57909_NC DOT_20110708

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New El Modification ❑Complete Reissue []Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name_
Address
City
Phone # ( )_
Authorized Agent
Affected ❑ CW
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
_ State ZIP
Fax # ( )
❑ EW ❑ PTA ❑ ES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
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: )
i
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubicyards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
I
-
-
i
—
t
<
P
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
4
❑ See note on back regarding River Basin rules.
Agent or Applicant Printed Name
PermitOfficer's Signature
Signature ** Please read compliance statement on back of permit ** Issuing Date
ApplicationFee(s) Check# Local PlanningJurisdiction
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, 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

AL'A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue
Governor
July 11, 2011
NCDOT
c/o Clay Willis
113 Airport Dr., Suite 100
Edenton, N.C. 27932
Dear Mr. Willis
James H. Gregson
Director
Dee Freeman
Secretary
Attached is General Permit #57909C to construct two 50' X 24" culverts to replace the existing two 50' X 24"
culverts on SR 1208, Kitty Hawk, 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
NorthCarolina
;Vaturallty

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
July 7, 2011
Stephen Lane
NC Division of Coastal Management
400 Commerce Ave.
Morehead City, NC 28557
Dear Mr. Lane,
EUGENE A. CONTI, JR.
SECRI 'ARY
This letter is requesting a general permit .2300 be issued for a pipe replacement on SR 1208 Kitty
Hawk Rd, 90' east of SR 1210 (Bob Perry Rd), in Kitty Hawk, Dare County. The current pipes are failing
and need to be replaced to ensure safe public travel. The existing pipes (2 @ 50' x 24" CMP) will be
replaced with the proposed pipes (2 @ 50' x 24" CAP). The road shoulder at the inlet and outlet of the pipe
will be stabilized with rip -rap. The Division of Coastal Management considers the project area to be within
an AEC that requires authorization for the pipe replacement. Included with this request are the MP-1, MP-
2, MP-5 forms, location map, landowner notices, and permit drawings depicting the proposed work. The
WBS element # is 1.202811. If any additional information is needed please contact Clay Willis at 252-482-
7977.
Sincerely,
Jerry Jennings, P.E.
Division Engineer, Division One
Clay Willis
Environmental Officer, Division One
113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

Dare County SR 1208 Kitty Hawk Rd
pipe replacement, 90' east of SR 1210
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W. KITTY IL4 WK RD. (SR 1208)
DARE CO UNTY
PIPE REPLACEMENT
TIM BEA CREM
4136 IVY LANE
KIM HAWK = 27949
V DB 1498 P 224 AU �: 'e"
"Fy
CANAL � � \
tt A" A
EXISTING PIPE 2@24"X W CMP
, cm PR POSED 2C 24" X 50- CAA
TO BE REMOVED
4
0 W. Kl= HAWK 1W. (SR 1208)
TO SR 1207
TO SR 1211 ------.
PWSZ&V EARM SLOAff AS MQUMD
ra0poSM MP Foit WorWER STAMIZAnON
7S7. -?aaOq
CANAL r Y.35.069792
RULUM S. FLETCHER
64 SPINDRIFT TRAIL
K= HAWK, NC 27949
DB 1603 P 374
NC DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
......... . . ........ . ................ .. .. .. ......................
COUNTY- DARE COUNTY
QUAD., KITTY HAWK
BASIN. PASQUOTANK
PROJECT: PIPE REPLACEMENT
SCALE I"= 30'
DRAWN: JGC DATE 6-09-2011
...... ............... ...... . .. .... . ...... .....................

W. ITT' HAWK RD. (SR 1208)
CL SR 1208
ELEV. 100.66
PROPOSED RIP RAP PROPOSED RIP RAP
AT END OF PIPE,"�' AT END OF PIPE
96.2 99.3 - --------- 100.1 98.8 /
PROPOSED2@24" X50'CAA -'-INV ELEV 96.3
EXISTING PlPg"2@24'X5(Y CMP
TO BE REMOVED
DETAIL SECTION CROSS SECTION
NOTE: CLASS B STONE TO BE PLACED AROUND END OF PIPES
NOTE: 130-170M OF NEW PIPE TO BE PLACED
6" TO VBELOW SILT LINE
EXISTING PIPE
PROPOSED PIPE
NC DEPARTMENT OF TRANSPORTATION
SR 1208 CL ROAD ELEV. 100.66 - - - - - - - - - DIVISION OF HIGHWAYS
NEW, 9AA COUNTY; DARE COUNTY
...... . ...
ti3tkiEM BEDEXISTING 2@ 24- X50
Z EXISTING PIPE 2@24'X50'CMP PROPOSED RIP RAPP NV ELEV 96.3'CAA QUAD,' KITTY HAWK
TO BE REMOVED AT END OF PIPE BASIN - PASQUOTANK
PROJECT -,PIPE REPLACEMENT
SCALE.- 1" = 10'
LINE AA DETAIL END SECTION VErW DRAWN- JGC DATE- 6-09-2011

