Lexington Drive
Elizabeth City, NC 27909
Name William Henry Garrett
Phone No.
Address 1177 Double Bridge Rd
Elizabeth City, NC 27909
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 Y�� Print Name _Clay Willis, Environmental Officer
Signature
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Form DCM MP-1 (Page 5 of 5)
APPLICATION for
Major Development Permit
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
.2 a2-808-2608 ,. 1-888-4RCOAST .. www."ccoastaImanagement.net
Form ON MP-5
BRIDGES and CULVERTS
4
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
®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):
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(modified stream channel) to Chapel
Creek.
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on back>
C.
Type of culvert (construction material):
1 - 40' x 73" x 55" Corrugated Aluminum Alloy Pipe Arch
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s Form DCM MP-5 (Bridges and Culverts, Page 2 of 4)
d. (i) Will proposed culvert replace an existing bridge?
e. (i) Will proposed culvert replace an existing culvert?
❑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.
2.5'
j. Will the proposed culvert affect navigation by reducing or
increasing the existing navigable opening? ❑Yes ®No
If yes, explain:
®Yes ❑No
If yes,
(ii) Length of existing culvert(s): 40'
(iii) Width of existing culvert(s): 48"
(iv) Height of the top of the existing culvert above the NHW or
NWL: 2.5'
(v) Will all, or a part of, the existing culvert be removed?
(Explain) All
9• Width of proposed culvert: 42"
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:
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: 1' feet affected.
(iii) Avg. width of area to be excavated: 10' ❑CW ❑SAV ❑SB
(iv) Avg. depth of area to be excavated: 2' OWL ®None
(v) Amount of material to be excavated in cubic yards: 0`7
(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: 40'
(iii) Avg. width of area to be excavated: 10
(iv) Avg. depth of area to be excavated: 2'
(v) Amount of material to be excavated in cubic yards: 29.6
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orm DCM MP-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.
a
(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:
(iii) Avg. width of area to be filled:
(iv) Purpose of fill:
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 _ ❑SAV ❑SB
❑WL ®None
(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.
d. How will excavated or fill material be kept on site and erosion
controlled?
Using NCDOT best management practices for sediment
and erosion control.
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For", CM 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 1115 Double Bridge Road Pipe Replacement
Project Name
Clay Willis, Environmental Officer
plicant Na
-lam
P
plicant Sig ature
f. Will wetlands be crossed in transporting equipment to project-.ite?
[]Yes ®No
If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
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