56372_NC DOT_20110425

0CAMA / ❑ 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 15A NCAC
❑ Rules attached.
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
City
Phone # ( )_
Authorized Agent
Affected ❑ CW
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
State ZIP
Fax # ( )
J .
❑ EW ❑ PTA ❑ ES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
PNA yes / no Crit.Hab. yes / no
Subdivision
City ZIP
Phone # (�) River Basin
Adj. Wtr. Body (naf /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
!
'
t
r
f •
l
TE
I
I�
r � _
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no i_
Photos: yes no
Waiver Attached: yes no ELL #
A building permit may be required by: r O See note on back regarding River Basin rules.
Notes/ Special Conditions" - '''
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit'*
Application Fee(s)
Check #
Permit Officer's Signature
Issuing Date
Local Planning Jurisdiction
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 [)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:
RNeuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

19-16AMA / [�?bREDGE & FILL
IOT° 56372
r. GENERAL PERMIT Previous permit#
IS?Gew []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 I SA NCAC ��
p [pRulesattached.
Applicant Name /V �— '�'� Project Location: County1C.�
Address Street Address/ State Road/ Lot #(s) 1
City G'! State l� ZIP�'� ..a ...,'':�
Phone # Fax # O Subdivision 11
Authorized Agent �Y ~j ` °i City �)l+' N` ZIPf
CAW
[�?fW ETA E ES ❑ PTS
Phone # ( )
River Basin u+l
Affected
❑OEA
AEC(s):
❑HHF ❑IH ❑UBA ❑N/A
IZ
Adj. Wtr. Body
\+ar. f�'�,rxc r
nat man unkn)
❑ PWS:
❑FC:
)vr�+
�``
ORW: yes /��
PNA es / no Crit.Hab. yes / no
Closest Maj. Wtr. Body
MEN IMMEMOM
0 MWEEM
ME ME
MIs
EN
Is
Is
Is
Is
MEMENE
MEMEN
MEMO
IN
No
1
0
E'll
MEMO
Emom
0
No
ONE
momommmmommommi
NONE
mommm
MENEM
MEMENEMMEMEMEM
0
INMEM
IMOMEN
MOMME
0
MOMMOMMEMEMEM
0
i
im
NIM-M
Mmmmmmmmmmmmmm
0
No
MEN
MEME
WE
MOMEMEMOMMEME10101
ONE
00
ME
MEMINMENEMME
1 ENE1ME
EMMUMlmmlq,mmmmmE 1 NMEN 0 0 ME= 0 0 OEM
ME N IN MME1NMM � 0 MENEM III
0 ME I� ■MENEM Wool MEEMEMMEM■ ■0
INMEMIN
Agent or Applicant Printed Name
Signature l Please read compliance statement on back of permit
Application Fee(s)�i Check #
Permit 0 icer's Signatuure
Issuing Date Expira ionA�G
Local Planning Jurisdiction Rover File Name

HaFficant:
Date: 4� J
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
impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both (" Other ❑
temp
b 0
6 D O
Dredge j Fill ❑ Both ❑ Other ❑
g
5�°"„�
Dredge[:] Fill [-I 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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
52-81 t, 4,?t.U:>a'a:'

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue
Governor
April 26, 2011
NCDOT
P.O. Box 1587
Greenville, N.C. 27835
Dear Mr.Johnson:
James H. Gregson
Director
Dee Freeman
Secretary
Attached is General Permit #56372C to replace a 95" X 67" X 50' culvert with a 95" X 67" X 50' culvert on
SR 1324, Merritt, Pamlico County, 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
NorthCarohna
Natmallry

MON HF4
APPLICATION for
J' 0f
major Development Permit MAR
past revised 12127/06) �i >��
North Carolina IVISION OF COASTAL MANAGEMENT
�A
1, Primary Applicant/ Landowner Information
Project Name (if applicable)
Business Name
NI-2030 Pipe Replacement SR 1324, Florence Road Over
North Carolina Department Of Transportation
Richardson Creek Pamlico County WBS Element Number
26.206911
Applicant 1: First Name
MI
Last Name
Jay
B.
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
State
1587
Greenville
NC
ZIP
Country
Phone No.
FAX No.
27835 1587
us
252 - 830 - 3490 ext. 248
252 - 830 - 3341
Street Address (if different from above)
City
State
ZIP
Email
[e-mail]
2. Agent/Contractor Information
Business Name
Agent/ Contractor 1: First Name
MI
Last Name
Agent/ Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box I
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>

Form DCM MP-1 (Page 2 of 5)
APPLICATION for
Major Development Permit
3. Project Location
County (can be multiple)
Street Address
State Rd. #
Pamlico
SR 1324, Florence Road
Subdivision Name
City
State
zip T mcm
"����D
Phone No.
- -
Lot No.(s) (if many, attach additional page with list)
MAR 10 201
ext.
I I I I
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
Neuse
Richardson Creek 1D(,`1►T
c. Is the water body identified in (b) above, natural or manmade?
d. Name the closest major water body to the proposed projects 4
®Natural ❑Manmade ❑Unknown
Spring 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 falls within.
4. Site Description
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
50' (27' East and 23' West)
N/A
c. Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
NWL (normal water level)
(If many lot sizes, please attach additional page with a list)
2.3' ❑NHW or ®NWL
e. Vegetation on tract
Maintained Roadside Grasses
f. Man-made features and uses now on tract
Road
g. Identify and describe the existing land uses adjacent to the proposed project site.
Residential Property
h. How does local government zone the tract?
i. Is the proposed project consistent with the applicable zoning?
N/A
(Attach zoning compliance certificate, if applicable)
❑Yes []No ®NA
j. Is the proposed activity part of an urban waterfront redevelopment proposal? - ❑Yes ®No
k. Has a professional archaeological assessment been done for the tract? If yes, attach a copy. ❑Yes No ONA
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?
<Fonn 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)
5