NICE MP-1
APPLICATION for
Major Development Permit
(last revised 12/2T06)
North Carolina DIVISION OF COASTAL.. MANAGEMENT
1. Primary Applicant/ Landowner Information
-----
.__.....................
Business Name
N.C. Department Of Transportation
Project Name (if applicable)
SR 1208 Kitty Hawk Rd 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 pages) with names listed.
Mailing Address
113 Airport Road, Suite 100
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
Emai!
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 I
6
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>

Form DCM MP-1 (Page 2 of 5)
APPLICATION for
Major Development Permit
3. Project Location
County (can be multiple)
Street Address
State Rd. #
Dare
SR 1208 Kitty Hawk Rd, 90' east of SR 1210 (Bob Perry Rd)
SR 1208
Subdivision Name
City
State
Zip
Kitty Hawk
NC
27949 -
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
UT to Kitty Hawk Bay
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
Albemarle 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.
n/a
4. Site Description
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
72'
4320
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 ❑NHW or ®NWL
e. Vegetation on tract -
Various roadside grasses on a maintained shoulder, sawgrass, & cattail.
f. Man-made features and uses now on tract
SR 1208
g. Identify and describe the existing land uses adiacent to the proposed project site.
Residential and coastal marsh.
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?
k. Has a professional archaeological assessment been done for the tract? If yes, attach a copy. Yes ®No ❑NA
If yes, by whom?
1. Is the proposed project located in a National Registered Historic District or does it involve a Yes MNo NA
National Register listed or eligible property?
<Form continues on next page>
m. (i) Are there wetlands on the site? ®Yes ONo
(it) Are there coastal wetlands on the site? [Dyes ❑No
(iii) If yes to either (i) or (it) above, has a delineation been conducted? Dyes ®No
(Attach documentation, if available)
.� >.-s{f3ia-�'3 I I -8P3-�'�11CisA 'e''"". 4 s:

Form DCM MP-1 (Page 3 of 5)
APPLICATION for
Major Development Permit
n. Describe existing wastewater treatment facilities.
None I
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 I$iPubliclGovernment
❑Private/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
The purpose of this project is to replace the existing pipes that are structuarlly failing on SR 1208.
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 the the existing pipe 2 @ 50' x 24" Corrugated Metal Pipe with 2 @ 50' x 24" Corrugated Aluminum Pipe with riprap on
both ends.
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? 450 ®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 1208.
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>
6. Additional Information M
In addition to this completed application form, (MP-1) the following items below, if applicable, must be submitted in order for the application
package to be complete. Items (a) - (0 are always applicable to any major development application. Please consult the application
instruction booklet on how to properly prepare the required items below.
a. A project narrative.
b. An accurate, dated work plat (including plan view and cross -sectional drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.

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.
E 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 Tim Beachem
Phone No.
Address 4136 Ivy Lane
Kitty Hawk, NC 27949
i
Name William S. Fletcher
Phone No.
Address 64 Spindrift Trail
Kitty Hawk, NC 27949
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.
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.
l 7. Certification and Permission to Enter on Land 1
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 Print Name _Clay Willis, Environmental Officer
Signature
Please indicate application attachments pertaining to your proposed project.

