30577_NC DOT_20030610

CAMA / DREDGE & FILL
GENERAL PERMIT
rNew " Modification Complete Reissue Partial Reissue
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
a
a�/ r -30577 g, i
Previous permi
Date previous permit issued
a
❑ Rules attached.
Applicant Name
Project Location: County
Address
Street Address/ State Road/ Lot #(s)
(6, "—
City{:. r r JLb
c State ziP
Phone # (-%.) r'��° "%% Fax # (�)
Subdivision
Authorized Agent
C%'t v t✓-t, �r / f S
City M I
zip Z78?9 0
Affected CW
JKEW ❑ PTA ES ❑ PTS
Phone # ( ) River Basing �
OEA
AEC(s):
❑ HHF ❑ IH ElUBA -- N/A
r
Adj. Wtr. Body P i �` ii: 41;1 + �
'Y '" � � (La Jman ./unkn)
PWS:
ORW: yes / no
❑ FC:
PNA yes / no Crit. Hab. yes / no
Aa
s
Closest Maj. Wtr. Body (�`t j`'
_r—
•� (U ___c C, r 4
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cuoic yarns
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other ! i�
Shoreline Length j
SAM 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: See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature *e Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
Local Planning Jurisdiction 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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
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)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 10/05/01

PAY TO THE
ORDER OF
^�-�'�I
NC Department of Transportation
1514 Mail Services Center
Raleigh, NC 27699-1514
NC DEPT OF ENVIRONMENT
AND NATURAL RESOURCES
DIVISION OF COASTAL MANAGEMENT
1638 MAIL SERVICE CTR
RALEIGH NC 27699-1638
66-105.9
531
Warrant 1451996
Date 06/27/2003
$ 200.00
State Treasurer, Raleigh, North Carolina Chief Financial Officer
Payable at Par Through Federal Reserve SystemTMisFoamcoNTnwsMicaocaiNTINc
- ----.
G� 306NO ? 30577
11■L45L99611■ 1:0531105"ll: 5���000���60L11'

Form DCM-MP-1
APPLICATION
(To be completed by all applicants)
1. APPLICANT
a. Landowner:
Name N. C. Department of Transportation
Address 113 Airport Road
City Edenton
State N.C.
Zip 27932 Day Phone [phone]
Fax [phone]
b. Authorized Agent:
Name Clay Willis, Environmental Officer
Address 113 Airport Road
City Edenton State N.C.
Zip 27932 Day Phone [phone]
Fax [phone]
Project name (if any) SR 1106 — (Newlands Rd)
NOTE: Permit will be issued in name of landowner(s), and/or
project name.
2. LOCATION OF PROPOSED
PROJECT
a. County Hyde
b. City, town, community or landmark
Middletown
c. Street address or secondary road number
SR 1106
d. Is proposed work within city limits or planning
jurisdiction? Yes X No
e. Name of body of water nearest project (e.g. river,
creek, sound, bay) Middletown Creek
3. DESCRIPTION AND PLANNED USE
OF PROPOSED PROJECT
a. List all development activities you propose (e.g.
building a home, motel, marina, bulkhead, pier, and
excavation and/or filling activities.
Secondary Road Construction & Pipe
Replacement
b. Is the proposed activity maintenance of an existing
project, new work, or both? Both
c. Will the project be for public, private or commercial
use? public
d. Give a brief description of purpose, use, methods of
construction and daily operations of proposed
project. If more space is needed, please attach
additional pages. Construct SR 1106 to comply
with current NCDOT design. Methods of
construction will be current NCDOT practices
using Best Management Practices.
Revised 03/95

Form DCM-MP-1
1 V,
4. LAND AND WATER
CHARACTERISTICS
a. Size of entire tract N/A
b. Size of individual lot(s) N/A
c. Approximate elevation of tract above MHW or
NWL 1.1'
d. Soil type(s) and texture(s) of tract
(Ud) Udorthents
e. Vegetation on tract Various roadside grasses such
as fescue and panic grass. Salt Grass & Black
Needlerush adjacent to canal bank.
f. Man-made features now on tract SR 1106 &
adjacent house
g. What is the CAMA Land Use Plan land
classification of the site? (Consult the local land use plan.)
Conservation Transitional
Developed X Community
Rural Other
h. How is the tract zoned by local government?
N/A
i. Is the proposed project consistent with the applicable
zoning? X Yes No
(Attach zoning compliance certificate, if applicable)
j. Has a professional archaeological assessment been
done for the tract? Yes X No
If yes, by whom?
k. Is the project located in a National Registered
Historic District or does it involve a National
Register listed or eligible property?
Yes X No
1. Are there wetlands on the site? X Yes _ No
Coastal (marsh) X Other
If yes, has a delineation been conducted? No
(Attach documentation, if available)
m. Describe existing wastewater treatment facilities.
N/A
n. Describe location and type of discharges to waters of
the state. (For example, surface runoff, sanitary
wastewater, industrial/commercial effluent, "wash
down" and residential discharges.) Surface runoff
o. Describe existing drinking water supply source.
N/A
5. ADDITIONAL INFORMATION
In addition to the completed application form, the
following items must be submitted:
• A copy of the deed (with state application only) or
other instrument under which the applicant claims title
to the affected properties. If the applicant is not
claiming to be the owner of said property, then
forward a copy of the deed or other instrument under
which the owner claims title, plus written permission
from the owner to carry out the project.
• An accurate, dated work plat (including plan view
and cross -sectional drawings) drawn to scale in black
ink on an 8 1/2" by 11" white paper. (Refer to
Coastal Resources Commission Rule 7J.0203 for a
detailed description.)
Please note that original drawings are preferred and
only high quality copies will be accepted. Blue -line
prints or other larger plats are acceptable only if an
adequate number of quality copies are provided by
applicant. (Contact the U.S. Army Corps of
Engineers regarding that agency's use of larger
drawings.) A site or location map is a part of plat
requirements and it must be sufficiently detailed to
guide agency personnel unfamiliar with the area to
the site. Include highway or secondary road (SR)
numbers, landmarks, and the like.
•A Stormwater Certification, if one is necessary.