Form DCM MP-1 (Page 3 of 5)
APPLICATION for
Major Development Permit
n. Describe existing wastewater treatment
N/A
o. Describe existing drinking water supply source.
N/A
p. Describe existing storm water management or treatment systems.
N/A
MAR
5. Activities and Impacts
a. Will the project be for commercial, public, or private use? ❑Commercial Public/Govemment
❑Private/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
The Existing 95" x 67" x 50' CMP Will Be Replaced By a Proposed 95" x 67"x 50' CAAPA. The Proposed Pipes Will Keep
The Rcpdway From Collapsing, Thus Preventing Possible Injury and Death.
c. Describe the proposed construction methodology, types of construction equipment to be.used during construction, the number of each type
of equipment and where it is to be stored.
The Existing Pipes Will Be Removed and the Proposed Pipes Will Be Installed. Typical Roadway Construction Equipment
Will Be Used, Including,But Not Limited To Tracked Excavators,Dump Trucks, Flat -Bed Trucks, Back-Hoes,And Boom
Trucks.
d. List all development activities you propose.
Pipe Replacement and Asphalt Patching
e. Are the proposed activities maintenance of an existing project, new work, or both? Both
f. What is the approximate total disturbed land area resulting from the proposed project? 848 ®Sq.Ft or ❑Acres
g. Will the proposed project encroach on any public easement, public accessway or other area ❑Yes []No ®NA
that the public has established use of?
h. Describe location and type of existing and proposed discharges to waters of the state.
N/A
i. Will wastewater or stormwater be discharged into a wetland? ❑Yes SNo ONA
If yes, will this discharged water be of the same salinity as the receiving water? ❑Yes ❑No ❑NA
j. Is there any mitigation proposed? OYes ONo 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, dearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.

Form DCM MP-1 (Page 4 of 5)
APPLICATION for
Major Development Permit
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e. The appropriate application fee. Check or money order made payable to DENR.
f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof 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 Rebert Cooper and Annie Cooper
Phone No.
Address 1785 Whortonsville Road Merritt, NC 28556 Parcel L08-52
MAR 10 2011
Name Weyerhaeuser Company,lnc. Timberlands Acct/Land Records i
Phone No.
iflCM-MHD CITTt•
Address 1785 Weyerhaeuser Road Vanceboro, NC 28586 L08-51
Name Jo Ann B. Alderman
Phone No.
Address 3405 Lubbock Drive Raleigh, NC 27612 Parcel L08-47
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 February 25, 2011 Print Name —Jay B. Johnson
Signature
Please indicate application attachments pertaining to your proposed project.
®DCM MP-2 Excavation and Fill Information ®DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
❑DCM MP-4 Structures Information

RECEIVED
Form DCM MP-2 APR 6 2011
EXCAVATION and FILL
DCM-MHD CITY
(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
9. EXCAVATION ®This section not applicable
a. Amount of material to be excavated from below NHW or NWL in b. Type of material to be excavated.
cubic yards.
c. (i) Does the area to be excavated include coastal wetlands/marsh
d. High -ground excavation in cubic yards.
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
[-]CW ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of the excavation in these areas:
2. DISPOSAL OF EXCAVATED MATERIAL
®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
(ii) If no, attach a letter granting permission from the owner.
(ii) 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 RNA
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
(ii) If yes, how much water area is affected?
❑CW []SAV ❑SB
❑WL ❑None
(ii) Describe the purpose of disposal in these areas:
3. SHORELINE STABILIZATION El This section not applicable
(If development is a wood groin, use MP-4 — Structures)

RECEIVED
APR 6 2011
Form w (r--or Lion and Fill, Page 2 of 2)
a. Type of shoreline stabilization: b. Length: 150' 75' East And 75' West
[]Bulkhead ORiprap ❑Breakwater/Sill ❑Other Width: 4'
c. Average distance waterward of NHW or NWL: 2'
e. Type of stabilization material:
Class B Marl
g. Number of square feet of fill to be placed below water level.
Bulkhead backfill Riprap 75' x 4' = 300 So. Ft.East
and West 75' x 4' = 300 So. Ft. Total = 600 Sq. Ft.
Breakwater/Sill Other
i. Source of fill material.
Clark's Quarry
d. Maximum distance waterward of NHW or NWL: 3'
f. (i) Has there been shoreline erosion during preceding 12
months?
❑Yes ®No RNA
(ii) If yes, state amount of erosion and source of erosion amount
information.
h. Type of fill material.
Class B Marl
4. OTHER FILL ACTIVITIES ®This section not applicable
(Excluding Shoreline Stabilization)
a. (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,
(ii) Amount of material to be placed in the water
(iii) Dimensions of fill area
(iv) Purpose of fill
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 fill in these areas.
5. GENERAL
i
a. How will excavated or fill material be kept on site and erosion b. What type of construction equipment will be used (e.g., dragline,
controlled? backhoe, or hydraulic dredge)?
Silt Fences and TRSC-B's Typical Road Construction Equipment
c. (i) Will navigational aids be required as a result of the project?
❑Yes ®No ❑NA
(ii) If yes, explain what type and how they will be implemented.
February 25, 2011 Revised: March 31, 2011
Date
SR 1324, Florence Road Over Richardson Creek NI-2030
Pamlico County Pipe Replacement WBS Element Number
28.201611
Project Name
Jay B. Johnson
plicant Name
d. (i) Will wetlands be crossed in transporting equipment to project
site? []Yes ®No []NA
(ii) If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
plicant