Form DCM MP-1 (Page 5 of 5)
APPLICATION for
®DCM MP-2 Excavation and Fill Information ®DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
E]DCM MP-4 Structures Information
Major Development Permit

Form QCM MP-2
EXCAVATION and FILL
(Except for bridges and culverts)
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
(NLW or
Canal
Boat Basin
Boat Ramp
Rock Groin
Rock
Breakwater
(excluding
shoreline
NWL
stabilization
Length
Width
�
Avg. Existing
NA
NA
Depth
Final Project
NA
NA
Depth
1. 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:
d. High -ground excavation in cubic yards.
2. DISPOSAL OF EXCAVATE© MATERIAL ❑ This section not applicable
a. Location of disposal area. b. Dimensions of disposal area.
c. (i) Do you claim title to disposal area? d. (i) Will a disposal area be available for future maintenance?
❑Yes ❑No ❑NA ❑Yes ❑No ❑NA
(0) If no, attach a letter granting permission from the owner. (0) If yes, where?
e. (i) Does the disposal area include any coastal wetlands/marsh f. (i) Does the disposal include any area in the water?
(CW), submerged aquatic vegetation (SAV), shell bottom (SB), ❑Yes []No ❑NA
or other wetlands (WL)? If any boxes are checked, provide the number of square feet affected. () yes, If es, how much water area is affected?
❑CW ❑SAV ❑SB
OWL ❑None
(5) 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)
a. Type of shoreline stabilization:
❑Bulkhead ®Riprap ❑Breakwater/Sill ❑Other:
c. Average distance waterward of NHW or NWL: 3'
e. Type of stabilization material:
riprap
g. Number of square feet of fill to be placed below water level.
Bulkhead backfill Riprap 48
Breakwater/Sill Other
I. Source of fill material.
b. Length: 16'
Width: 3'
d. Maximum distance waterward of NHW or NWL: 3'
f. (i) Has there been shoreline erosion during preceding 12
months?
❑Yes ®No ❑NA
(ii) If yes, state amount of erosion and source of erosion amount
information.
h. Type of fill material.
riprap
4. OTHER FILL ACTIVITIES ®This section not applicable
(Excluding Shoreline Stabilization)
s. (i) Will fill material be brought to the site? ❑Yes ❑No ❑NA b. (i) Will fill material be placed in coastal wetlands/marsh (CW),
If yes, submerged aquatic vegetation (5AV), sneii bottom (bb), or
n Amount of material to be laced in the water other wetlands (WL)? If any boxes are checked, provide the
(1i) P number of square feet affected.
(iii) Dimensions of fill area ❑CW ❑SAV ❑SB
(iv) Purpose of fill OWL []None
(ii) Describe the purpose of the fill in these areas:
5. GENERAL _
a. How will excavated or fill material be kept on site and erosion b. What type of construction equipment will be used (e.g., dragline,
controlled? backhoe, or hydraulic dredge)?
Using NCDOT Best Management Practices for soil and erosion tracked excavator, backhoe, dumptruck
control. -----
c. (i) Will navigational aids be required as a result of the project? d. (i) Will wetlands be crossed in transporting equipment to project
[]Yes ®No ❑NA site? []Yes ®No []NA
(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.
Clay Willis, Division Environmental Officer
Date n Applicant Name 1
SR 1208 Kitty Hawk Rd pipe replacement
Applicant Signature
Project Name

FOrM DCM MP-5
BRIDGES and CULVERTS
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.
9 BRIDGES ®This section not applicable
a. Is the proposed bridge: b. Water body to be crossed by bridge:
[]Commercial ❑Pubiic/Government ❑Private/Community
c. Type of bridge (construction material):
e. (i) Will proposed bridge replace an existing bridge? ❑Yes ONO
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)
9. Length of proposed bridge:
i. Will the proposed bridge affect existing water flow? ❑Yes ❑No
If yes, explain:
k. Navigation clearance underneath proposed 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:
j. Will the proposed bridge affect navigation by reducing or
increasing the existing navigable opening? ❑Yes []No
If yes, explain:
1. 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
a. Number of culverts proposed:
c. Type of culvert (construction material):
2 - 50' x 24" Corrugated Aluminum Pipe
❑This section not applicable
Water body in which the culvert is to be placed:
Unnamed tributary to Kitty Hawk Bay.
< Form continues on back>

