58370_NC DOT_20111020

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GENERAL PERMIT Previous permit#
❑New ❑Modification El 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
❑ Rules attached.
Applicant Name
Address
City
State ZIP
Phone # ()
Fax # ( )
Authorized Agent
❑ CW
❑ EW ❑ PTA ❑ ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑FC:
ORW: yes / ,no
PNA yes / no Crit.Hab. yes / no
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
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
(Scale: )
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
I
�
o
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
J ❑ See note on back regarding River Basin rules.
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
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 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 (252-946-648 [)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/ 1-888ARCOAST
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

�� _*
NCD NR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue
Governor
October 21, 2011
NCDOT
c/o Gregory Thorpe
1548 Mail Service Center
Raleigh, N.C. 27699-1548
Dear Mr. Thorpe:
Dee Freeman
Secretary
Attached is General Permit #58370 C to relocate two utility poles and approximately 850 feet of overhead
power line on the North side of US 158, in Ahoskie, North Carolina.
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
rcb
Enclosures
400 Commerce Ave., Morehead City, NC 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer
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NorthCarolina
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RECEIVED
STATE OF NORTH CAROLINA OCT 17 2011
DEPARTMENT OF TRANSPORTATION DCM-MHD CITY
BEVERLY EAVES PERDUE EUGENE A. CONTI, JR.
GOVERNOR SECRETARY
October 12, 2011
N.C. Dept. of Environment and Natural Resources
Division of Coastal Management
400 Commerce Avenue
Morehead City, NC 28557
Attn: Mr. Stephen Lane
NCDOT Coordinator
Dear Sir:
Subject:
Application for a CAMA General Permit for utility work due to the proposed
widening of US 158 from Murfreesboro Bypass to US 13 West of Winton,
Hertford County. TIP R-2583; Debit $400 from WBS 35489.1.1
Please find enclosed the North Carolina Division of Coastal Management Major Permit Form
and utility plans for the above referenced project. An Environmental Assessment and Finding of
No Significant Impact were completed April 27, 2008 and June 3, 2008 respectively, and were
distributed shortly thereafter. Additional copies are available upon request.
The North Carolina Department of Transportation (NCDOT), Division of Highways, in
consultation with the Federal Highway Administration (FHWA), proposes to widen US 158 from
Murfreesboro Bypass to US 13 West of Winton, Hertford County. No impacts to wetlands or
surface waters due to utilities are proposed. This application is for utility work associated with
the project and is being requested in advance to allow time for utility relocations to commence
prior to widening operations.
The work involves relocating an overhead power line that will cross a bend of Potecasi Creek.
Two poles will be removed and two new poles will be installed in new locations to accomplish
the work. The poles will be located on the same bank and the line will only cross over the
outside bend of the stream.
Regulatory Approvals
Section 404 Permit: A Section 404 Nationwide permit from the U.S. Army Corps of Engineers is
not required for the utility relocation.
MAILING ADDRESS: TELEPHONE: [phone] LOCATION:
NC DEPARTMENT OF TRANSPORTATION FAX: [phone]
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS 1020 BIRCH RIDGE DRIVE
1598 MAIL SERVICE CENTER WEBSITE. WWW.NCDOT.ORG RALEIGH NC 27610-4328
RALEIGH NC 27699-1598

Section 401 Permit: A Section 401 General Certification from the North Carolina Department of
Environmental and Natural Resources, Division of Water Quality is not required for the utility
relocation.
CAMA: NCDOT requests that the proposed utility work associated with this project be
authorized under a Coastal Area Management Act General Permit. The remaining construction
activities will be requested via a Coastal Area Management Act Major Development Permit.
Certified mail return receipts will be forwarded when available. A check in the amount of $400 is
also enclosed for the application fee.
A copy of this permit application and its distribution list will be posted on the NCDOT Website
at: http://www.ncdot.org/doh/preconstruct/pe/. Thank you for your assistance with this project.
If you have any questions or need additional information, please contact Chris Manley at
[e-mail] or [phone].
Sincerely,
Gregory J. Thorpe, Ph.D., Branch Manager
Project Development and Environmental Analysis
cc:
NCDOT Permit Application Standard Distribution List
2