MR gem Nrs
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.
1. BRIDGES ®This secti?h not aapplicaRe
a. Is the proposed bridge:
❑Commercial ❑PublictGovernment ❑Private/Community
c. Type of bridge (construction material):
e. (i) Will proposed bridge replace an existing bridge? ❑Yes ❑No
If yes,
(ii) Length of existing bridge:
(iii) Width of existing bridge:
(iv) Navigation clearance underneath existing bridge:
(v) Will all, or a part of, the existing bridge be removed?
(Explain)
9• Length of proposed bridge:
b. Water body to be crossed by bridge:
Cj I
d. Water depth at the proposed crossing at NLW or NWL:
f. (i) Will proposed bridge replace an existing culvert? ❑Yes ❑No
If yes,
(ii) Length of existing culvert:
(iii) Width of existing culvert:
(iv) Height of the top of the existing culvert above the NHW or
NWL:
(v) Will all, or a part of, the existing culvert be removed?
(Explain)
h• Width of proposed bridge:
i. Will the proposed bridge affect existing water flow? []Yes ❑No j. Will the proposed bridge affect navigation by reducing or
If yes, explain: increasing the existing navigable opening? ❑Yes []No
If yes, explain:
k. Navigation clearance underneath proposed bridge:
I. Have you contacted the U.S. Coast Guard concerning their
approval? ❑Yes ❑No
If yes, explain:
m. Will the proposed bridge cross wetlands containing no navigable n. Height of proposed bridge above wetlands:
waters? ❑Yes []No
If yes, explain:
Z. CULVERTS El This section not applicable
a. Number of culverts proposed: 1
b. Water body in which the culvert is to be placed:
Richardson Creek
t Form continues on back>

For.,.--ii DC;di MP-5 (Bridges and Culverts, Pane 2 of 4)
c. Type of culvert (construction material):
CAAPA
d. (i) Will proposed culvert replace an existing bridge?
❑Yes ®No
If yes,
(ii) Length of existing bridge:
(iii) Width of existing bridge:
(iv) Navigation clearance underneath existing bridge:
(v) Will all, or a part of, the existing bridge be removed?
(Explain)
f• Length of proposed culvert: 50'
h. Height of the top of the proposed culvert above the NHW or NWL.
2_3"
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 cult' T 44vp .@
If yes,
®Yes�90,%
� G
(ii) Length of existing culvert(s): 50'
(iii) Width of existing culvert(s): 95" C�,�_ /'
(iv) Height of the top of the existing culvert above the NHW or t"
NWL: 2.3'
(v) Will all, or a part of, the existing culvert be removed?
(Explain) All of the Existing Culverts Will be Replaced
9• Width of proposed culvert: 95"
i. Depth of culvert to be buried below existing bottom contour.
1'
k. Will the proposed culvert affect existing water flow?
If yes, explain:
❑Yes ®No
3. EXCAVATION and FILL ❑ This section not applicable
a. (i) Will the placement of the proposed bridge or culvert require any
excavation below the NHW or NWL? ®Yes ❑No
If yes,
(ii) Avg. length of area to be excavated: East 4' West 4'
(iii) Avg. width of area to be excavated: 12' North 12' South
(iv) Avg. depth of area to be excavated: 1_0'
(v) Amount of material to be excavated in cubic yards: 4 Cubic
Yards
c. (i) Will the placement of the proposed bridge or culvert require any
high -ground excavation? ®Yes ❑No
If yes,
(ii) Avg. length of area to be excavated: 40'
(iii) Avg. width of area to be excavated: 12'
(iv) Avg. depth of area to be excavated: 1_8'
(v) Amount of material to be excavated in cubic yards: 32
Cubic Yards
b. (i) Will the placement of the proposed bridge or culvert require any
excavation within coastal wetlands/marsh (CW), submerged
aquatic vegetation (SAV), shell bottom (SB), or other wetlands
(WL)? If any boxes are checked, provide the number of square
feet affected.
®CW 48 Sq. Ft. ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of the excavation in these areas:
Excavation for Pipe Bedding

Form DI —MI MP-5 (3ridges 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: Temporary Spoil Area is in the Existing Road
e.
9.
/011161 4�41
Af. _ GY
f
(n) Dimensions of the spoil disposal area: 100' x 200' 19 ZQ
(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.
(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: North 4' South 4'
(iii) Avg. width of area to be filled: 10'
(iv) Purpose of fill: Pipe Bedding
(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? OYes ®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.
f. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
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 112 Sq. ft. ❑SAV ❑SB
OWL [-]None
(ii) Describe the purpose of the excavation in these areas:
Fill for Proposed Pipe and Class B Stone
b. Will the proposed project require the construction of any temporary
detour structures? ❑Yes ®No
If yes, explain:
< Form continues on back>

�r.PA 3rldges and Cu;v<ar:s, Page 4 of 4)
c. Will the proposed project require any work channels?
❑Yes ®No
If yes, complete Form DCM-MP-2.
e. What type of construction equipment will be used (for example,
dragline, backhoe, or hydraulic dredge)?
Typical Bridge Construction Equipment
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.
February 25,2011
Date
SR 1324, Florence Road NI-2030 Over Richardson Creek, Pipe
Replacement, Pamlico County WBS Element Number
2B.206911
Project Name
Jay B. Johnson
Applicant Name
Applicant Signatu
How will excavated or fill material be kept on site and losion
controlled? �,/A
Turbidity Curtains and Silt Fences will be used to r#409
sediment on -site 1 ?Oil
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.

NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
DIVISION TWO, BRIDGE MAINTENANCE
NEW BERN, N.C.
AREA /
4B SO. FT.
COASTAL IMPACT
RECEIVED
APR 6 2011
PIPE REPLACEMENT
DCM-MHD CITY N/- 2030
SR /324,FLORENCE ROAD
OVER RICHARDSON CREEK
L08-52 BUFFER TIDAL
REBERT COOPER AND ANNIE COOPER zoNE
N
1785 WHORTONSVILLE ROAD
FLOW
MERRITT, NC 28556 B/
DBK. 216, Pg. 920
BUFFER ZONE /IMPACTS = 196 Sq, Ft
BUFFER ZONE 2 IMPACTS 0 Sq. Ft.
STREAM IMPACTS = 4 Sq. Ft. -------------
TEMPORARY SILT FENCE I I
Y= 509814.3601
x= 2711126Z414
0
------------------------------
4'
— — — — — — — — PROPOSED RIP RAPS'
L08-47 4RZ-14 2
JO ANN B. ALDERMAN 64 So, FT.
COASTAL IMPACT
3405 LUBBOCK DRIVE 92
RALEIGH, NC 27612 BUFFER ZONE /IMPACTS = 96 Sq. FY;
DBK. 328, Pg. 422 BUFFER ZONE 2 IMPACTS = 0 Sq. F>.
STREA& /&PACTS = 4 Sq. Ft 2O,
COWST4L /&PACTS OPEN #14 TER
IMPACTS
AREA /.•
46' SO. FT.
AREA /,• 44 SO. FT_
AREA 2.
64 SO. FT.
AREA 2.• 44 SO FT,
TOTAL:
//? SO. FT.
0.002 ACRES
BUFFER
ZONE
/
PROPOSED PIPE REPLACEMENT
/ PAMLICO, (SR-1324) 2030
PAMLICO COUNTY, DATE: 1/25/2011
DRAWN BY: T.CASEY
WBS ELEMENT NUMBER 2B206911
LOB-51
WEYERHAEUSER COMPANYJnc.
TIMBERLANDS ACCT/LAND RECORDS
1785 WEYERHAEUSER ROAD
VANCEBORO,NC 28586
DBK.175, Pg.139 AREA -7
PLAT W/S RT 1324 NO COASTAL IMPACT
TRACT #36 B3
BUFFER ZONE /IMPACTS = 96 Sq. Ft.
BUFFER ZONE 2 IMPACTS = 0 Sq, Ft
-- —— — — — — — — — — — — —
- R/W
TURBIDITY CURTAIN
PROPOSED RIP RAP -------------- SHOULDER POINT
IAtE
EXISTING PIPE: 1095'XG7'X50'CMP Y= 510111.6755
N 20'-12'-44' E X= 2711236JO45
_ _ _ _ _ _ 2.6 MI. N. TO JCT. SR-1_
IeL— — — — — — — — — — — — — _
-- 16
r O.I MI. S. TO JCT. SR-1327 N 35'-0T-42' I I
IN 76'-37'-16' I PROPOSED PIPE: IQ95'X67'X50 CAAPA
I I (8 GAGE) 11,EQP
'TEMPORARY SILT FENCE - SHOULDER POINT
TIDAL
N
FLOW
.JQ'
BUFFER
,JO' ,
BUFFER
ZONE
ZONE
RICHARDSON
CREEK
-EOP
60, C/L SR-1324
}
IFLORENCE ROAD
DITY CURTAIN — —'
------------ R/W
,4fi'E,4 4' B4
NO COASTAL /&PACT _ f
20'
NOTE: NOT TO SCALE
FOR PERMIT USE ONLY
BUFFER ZONE /IMPACTS - 86 Sq. t.
L08-47 BUFFER ZONE 2 IMPACTS = O Sq. Ft.
JO ANN B. ALDERMAN
3405 LUBBOCK DRIVE
RALEIGH, NC 27612
DBK. 328, PG. 422
RICHARDSON CREEK SA;HOW;NSW
NEUSE RIVER BASIN
NEUSE RIPARIAN BUFFER RULES APPLY