d. (i) Will proposed culvert replace an existing bridge?
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: 50'
h. Height of the top of the proposed culvert above the NHW or NWL.
0'
j. Will the proposed culvert affect navigation by reducing or
increasing the existing navigable opening? ❑Yes ®No
If yes, explain:
e. (i) Will proposed culvert replace an existing culvert?
®Yes ❑No
If yes,
(ii) Length of existing culvert(s): 50'
(iii) Width of existing culvert(s): 24"
(iv) Height of the top of the existing culvert above the NHW or
NWL: 0'
(v) Will all, or a part of, the existing culvert be removed?
(Explain) All
9• Width of proposed culvert: 2 a 24'
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:
13. EXCAVATION and FILL El This section not applicable I
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: 50' feet affected.
(iii) Avg. width of area to be excavated: 6' ❑CW ❑SAV ❑SB
(iv) Avg. depth of area to be excavated: 2' OWL ®None
(v) Amount of material to be excavated in cubic yards: 22.22
(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: 45'
(iii) Avg. width of area to be excavated: 6'
(iv) Avg. depth of area to be excavated: 2'
(v) Amount of material to be excavated in cubic yards: 20
I +'.><+d>-.�,�@3 .z d Y°kis `b H?<-F• x i :8.""€ at �.,�g� Yz§�>§a'2'. r84?d •"? 'it:-.. ? : �.§�,;.,

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.
(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 ❑SS ®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: 12
(iii) Avg. width of area to be filled: 2=3'
(iv) Purpose of fill: Bank stabiliztion.
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
(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:
a. Will the proposed project require the relocation of any existing b. Will the proposed project require the construction of any temporary
utility lines? []Yes ®No detour structures? ❑Yes ®No
If yes, explain: 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.
< Form continues on backs
c. Will the proposed project require any work channels? d. How will excavated or fill material be kept on site and erosion
❑Yes ®No controlled?
If yes, complete Form DCM-MP-2. Using NCDOT best management practices for sediment
and erosion control.

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.
1
Date
SR 1208 Kitty Hawk Rd Pipe Replacment
Project Name
Clay Willis, Environmental Officer
plicant Name p
L�Z?
p
plicant Signature
f. Will wetlands be crossed in transporting equipment to project site?
[]Yes ®No
If yes, explain steps that will be taken to avoid or minimize
environmental impacts.

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERt_Y EAVES PERDUE
GOVERNOR
June 20, 2011
Tim Beachem
4136 Ivy Lane
Kitty Hawk, NC 27949
To Whom It May Concern:
EUGENE A. CON11, J R.
SECRETARY
CERTIFIED MAIL
The NC Department of Transportation is proposing to replace 2 metal pipes on SR
1208 Kitty Hawk Rd. The site is located approximately 90' east of the intersection of
SR 1210 (Bob Perry Rd). The existing pipes are 2 tr 50' x 24" and the proposed pipes are
50' x 24" with the inlet and outlet ends of the pipe stabilized with riprap. All work will be
conducted within NCDOT right-of-way.
The Division of Coastal Management (DCM) considers the adjacent waters to be
estuarine waters under their regulations. Therefore, it is provided protection under state
law. For this reason the NCDOT will apply for a permit from the DCM to perform the
described work. Part of the permit process is notifying the adjacent landowners of the
proposed work. A map depicting the project area, along with a design plat is included
with this letter. If you have any questions concerning the proposed work you can contact
Clay Willis at 252-482-7977.
113 Aiij)ort Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

The attached form is submitted to insure that you have an opportunity to comment
on the proposal. The work is depicted on the attached drawings. If you have no objects to
the proposal, please return the form with your response within ten (10) days to this office.
tf you do have objections to the project, please forward your comments to:
Stephen Lane
NC Division of Coastal Management
400 Commerce Ave
Morehead City, NC 28557
No response within ten (10) days will be construed to mean you have no objections.
Thank you for your cooperation.
Sincerely,
Jerry Jennings, P.E.
Division Engineer, Division One
Clay Willis
Environmental Officer, Division One

ADJACENT RIPARIAN LANDOWNER STATEMENT
(Dare County: SR 1208, 90' east of SR 1210)
1, __—, am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on SR 1208. I am further aware that this work will occur in an AEC and
therefore will require authorization from the Division of Coastal Management in
accordance with the Coastal Area Management Act (LAMA).
I have no objection to the project as presently proposed and hereby waive
that right of objection as provided in General Statute 113-229.
are attached
I have objections to the project as presently proposed and my comments
Signature of Adjacent Landowner
Date:

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
June 20, 2011
William S. Fletcher
64 Spindrift Trail
Kitty Hawk, NC 27949
To Whom It May Concern:
EUGEnE A. CONTI, JR.
SICREI'ARY
CERTIFIED MAIL
The NC Department of Transportation is proposing to replace 2 metal pipes on SR
1208 Kitty Hawk Rd. The site is located approximately 90' east of the intersection of
SR1210 (Bob Pery Rd). The existing pipes are 2 @ 50' x 24" and the proposed pipes are
50' x 24" with the inlet and outlet ends of the pipe stabilized with riprap. All work will be
conducted within NCDOT right-of-way.
The Division of Coastal Management (DCM) considers the adjacent waters to be
estuarine waters under their regulations. Therefore, it is provided protection under state
law. For this reason the NCDOT will apply for a permit from the DCM to perform the
described work. Part of the permit process is notifying the adjacent landowners of the
proposed work. A map depicting the project area, along with a design plat is included
with this letter. If you have any questions concerning the proposed work you can contact
Clay Willis at 252-482-7977.
113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

The attached form is submitted to insure that you have an opportunity to comment
on the proposal. The work is depicted on the attached drawings. If you have no objects to
the proposal, please return the form with your response within ten (10) days to this office.
If you do have objections to the project, please forward your comments to:
Stephen Lane
NC Division of Coastal Management
400 Commerce Ave
Morehead City, NC 28557
No response within ten (10) days will be construed to mean you have no objections.
Thank you for your cooperation.
Sincerely,
Jerry Jennings, P.E.
Division Engineer, Division One
Clay Willis
Environmental Officer, Division One

ADJACENT RIPARIAN LANDOWNER STATEMENT
(Dare County: SR 1208, 90' cast of SR 1210)
11 _ _ , am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on SR 1208. 1 am further aware that this work will occur in an AEC 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 asyrovided in General Statute 1.1.3-229.
are attached.
I have objections to the project as presently proposed and my comments
Signature of Adjacent Landowner
Date:

I Complete Items 1, 2, and 3. Also complete
item 4 if Restricted Delivery Is desired.
I 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:
Tim Seachem
4136 Ivy Lane
Kitty Hawk, NC 27949
A. Si ature
,! ❑ Agent
B. Veceived by rirrfed N e) C. Date of Dellyery
D. Is delivery address different from item 1? Yes
If YES, enter delivery address below: ❑ No
3. Service Type
0 certified Mail ❑ Express Mail
C3 Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
Article Number 7009 2820 0003 3738 3838
(TFansfor from service label)
IS Form 3811, February 2004 Domestic Return 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.
t. Article Addressed to
William S. Fletcher
64 Spindrift Trail
Kitty Hawk, NC 27949
A.
0 Agent
B. Received by Na j tC. Date ofbelivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
11 Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
Article Number
(Transfer from service fat 7009 2823 0003 3738 3821
IS Form 3811, February 2004 Domestic Return Receipt P 702595-02-M-15i'
tti
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(Endorsemard Required)
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William S. Fletcher
Er
64 Spindrift Trail
----------
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Kitty Hawk, NC 27949
Gi:
..........

ADJACENT RIPARIAN LANDOWNER STATEMENT
(Dare County: SR 1208, 90' east of SR 1210)
I, �1 LUA*rf) S . I—(e e 6b<. am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on SR 1208. 1 am further aware that this work will occur in an AEC 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.
are attached.
I have objections to the project as presently proposed and my comments
Signature oPAdj7ent Landowner
Date: — Zg —
RECEIVED
t`
'JUL 6 6 2011
ACM -MHO Cffy

ADJACENT RIPARIAN LANDOWNER STATEMENT
(Dare County: SR 1208, 90' east of SR 1210)
19 % tr' ��Cl l , am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on SR 1208. I am further aware that this work will occur in an AEC 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 Landowner
Date: G �-q D I
RECEIVED
r JUN 3 0 2011
DCM-MHD CITY

Applicant:
Date: -7- ll
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet. '
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
ternimpacts
(Anticipated final(Applied
FINAL Sq. Ft.[any
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
for.
Disturbance
total includes
anticipated
restoration or
ternimpacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill (Both ❑ Other ❑
1 ,
Dredge ❑ Fill N� Both ❑ Other ❑
Dredge ❑ Fill ❑ Both [9"'Olher ❑
't
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ . Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
__?2a02?13 .. .. '11 COA'S ".I mcl :.,.ayt_M..,4f I1