RECEIVED
DCM MP4
APPLICATION for OCT 17 2011
Major Development Permit DCM-MHD CITY
(last revised 12/27/06)
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Information
Business Name
Project Name (if applicable)
North Carolina Department Of Transportation (Ncdot)
US 158 Widening from Murfreesboro to US 13 east of Winton
Applicant 1: First Name
MI
Last Name
Gregory
J.
Thorpe
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
1548 Mail Service Center
Raleigh
NC
ZIP
Country
Phone No.
FAX No.
27699-1548
Wake
919 - 707 -
6000 ext.
-
Street Address (if different from above)
City
State
ZIP
PDEA - Century Center Building A 1000 Birch Ridge Drive
Raleigh
NC
27610-
Email
[e-mail]
2. Agent/Contractor Information
Business Name
Arcadis G&M Of Nc Inc.
Agent/ Contractor 1: First Name
MI
Last Name
Robert
S
Lepsic
Agent/ Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box
City
State
801 Corporate Center Drive, Suite 300
Raleigh
NC
ZIP
Phone No. 1
Phone No. 2
27607 5073
919 - 854 -
9812 ext. 195
919 - 854 - 1282 ext. 195
FAX No.
Contractor #
919 854 5448
Street Address (if different from above)
City
State
ZIP
Email
[e-mail]
<Form continues on back>
2 2-f398-280 .. I - 88-4 OAST ..

i
Form''DCM MP-1 (Page 2 of 4)
APPLICATION for
RECEtVibjor Development Permit
nA AI
3. Project Location
County (can be multiple)
Street Address
State Rd. #
Hertford
Highway 158 DCM-MRD
�ITY
Subdivision Name
City
State
Zip
N/A
Winton Township
NC
-
Phone No.
Lot No.(s) (if many, attach additional page with list)
- - ext.
N/A, I I ,
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
Chowan USGS HUC 03010204 NCDWQ SubBasin 03-01-
Potecasi Creek
02
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
Chowan River
e. Is proposed work within city limits or planning jurisdiction?
f. If applicable, list the planning jurisdiction or city limit the proposed
❑Yes ®No
work falls within.
N/A
4.
Site Description
a.
Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
5,450 ft of shoreline along Potecasi Creek
6,850,245.6 sq ft
c.
Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
N/A, I I
NWL (normal water level)
(If many lot sizes, please attach additional page with a list)
❑NHW or ❑NWL
e.
Vegetation on tract
Area is located on a maintained overhead powerline easement. The vegetation was recently mowed. Vegetation
surrounding the easement is mature pine/hardwood forest.
f.
Man-made features and uses now on tract
The only manmade features on tract are wooden power poles and the overhead powerline.
g.
Identify and describe the existing land uses adjacent to the proposed project site.
Adjacent land uses are forested.
h.
How does local government zone the tract?
i. Is the proposed project consistent with the applicable zoning?
RA-20 Residential
(Attach zoning compliance certificate, if applicable)
®Yes ❑No ❑NA
j.
Is the proposed activity part of an urban waterfront redevelopment proposal? ❑Yes ®No
k.
Hasa professional archaeological assessment been done for the tract? If yes, attach a copy. ®Yes ❑No ❑NA
If yes, by whom?
I.
Is the proposed project located in a National Registered Historic District or does it involve a ❑Yes ®No ❑NA
National Register listed or eligible property?
<Form continues on next page>
25 2 - 8 0 8-280�-a88-4 CO T .. vuww.nnco sfalm ara ent.ntta

Form DCM MP-1 (Page 3 of 4)
APPLICATION for
Major Development Permit
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) RECEIVED
n. Describe existing wastewater treatment facilities.
N/A
OCT 17 201
o. Describe existing drinking water supply source. migi-NHID CITY
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/Government
❑ Private/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
The purpose of the proposed project is to realign an existing overhead powerline to
accommodate the relocation of US 158.
The use of the site will remain the same, transmission of electricty.
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.
Equipment will be stored within the utility easement. An auger truck will be used to
drill the two new holes. A small crane will
be used to remove the old poles and install the new.
d. List all development activities you propose.
There will be no development.
e. Are the proposed activities maintenance of an existing project, new work, or both?
New work
f. What is the approximate total disturbed land area resulting from the proposed project?
0.5 ❑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.
There will be no discharge into waters of the state.
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>
25 -80 8 - .a 1-88,8-4 RC 0 A S <. ,,4vt�A�, n --r-o a staImarzi9ame n f.net

Form'DCM MP-1 (Page 4 of 4)
APPLICATION for
Maj&rbDe elopment Permit
T 1 n onil
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 con�yt �!e ppkccghpn
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.
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e. The appropriate application fee. Check or money order made payable to DENR.
f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name Phone No.
Address
Name Phone No.
Address
Name Phone No.
Address
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
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.
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 L f 1 7011 Print Name CV'-g
n
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
252-BOB- . -1-a - kCa AS �ranr�t.ra�ces�st �r�r�r�� ��as� kera��

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
October 11, 2011
John Charles Jones
PO Box 368
Ahoskie, NC 27910
Dear Landowner:
RECEIVED
OCT 17 2011
DCM-MHD CITY
EUGENE A. CONTI, JR.
SECRETARY
The North Carolina Department of Transportation is planning to US 158 from Murfreesboro Bypass
to US-13 west of Winton. This project crosses an Area of Environmental Concern, as defined by the
North Carolina Division of Coastal Management (DCM), and must be approved by the DCM under
provisions of the Coastal Area Management Act (CAMA). One of the prerequisites to this approval
is that adjacent riparian landowners be given an opportunity to comment on the proposal. A vicinity
map and site drawings are enclosed for your review.
The attached form is submitted to ensure that you have an opportunity to comment on the proposal.
The work planned is depicted in the attached drawing. If you have no objections to the proposal,
please return the form with your response within 10 days to this office. If you do have objections to
the project, please forward your comments to:
Enclosures
cc: Stephen Lane, NCDCM
File R-2583
MAILING ADDRESS:
NC DEPARTMENT OF TRANSPORTATION
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS
1598 MAIL SERVICE CENTER
RALEIGH NC 27699-1598
Mr. Stephen Lane
N.C. Division of Coastal Management
400 Commerce Avenue
Morehead City, NC 28557
Thank you for your cooperation.
Sincerel
Gre ry J. Thorpe, Ph.D., Manager
Project Development Environmental Analysis
TELEPHONE: [phone] D
FAX: [phone]
WEBSITE: WWW.NCDOT.ORG
LOCATION:
1020 BIRCH RIDGE DRIVE
RALEIGH NC 276104328

ADJACENT RIPARIAN LANDOWNER STATEMENT
(US 158 from Murfreesboro Bypass to US-13 west of Winton)
TIP Project No. R-2583
General Statutes and Division of Coastal Management Major Development Permit approval
procedures require that riparian landowners with property adjoining a proposed
development in an Area of Environmental Concern (AEC) be given ten (10) days in which
to comment on the proposed development. This form allows the adjacent riparian
landowner to express either: (1) that he/she objects to the project; or, (2) that he/she does
not object and desires to waive his/her right to the 10-day period so that the processing of
the application can progress more rapidly. Of course, the adjacent riparian landowner
need not sign this form at all if he/she so chooses.
I, , am an adjacent riparian property owner and am aware
of the North Carolina Department of Transportation's plans for widening US 158 from
Murfreesboro Bypass to US-13 west of Winton in Hertford County, North Carolina. I am
further aware that this work will occur in one or more Areas of Environmental Concern and
therefore will require authorization from the Division of Coastal Management in accordance
with the Coastal Area Management Act (CAMA).
I have no objection to the project as presently proposed and
hereby waive that right of objection as provided in General
Statute 113-229
I have objections to the project as presently proposed and my
comments are attached
Signature of Adjacent Riparian Landowner Date
Phone Number with Area Code
2

pSTATE
o
RECEIVED
•tea �• OCT 17 2011
STATE OF NORTH CAROLINA
DCM-MHD CITY
DEPARTNENT OF TRANSPORTATION
BEVERLY EAVES PERDUE EUGENE A. CONTI, JR.
GOVERNOR SECRETARY
October 11, 2011
Annie Baker
142 Sheriff Road
Ahoskie, NC 27910
Dear Landowner:
The North Carolina Department of Transportation is planning to US 158 from Murfreesboro Bypass
to US-13 west of Winton. This project crosses an Area of Environmental Concern, as defined by the
North Carolina Division of Coastal Management (DCM), and must be approved by the DCM under
provisions of the Coastal Area Management Act (CAMA). One of the prerequisites to this approval
is that adjacent riparian landowners be given an opportunity to comment on the proposal. A vicinity
map and site drawings are enclosed for your review.
The attached form is submitted to ensure that you have an opportunity to comment on the proposal.
The work planned is depicted in the attached drawing. If you have no objections to the proposal,
please return the form with your response within 10 days to this office. If you do have objections to
the project, please forward your comments to:
Mr. Stephen Lane
N.C. Division of Coastal Management
400 Commerce Avenue
Morehead City, NC 28557
Thank you for your cooperation.
Sincereby,
-(OV Gregory . Thorpe, Ph.D., Manager
Project Development Environmental Analysis
Enclosures
cc: Stephen Lane, NCDCM
File R-2583
MAILING ADDRESS:
NC DEPARTMENT OF TRANSPORTATION
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS
1598 MAIL SERVICE CENTER
RALEIGH NC 27699-1598
TELEPHONE: [phone]
FAX: [phone]
WEBSITE: W tW.NCDOT.ORG
LOCATION:
1020 BIRCH RIDGE DRIVE
RALEIGH NC 27610-4328