NI--2030
SR 1324, Florence Road Over Richardson Creek
Pamlico County
DETAIL SECTION - CROSS SECTION
ti
V �A
PROPOSED RIP RAP
PROPOSED 95' x 87" x 80' CAAPA
EXISTING STREAM BED - - - - - - - - - - - - - - - - -
20'-0'
A QLrwT I .02 _ 0FLFT 0.02 FM
EXISTING 95' x 67" x %MP
- _ - _ - -
VAR.
PROPOSED RIP RAP
PROPOSED 98" x 87" x 50' CAAPA
- - - - -EXISTING WATER SURFACE
PROPOSED PIPE BED
REPLACE EXISTING 95" x 67" x 50' CMP WITH 95" x 67" x 50' CAAPA
ELEVATIONS ARE BASED ON
ASSUMED DATUM.
OF PAVEMENT
---------- — ELEV. = 100.00'
PROPOSED RIP RAP
EXISTING
STREAM BED
--- - - - - - --
ELEV. = 92.6'
SYMBOLS
PROPOSED CROSS SECTION
— — — EXISTING CROSS SECTION
EXISTING e
WATER SURFACE 4"NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
ELEV. = 94.9' DIVISION 2
----------- P.O. BOX 1587
-
------- - -- -ELEV. = 92.6------- GREENVILLE NC 2783$ [phone]
PROPOSED a
PIPE BED
PROPOSED 95" x 67" x 50' CAAPA ELEV. = 91.6' k WBS# 28 208911
DETAIL SECTION - END VIEW
COUNTY:PAMLICO
QUAD: JONES BAY QUAD DATE: FEBRUARY 25, 2011
BASIN:NEUSE SHEET #: 2 OF 2
9 U BJ E CT N I.20 30,n,
EXISTING 95" x 67" x 50' CMP
TO BE REPLACED WITH PROPOSED 95" x 67" x 50' CAAPA
LAT. = 35.128209 N LONG. = 76,821024 W SCALE: 1" = 10'

_ 77
NI-2030 PIPE REPLACEMENT-
PAMLICO COUNTY
SR 1324, FLORENCE ROAD OVER RICHARDSON CREEK
JONES BAY USGS QUAD MAPAND SHEET NUMBER 5
OF THE SOIL SUR VEY OF PAMLICO COUNTY
1 ' FIRM PANEL 7500 RICHARDSON CREEK SA; H W; NS
Q _
` zc AL4PNUMBER 3720750000 J WBS ELEMENT NUMBER
' D LOWER NEUSE 03020204 FEBRUARY25, 20 1 j
•, � - s �. — COI ..'
nee
Fi en
� ' =� ortm►.. 'N
---
�.'E-
t Mark' -
NI-2030 h % ` x,.
s
Y= 510111.6755 _
X=2711236.1045
W 76^-37--16" a\�
N 35.128209 DEGREES
W 76.621024 DEGREES
I:y
. ' zim a;u cn''
x s x6 A-k.AJjCC �
iQ�,�3 � _4�= . ,/� \ +; �\ ,�l yam__ $o•
SR#1
1 inch = 2,000 feet �' \Mk
0 750 1,500 3,000 4,500 6,000 "
Ll

UNITED STATES POSTAL SERVICE
• Sender: Please print your name, address, and ZIP+ i
N.C. Dept. of Transportation
PO Box 1587
Greenville, NC 27835
!I �
? Paid
lSU t
hi �x •
1�LS
UNITED STATES ��l`AL. �R/IC - '4•w "f Gkiss�
• Sender: Please print your name, address, and ZIP+4 in this box •
N.C. Dept. of Transportation
PO Box 1587
Greenville, NC 27835
I?tl?f�{Ff�i!il?itil!{!Fi?!t?fl71!1{1{*j?!{i?liit t{1!!I��SIIi�3� — �3D
FAn,Lico
Mail
UNITED S rATES POSTAL v _
SERVICE Fir t Af
Class
-^ J,,..� �:y?,: �r�•. �' _ram
• Sender. Please print your name, address, and ZIP+4. in this box'-
N.C. Dept. of Transportation
PO Box 1587
Greenville, NC 27835
eP"7
i ,
lilt i i III
III {1(7 1IIJ ,•1
1ii13 ilIfi}!liti!l ti!}it!ititlii:t �AM G�
e

■ 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:
�p.'TN C.
/L,nn(.0
�-7 k61Ve4 ti �sE2 r-zv.
VAN cEl 0,LD / N G 28 5 8 (o
A. Sign4ture
X z6 Id
❑ Agent
❑ Addressee
B. Fj9e6ved by (Printed Name) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. ice Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Retum Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service labeq 7 010 1870 0001 0070 8855
PS Form 3811, February 2004
Domestic Return Receipt
102595-02-M-1540

O�OF W A T�cRQG
Office Use Only:
Corps action ID no.
DWQ project no.
Form Ve ion 1. ec 10 0&'�
Pr4onstrucAon Notif ation C Forii
If
AlA &ant In ormation
1. Processin /
1 a. Type(s) of app val sought from th
Corps:
®Section 4 Perm ❑Sec€in-1 0 Permit
1 b. Specify Nationwide rmit (NWP) number: 3 or General Permit (GP) number:
1 c. Has the NWP or GP nu er been verified by the Corps?
❑ Yes
® No
1d. Type(s) of approval sought the DWQ (check all that apply):
® 401 Water Quality Certificati —Regular ❑Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — xpress ® Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
® Yes ❑ No
1f. Is payment into a mitigation bank or in -lieu fee p gram proposed for mitigation
of impacts? If so, attach the acceptance letter fro mitigation bank or in -lieu
fee program.
❑ Yes
® No
1 g. Is the project located in any of NC's twenty coastal cou es. If yes, answer 1 h
below.
® Yes
❑ No
1h. Is the project located within a NC DCM Area of Environments Concem (AEC)?
❑ Yes
® No
2. Project Information
2a. Name of project:
SR 1129, Haw Branch Road PillReplacement Station 80+00 and Roadway Ditch
Relocation Station 90+42
2b. County:
Beaufort
2c. Nearest municipality 1 town:
Washington
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
26.200711
3. Owner Information
3a. Name(s) on Recorded Deed:
North Carolina Department of Transportation
3b. Deed Book and Page No.
N/A
3c. Responsible Party (for LLC if
applicable):
N/A
3d. Street address:
105 Pactolus Highway NC 33 P.O. Box 1587
3e. City, state, zip:
Greenville, NC 27835 `
3f. Telephone no.:
252-830-3490
3g. Fax no.:
252-830-3341
3h. Email address:
[e-mail]
Page 1 of 11
PCN Form —Version 1.3 December 10, 2008 Version