Form DCM-MP-1
•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. Upon signing this form, the applicant
further certifies that such notice has been provided.
Name Cecil R. & Norma S. Lupton
Address Rt. 1, Box 21783
Engelhard, NC 27824
Phone
Name Joseph Cox
Address Rt. 1, Box 21788
Engelhard, NC 27824
Phone
Name
Address
Phone
• A list of previous state or federal permits issued for
work on the project tract. Include permit numbers,
permittee, and issuing dates.
N/A
• A check for $250 made payable to the Department of
Environment, Health, and Natural Resources
(DEHNR) to cover the costs of processing the
application.
• A signed AEC hazard notice for projects in
oceanfront and inlet areas.
• A statement of compliance with the N.C.
Environmental Policy Act (N.C.G.S. 113A - 1 to
10) If the project involves the expenditure of public
funds or use of public lands, attach a statement
documenting compliance with the North Carolina
Environmental Policy Act.
6. CERTIFICATION AND PERNIISSION
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 conditions
and restrictions contained in the permit.
I certify that to the best of my knowledge, the proposed
activity complies with the State of North Carolina's
approved Coastal Management Program and will be
conducted in a manner consistent with such program.
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.
This is the 'I day of , 20P J,
Print Name Clay Willis
Signature Z /14/1
Landowner o Authorize Agent
Please indicate attachments pertaining to your proposed
project.
DCM MP-2
Excavation and Fill Information
DCM MP-3
Upland Development
DCM MP-4
Structures Information
X DCM MP-5
Bridges and Culverts
DCM MP-6
Marina Development
NOTE. Please sign and date each attachment in the
space provided at the bottom of each form.
Revised 03/95

Form ElCM-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.
1. BRIDGES N/A
a. Public Private
b. Type of bridge (construction material)
c. Water body to be crossed by bridge
d. Water depth at the proposed crossing at MLW or
NWL
e. Will proposed bridge replace an existing bridge?
_Yes No
If yes,
(1) Length of existing bridge
(2) Width of existing bridge
(3) Navigation clearance underneath existing
bridge
(4) Will all, or a part of, the existing bridge be
removed? (Explain)
f. Will proposed bridge replace an existing culvert(s)9
Yes No
If yes,
(1) Length of existing culvert
(2) Width of existing culvert
(3) Height of the top of the existing culvert above
the MHW or NWL
(4) Will all, or a part of, the existing culvert be
removed? (Explain)
g. Length of proposed bridge
h. Width of proposed bridge
i. Height of proposed bridge above wetlands
j. Will the proposed bridge affect existing water flow?
Yes No
If yes, explain
k. Navigation clearance underneath proposed bridge
1. Will the proposed bridge affect navigation by
reducing or increasing the existing navigable
opening? Yes No
If yes, explain
in. Will the proposed bridge cross wetlands containing
no navigable waters? Yes _ No
If yes, explain
n. Have you contacted the U.S. Coast Guard
concerning their approval?
Yes _ No
If yes, please provide record of their action.
2. CULVERTS
a. Water body in which culvert is to be placed
Tributary of Middletown Creek
b. Number of culverts proposed 1
c. Type of culvert (construction material, style)
48" corrugated metal pipe
d. Will proposed culvert replace an existing bridge?
Yes X No
If yes,
(1) Length of existing bridge
Revised 03/95