ADJACENT RIPARIAN LANDOWNER STATEMENT
(US 158 from Murfreesboro Bypass to US-13 west of Winton)
TIP Project No. R-2583
General Statutes and Division of Coastal Management Major Development Permit approval
procedures require that riparian landowners with property adjoining a proposed
development in an Area of Environmental Concern (AEC) be given ten (10) days in which
to comment on the proposed development. This form allows the adjacent riparian
landowner to express either: (1) that he/she objects to the project; or, (2) that he/she does
not object and desires to waive his/her right to the 10-day period so that the processing of
the application can progress more rapidly. Of course, the adjacent riparian landowner
need not sign this form at all if he/she so chooses.
I, , am an adjacent riparian property owner and am aware
of the North Carolina Department of Transportation's plans for widening US 158 from
Murfreesboro Bypass to US-13 west of Winton in Hertford County, North Carolina. I am
further aware that this work will occur in one or more Areas of Environmental Concern and
therefore will require authorization from the Division of Coastal Management in accordance
with the Coastal Area Management Act (CAMA).
I have no objection to the project as presently proposed and
hereby waive that right of objection as provided in General
Statute 113-229
I have objections to the project as presently proposed and my
comments are attached
Signature of Adjacent Riparian Landowner Date
Phone Number with Area Code
2

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ADJACENT RIPARIAN LANDOWNER STATEMENT
(US 158 from Murfreesboro Bypass to US-13 west of Winton)
TIP Project No. R-2583
General Statutes and Division of Coastal Management Major Development Permit approval
procedures require that riparian landowners with property adjoining a proposed
development in an Area of Environmental Concern (AEC) be given ten (10) days in which
to comment on the proposed development. This form allows the adjacent riparian
landowner to express either: (1) that he/she objects to the project; or, (2) that he/she does
not object and desires to waive his/her right to the 10-day period so that the processing of
the application can progress more rapidly. Of course, the adjacent riparian landowner
need not sign this form at all if he/she so chooses.
I, cY'2 am an adjacent riparian property owner and am aware
the North Caroli64 Department of Transportation's plans for widening US 158 from
Murfreesboro Bypass to US-13 west of Winton in Hertford County, North Carolina. I am
further aware that this work will occur in one or more Areas of Environmental Concern and
therefore will require authorization from the Division of Coastal Management in accordance
with the Coastal Area Management Act (CAMA).
I have no objection to the project as presently proposed and
hereby waive that right of objection as provided in General
Statute 113-229
I have objections to the project as presently proposed and my
comments are attached
ignature of Adjacent Rip , an Landowner
Phone umber with Area Code
RECEIVED
Date
w2QZV
DCM_MHD C11Y
OCT 18 2011
Dill!" hr.i,
2

ADJACENT RIPARIAN LANDOWNER STATEMENT
(US 158 from Murfreesboro Bypass to US-13 west of Winton)
TIP Project No. R-2583
General Statutes and Division of Coastal Management Major Development Permit approval
procedures require that riparian landowners with property adjoining a proposed
development in an Area of Environmental Concern (AEC) be given ten (10) days in which
to comment on the proposed development. This form allows the adjacent riparian
landowner to express either: (1) that he/she objects to the project; or, (2) that he/she does
not object and desires to waive his/her right to the 10-day period so that the processing of
the application can progress more rapidly. Of course, the adjacent riparian landowner
need not sign this form at all if he/she so chooses.
11 �LJ� , am an adjacent riparian property owner and am aware
of the North Carolina Department of Transportation's plans for widening US 158 from
Murfreesboro Bypass to US-13 west of Winton in Hertford County, North Carolina. I am
further aware that this work will occur in one or more Areas of Environmental Concern and
therefore will require authorization from the Division of Coastal Management in accordance
with the Coastal Area Management Act (CAMA).
I have no objection to the project as presently proposed and
hereby waive that right of objection as provided in General
Statute 113-229
I have objections to the project as presently proposed and my
comments are attached
Signature of Adjacent Riparian Landowner
Phone umber with Area Code
RECEIVED
OCT 2 0 2011
DCM-MRD CITY
2
Date
RE' V ED
OCT .18 2011