■ 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:
-T ,j,,j B . AIclfem-.t'j
A. Signatur3
X ❑ Agent
❑ Addressee
B. eceiveI by (Anted . Date of Delivery
q 3-1 I
Is deliveryaddre&Brent fro em 1? ❑Yes
If YES, enter delivery adw: ❑ No
MAK 3 20i1 �
,Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7010 1870 0001 OD70 9135
(Transfer from service label)
PS 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.
1. Article Addressed to:
/��5� 1���i2'TDNSYIl'E Kd•
MF-,-2rrrI NC �gss�.
A. Signature
\ ,� C C �� ❑Agent
X >�' — ^ ' ❑ Addressee
B. Received by (Printed Name) C.--p Delivery
7to /'
D. Is delivery address different from item 1? 1 ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
rtifled Mail ❑ Express Mail
Registered ❑ Return Recelpt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from serviceta TAO 1870 0001 0070 8862
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

RECEIVED
A r.y
APR 6 2011
Office Use Only:
DCM-MHDCIW Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre -Construction Notification C Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ❑Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
N 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ® Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes N No
1f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
❑ Yes
® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
® Yes
❑ No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
® Yes
❑ No
2. Project Information
2a. Name of project:
Pamlico NI-2030 SR 1324, Florence Road Over Richardson Creek
WBS Element Number 2B.206911
2b. County:
Pamlico
2c. Nearest municipality / town:
Oriental
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
213.2069111
3. Owner Information
3a. Name(s) on Recorded Deed:
North Carolina Department of Transportation
3b. Deed Book and Page No.
N/A
3c. Responsible Party (for LLC if
applicable):
N/A
3d. Street address:
105 Pactolus Highway NC 33 P.O. Box 1587
3e. City, state, zip:
Greenville, NC 27835
3f. Telephone no.:
252-830-3490
3g. Fax no.:
252-830-3341
3h. Email address:
[e-mail]
Page 1 of 10
PCN Form — Version 1.3 December 10, 2008 Version

4.
Applicant Information (if different from owner)
4a.
Applicant is:
❑ Agent ® Other, specify: Division 2 Environmental Officer
4b.
Name:
Jay B. Johnson
4c.
Business name
(if applicable):
North Carolina Depratment of Transportation
4d.
Street address:
P.O. Box 1587
4e.
City, state, zip:
Greenville, NC 27835
4f.
Telephone no.:
252-830-3490
4g.
Fax no.:
252-830-3341
4h.
Email address:
[e-mail]
5.
Agent/Consultant Information (if applicable)
5a.
Name:
N/A
5b.
Business name
(if applicable):
5c.
Street address:
5d.
City, state, zip:
5e.
Telephone no.:
5f.
Fax no.:
5g. Email address:
Page 2 of 10
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
C)
NI-2030 SR 1324, Florence Road Qver RichardsonCreek 2f
Latitude: N 35.128209 Lo itude:
1b. Site coordinates (in decimal degrees):
76.621024 "f�
(DD.DDDDDD) (4DDDDDD)
1 c. Property size:
N/A acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Richardson Creek, a Tributary of Spring Creek
proposed project:
2b. Water Quality Classification of nearest receiving water:
SA;HQW;NSW
2c. River basin:
Neuse Lower Neuse 03020204
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
SR 1324, Florence Road is a paved secondary state highway. Woodlands and Agriculture dominate the landscape.
3b. List the total estimated acreage of all existing wetlands on the property:
112 Square Feet (0.003 Acres) of Coastal Wetland Impacts For The Pipe To Pipe Replacement.
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
60' This site is part of a longer adjacent stream system
3d. Explain the purpose of the proposed project:
Pipe To Pipe Replacement ; the existing pipe has deteoriated and needs replacing.
3e. Describe the overall project in detail, including the type of equipment to be used:
The Existing 95 Inch x 67 Inch x 50 Feet Long CMP will be replaced with a Proposed 95 Inch x 67 Inch x 50 Feet Long
CAAPA. Excavators, Dump Trucks,and Crane Trucks will be used for the Pipe To Pipe Replacement.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
El Yes ®No ❑Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
Preliminary El Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency/Consultant Company:
Name (if known): Stephen Lane
Other. NCDCM
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
August,2010
5. Project History
5a. Have permits or certifications been requested or obtained for
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ® No
6b. If yes, explain.
Page 3 of 10
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ❑ Streams - tributaries ® Buffers
® Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non-404, other)
(acres)
T
—Temporary
W1 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
0 Sq. Ft.
W2 ❑ P ❑ T
t
❑ Yes
❑ No
❑ Corps
❑ DWQ
0 Sq. Ft
W3 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
OSq. Ft.
W4 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
0 Sq. Ft.
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
0 Sq. Ft.
2h. Comments: No 404 Wetland Impacts 112 Sq. ft. Coastal Impacts
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non-404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ®P ❑ T
Pipe
Richardson Creek
® PER
❑ INT
❑ Corps
® DWQ
32'
4'
S2 ®P ❑ T
Pipe
Richardson Creek
® PER
❑ INT
❑ Corps
® DWQ
32'
4'
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
8 LF
3i. Comments: 8 Linear Feet of Stream Impacts
Page 4 of 10
PCN Form — Version 1.3 December 10, 2008 Version