Applicant: N C---7
Date: O
Describe below the HABITAT disturbances for the application, All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied fcr.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
dis(urbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temn imnacts)
impact ameunt)
I temo imoacts)
amount)
Dredge [Fill ❑ Both ❑ Other ❑
l
u
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PLAN - POTECASI
\ \ \✓S Abe.
\ v0 F r N
_ \ \ PROPOSED POLES +
\ 256
\ \ \ \✓ ANNIE BAKER
OB 340 PG 327 �
REMOVE POLES 6�
I� 1 \ S 761\JS r0i.903 p\
I • �•� • • • • • • - - - _ � \ N 86'd321 E PUE
F
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ew— — 86
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e PUE-L-
.+ LT p 6 — — — — —.L6— — — — , \. . �\ 2i\� PU�JB L- �3Jzr . 125m64.0
LT12 m Byi
\ 105mL '�L
I ON 5
en 972754 116.10' E 90
• l LEFT
2-•LB---� E- 8 F ���� R/R SPIKE IN BASE iF--}a-T+QO$�-
N
l .jam
10' PS
_ _ _
c � r-
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FULL WIDTH LANE TAPER BITAPER P) ' r-
ULLiI'IOrM-LMF_
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\ ---------- -- ->-------- -------W-- -- - ---------
50
40
30
20
10
0
-10
11
PROJECT REFERENCE NO. 1 SHEET NO.
R 2583
UTILITIES BY OTHERS
NOTE;
ALL PROPOSED UTILITY WORK
SHOWN ON THIS SHEET WILL
BE DONE BY OTHERS
— pU
PUE
, r ccFCDETAILTBDITCH
TAPER (TYP) \ \
350 vEPco• ��
—E—�
R' v SEE�CROSS SECTIONS ----------
Q7 ----
_ N a N ---- ---\_ - - p----------- ��
m•q.58-EL- �E �I — — — G �E%IS N/W
58.00 _
—E )2b0 SZ
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— — — — — — — — — — — C—
IV 65.0062.00'
R +23,65 T 06 a-
N 125.00 R-
TOP F BANK TOP F BANK
WS EL.= 0.5 +/-
25' MIN
I
-20
0+00
RECEI`dED
OCT 17 Z011
DCM-MHD CITY
1+00 2+00 3+00 4+00 5+00 6+00 7+00 8+00 9+00 10+00 11+OU +25

UNITED $TA
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•
Sender: Please print your name, addr�
Chris Manley (R-2583
NCDOT-Natural Envii
1598 Mail Service Cer
Raleigh, NC 27699
I W ........ I I h
()CT 18
vF MAP$
ALE
UNITED STATES POSTAL SERVICE
!E Y. . N . ;"
157- 10C-T 20-1, 1 T
•
Sender: Please print your name, address, and ZI
Chris Manley (R-2583)
NCDOT-Natural Envir(
1598 Mail Service Ceni
Raleigh, NC 27699
H.j.1i.jj j
I t . f f i - I i F
box 0
E I V ED
ment Unit
OCT 18 2011
"WAYS
1p,
L rN
f

■ Complete items 1, 2, and 3. Also complete
nature
item 4 if Restricted Delivery is desired.
nt
■ Print your name and address on the reverse
❑ Addressee
so that we can return the card to you.
B.. Rec ived by (Pri
ame)
C. Date of Delivery
■ Attach this card to the back of the mailpiece,
%
or on the front if space permits.
��// ly
1. Article Addressed to:
D. Is delivery addre
If YES, enter 1
m item 1? ❑ Yes
4, low: ❑ No
John Charles Jones
�2
O
Q
PO Box 368
t
11
Ahoskie, NC 27910
A.
3. Service Typ
Q
5
❑ Certified Ma
ss Mail
RECEIVED
❑ Registered
❑ Return Receipt for Merchandise
❑ Insured Mail
❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 701, ,
(1110 0000 0620 0986
(Transfer from service label)
PS Form 3811, February 2004 DCNPorries>I¢,Rpturn Receipt
102595-02-M-1540

■ 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:
Annie Baker
142 Sheriff Road
Ahoskie, NC 27910
A. Signature
X
❑ Agent
❑ Addre
eceive by (Printed Name) C. Ite of f ry
D. Is delivery address different from item 1? 141yes
If YES, enter delivery address below: ❑ No
RECEIVED
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
0-1rfs4�ail❑C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7❑11 ❑11❑ ❑❑❑❑ ❑62❑ 1❑❑6
(transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540