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of��
the U.S. then individually list all open water impacts below.
4a.
4b.
4c.
4d.
4e. Gs'
r�
Open water
Name of waterbody
impact number -
(if applicable)
Type of impact
Waterbody type
Area of irivact (acr*
Permanent (P) or
4
Temporary
01 ®P ❑ T
Richardson Creek
Fill
Tributary
44 Sq. Ft.
02 ®P ❑ T
Richardson Creek
Fill
Tributary
44 Sq. Ft.
03 ❑P❑T
04 ❑P❑T
4f. Total open water impacts
88 Sq. Ft.
4g. Comments: 88 Square Feet of Open Water Impacts
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
None
5g. Comments: None
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
® Neuse ❑Tar -Pamlico ❑Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number-
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary
impact
required?
131 ®P ❑ T
Rap
Richardson Creek
El No
86 Sq. Ft.
0 Sq. Ft.
B2 ® P [:IT
Rip
Richardson Creek
El Nos
86 Sq. Ft.
0 Sq. Ft.
B3 ® P [-IT
R P
Richardson Creek
El ❑ No
86 Sq. Ft.
OSq. Ft.
6h. Total buffer impacts
6i. Comments: See Page 6-A For Totals
Page 5 of 10
PCN Form - Version 1.3 December 10, 2008 Version

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary
01 ❑P❑T
02 []PDT
03 ❑P❑T
04 ❑P❑T
4L Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
® Neuse El Tar -Pamlico ❑Other: None
Project is in which protected basin?
❑ Catawba ❑ Randleman
fib.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary
im act
required?
B1 ®P ❑ T
B4 Fill
Richardson Creek
® Nos
86 Sq. Ft.
0 Sq. Ft.
B2 ❑P❑T
❑Yes
❑ No
B3 ❑P❑T
El Yes
❑ No
6h. Total buffer impacts
344 Sq. Ft.
0 Sq. Ft.
6i. Comments: 344 Square Feet of Buffer Zone 1 Impacts and 0 Sq. Ft. of Buffer Zone 2 Impacts
Page f of 10
PCN Form — Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation v
1. Avoidance and Minimization 41
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
There are No 404 Wetland Impacts for this Project; However, There are 112 Square Feet (0.002 Acres) of Coastal Impacts,
Sq. ft. of Open Water Impacts, and 8 Linear Feet of Stream Impacts due to the installation of a proposed pipe to replace the
existing pipe. The Wetland Impacts have been minimized to the greatest extent feasible.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Use of existing roadway to operate construction equipment; no equipment will enter wetlands.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
❑ Yes ® No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments:
4. Complete if Making a Payment to In4ieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10
PCN Form — Version 1.3 December 10, 2008 Version
�OIJ

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
❑ Yes ® No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
None
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
N/A
6h. Comments:
Page 7 of 10
PCN Form — Version 1.3 December 10, 2008 Version

11'�
0,9 6'
In. .
E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
Cry
1.
Diffuse Flow Plan
1a.
Does the project include or is it adjacent to protected riparian buffers identified
® Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
1b.
If yes, then is a diffuse flow plan included? If no, explain why.
Comments: Storm Water will diffuse flow through vegetated uplands before entering
® Yes ❑ No
wetlands. Silt Fences and Turbidity Curtains will be used to contain sediment and
turbidity in Richardson Creek.
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
N/A Roadway/Bridge Project %
2b.
Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why:
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
The Project will diffuse flow through vegetated uplands before entering wetlands. Silt
Fences and Turbidity Curtains will
be used to contain sediment and turbidity in Richardson Creek.
❑ Certified Local Government
2e.
Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
® DWQ 401 Unit
3.
Certified Local Government Stormwater Review
3a.
In which local government's jurisdiction is this project?
N/A
❑ Phase II
3b.
Which of the following locally -implemented stormwater management programs
❑ NSW
El USMP❑
apply (check all that apply):
Water Supply Watershed
❑ Other: N/A
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
4.
DWQ Stormwater Program Review
® Coastal counties
® HQW
4a.
Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
® Other: NPDES Permit
4b.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1.3 December 10, 2008 Version

F.
Supplementary Infonmation
1.
Environmental Documentation (DWQ Requirement)
la.
Does the project involve an expenditure of public (federal/state/local) funds or the
® Yes ❑ No
use of public (federal/state) land?
lb.
If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes ❑ No
letter.)
Comments:
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after -the -fact permit application?
❑ Yes ® No
2c.
if you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
El Yes ® No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4.
Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
N/A
Page 9 of 10
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes No O�
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑Yes ®No
impacts?
❑ Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NCDCM
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NCDCM
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
Not Applicable
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
® Yes ❑ No
8b. If yes, explain how project meets FEMA requirements: Pipe designed to no -rise standards
8c. What source(s) did you use to make the floodplain determination? FEMA FIRM Maps
Jay B. Johnson
March 31, 2011
Applicant/Agent's Printed Name
Date
Applicant/ gen Sign ure
(Agent's signature is valid only/rf n a o izatio tter from the applicant
is ov
Ili
Page 10 of 10
PCN Form — Version 1.3 December 10, 2008 Version

NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
DIVISION TWO, BRIDGE MAINTENANCE
NEW BERN, N.C.
AREA /
49 SO. FT.
COASTAL IMPACT
PIPE REPLACEMENT
N/-2030
SR 1324,FLORENCE ROAD
OVER RICHARDSON CREEK
L08-52
REBERT COOPER AND ANNIE COOPER
1785 WHORTONSVILLE ROAD
MERRITT, NC 28556 B/
DBK. 216, Pg. 920
BUFFER ZONE //"PACTS = 86 Sq. Ft.
BUFFER ZONE 2 IMPACTS 0 Sq. Ff
STREAM /"PACTS = 4 Sq. Ft.
Y= 509814.3601
X = 2711126.6414
0
---- -------------
TEMPORARY SILT FENCE—�-
20'
30'
�F�
tam
B[/FfER
ZONE
TIDAL
N
FLOW
-70,
ZONE
I
PROPOSED PIPE REPLACEMENT
PAMLICO, (SR-1324) 2030
PAMLICO COUNTY, DATE: 1/25/2011
�Ak DRAWN BY: T.CASEY
WBS ELEMENT NUMBER 2B206911
LOB-51
WEYERHAEUSER COMPANY,Inc.
TIMBERLANDS ACCT/LAND RECORDS
1785 WEYERHAEUSER ROAD
VANCEBORO,NC 28586
DBK.175, Pg.139 AREA -7
PLAT W/S RT 1324 NO C0457,4L I"PACT
TRACT '36 BUFFER ZONEI PACTS = 96 Sq. Ft.
BUFFER ZONE 2 IMPACTS = 0 Sq, Ft,
—-------------z- R/W
ZBIDITY CURTAIN
PROPOSED RIP RAP
--------------------------------
EXISTING PIPE: I@95'X67'X50'CMP Y= 510111.6755
N 20'-12'-44' E i I X- 2711236J045
2.6 MI. N. TO JCT. SR-1327
F— O.I MI. S. TO JCT. SR-1327 N 35-07'-4Z I 16
W 76'-37'-16' 1= PROPOSED PIPE:1(D95'X67'X50 CAAPA
1 (6 GAGE) I
E 0 P
'TEMPORARY SILT FENCE - SHOULDER POINT
4
— — — — — — — — PROPOSED RIP RAP
LOB -47 A117E4 2
JO ANN B. ALDERMAN 64 S0, FT.
COASTAL /"PACT
3405 LUBBOCK DRIVE 92
RALEIGH, NC 27612 BUFFER ZONE //"PACTS = 9,6 Sq. FY
DBK. 328, Pg. 422 BUFFER ZONE 2 IMPACTS = 0 Sq. Fr:
TRE4" IMPACTS - 4 S Ff
TIDAL
N
S - q FLOW
COASTAL IIVIOW CTS OPEN 014 TER �' '° BUFFER BUFFER a
tam ZONE ZONE tae
/rLlf ,4CTS / /
RICHARDSON CREEK
HOULDER POINT
-EOP
60 C/L SR-1324
t FLORENCE ROAD
DITY CURTAIN
-- R/W
-------------
,4fiE,4 994
NO COASTAL /"PACT
AREA /, 49SO. FT. AREA /.• 44 S.7 FT.
—_............... __...................-........
AREA 2.• 64 SO. Fr. 419E4 2.• 44 SO. FT.
TOTAL: I/2 SO. FT.
0.002 ACRES
NOTE: NOT TO SCALE
FOR PERMIT USE ONLY
BUFFER ZONE //"PACTS = 66 Sq. Ft.
L08-47 BUFFER ZONE 2 /&PACTS = O Sq Ft.
JO ANN B. ALDERMAN
3405 LUBBOCK DRIVE
RALEIGH, NC 27612
DBK. 328, Pg. 422
RICHARDSON CREEK SA;HOW;NSW
NEUSE RIVER BASIN
NEUSE RIPARIAN BUFFER RULES APPLY

Lane, Stephen
From:
Hart, Kevin
Sent:
Thursday, April 21, 2011 9:56 AM
To:
Lane, Stephen
Cc:
Deaton, Anne; West, Katy
Subject:
RE: Google Earth Image
Stephen,
The NCDMF requests that the DOT utilizes turbidity curtains up and downstream of the culvert
to minimize the adverse impacts from the elevated turbidity. We also request that NCDOT makes
all attempts to perform the work outside of the April 1 to July 30 moratorium to minimize the
impacts to juvenile fish in the area.
If you have any questions let me know.
Kevin
-----Original Message -----
From: Lane, Stephen
Sent: Monday, April 18, 2011 3:10 PM
To: Hart, Kevin
Subject: Google Earth Image
Hi Kevin,
The culvert over the UT to Brown Creek is located at : 35 degrees 6 minutes 52 seconds
North
76 degrees 37 minutes 56 seconds
West
The culvert over Richardson Creek which is a tributary to Spring Creek is located at : 35
degrees 7 minutes 43 seconds North
76
degrees 37 minutes 15 seconds West
Hope this helps and please let me know if you need further information.
Thanks,
Stephen
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1