Form DCM-MP-5
.
(2) Width of existing bridge
(3) Navigation clearance underneath existing
bridge
(4) Will all, or a part of, the existing bridge be
removed? (Explain)
e. Will proposed culvert replace an existing culvert?
X Yes No
If yes,
(1) Length of existing culvert 40'
(2) Width of existing culvert 36"
(3) Height of the top of the existing culvert above
the MHW or NWL - 0.1'
(4) Will all, or a part of, the existing culvert be
removed? (Explain) All
f. Length of proposed culvert 50'
(1) Length of area to be excavated
(2) Width of area to be excavated
(3) Amount of material to be excavated in cubic
yards
c. Will the placement of the proposed bridge or culvert
require any highground excavation?
X Yes No
If yes,
(1) Length of area to be excavated 40'
(2) Width of area to be excavated 8'
(3) Amount of material to be excavated in cubic
yards 13
d. If the placement of the bridge or culvert involves
any excavation, please complete the following:
(1) Location of the spoil disposal area
NCDOT approved waste area site
(2) Dimensions of spoil disposal area
g.
Width of proposed culvert 48"
(3) Do you claim title to the disposal area?
h.
Height of the top of the proposed culvert above the
X Yes No
MHW or NWL - 0.1'
If no, attach a letter granting permission from
the owner.
i.
Will the proposed culvert affect existing water flow?
(4) Will the disposal area be available for future
Yes X No
maintenance? X Yes No
If yes, explain
(5) Does the disposal area include any coastal
wetlands (marsh), SAVs, or other wetlands?
Yes X No
j.
Will the proposed culvert affect existing navigation
If yes, give dimensions if different from (2)
potential? Yes X No
above.
If yes, explain
(6) Does the disposal area include any area below
the MHW or NWL? Yes X No
If yes, give dimension if different from No. 2
3.
EXCAVATION AND FILL
above.
e. Will the placement of the proposed bridge or culvert
a.
Will the placement of the proposed bridge or culvert
result in any fill (other than excavated material
require any excavation below the MHW or NWL?
described in Item d. above) to be placed below
X Yes No
MHW or NWL? X Yes No
If yes,
If yes,
(1) Length of area to be excavated 40'
(1) Length of area to be filled 10'
(2) Width of area to be excavated 8'
(2) Width of area to be filled 8'
(3) Depth of area to be excavated 4.5'
(3) Purpose of fill Stabilization
(4) Amount of material to be excavated in cubic
yards 55
f. Will the placement of the proposed bridge or culvert
b.
Will the placement of the proposed bridge or culvert
result in any fill (other than excavated material
require any excavation within: None
described in Item d. above) to be placed within: No
Coastal Wetlands SAVs Wetlands
_ Coastal Wetlands _ SAVs _ Other Wetlands
_ _ _Other
If yes,
If yes,
Revised 03/95

Form I)CM-MP-5
g
(1)
(2)
(3)
Length of area to be filled
Width of area to be filled
Purpose of fill
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
highground? _ Yes X No
If yes,
(1) Length of area to be filled
(2) Width of area to be filled
(3) Purpose of fill
4. GENERAL
a
Will the proposed project involve any mitigation?
Yes X No
If yes, explain in detail
b. Will the proposed project require the relocation of
any existing utility lines? X Yes No
If yes, explain in detail Possible underground
utilities conflict.
c. Will the proposed project require the construction of
any temporary detour structures?
Yes X No
If yes, explain in detail
d. Will the proposed project require any work
channels? Yes X No
If yes, complete Form DCM-MP-2
e. How will excavated or fill material be kept on site
and erosion controlled? Using NCDOT Best
Management Practices.
f. What type of construction equipment will be used
(for example, dragline, backhoe or hydraulic
dredge)? tracked excavator
g. Will wetlands be crossed in transporting equipment
to project site? Yes X No
If yes, explain steps that will be taken to lessen
environmental impacts.
h. Will the placement of the proposed bridge or culvert
require any shoreline stabilization?
Yes X No
If yes, explain in detail
Clay Willis, Environmental Officer
Applicant or Project Name
Signature
Date
Revised 03/95

VICINITY MAP
HYDE COUNTY

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Ireek NC Department of Transportation
Division of Highways
II{
COUNTY: HYDE
W QUAD: MIDDLETOWN
+
BASIN: TARIPAMLICO
c�N35'-28'
PROJECT R110 .S 6 NEWLANDS RD ( )
DATE-OCT. 14, 2002
PERMIT DRAWING: of

Z_T CECIL R. + NORMA S. LUPTON '
�8 RT.1 BOX 21783
ENGELHARD,NC.27824
@ o \� \
PROPOSED \ : ' \ \ - / ,
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BEGIN STA:0+00
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Pao?Vsev NC Department of Tran
�� TURa�bZT\ Division of High
�C ► ST ► r1 G � e 3 /� " C mpQp - �10 iaw �.� \ c u ttT.w.>
iZatLAC-E WIMA ` �V Cmp - / COUNTY: HYDE
QUAD: MIDDLETOWN
50'• LEN GT't f` � BASIN: TAR/PAMLICO
3. PROJECT: NEWLANDS RD.(
DATE: OCT. 14, 2002

EDGE OF PAVEMENT
CENTERLINE
PROPOSED EDGE OF PAVEMENT I
3 : 1 6; 1 6: I�.
EDGE OF PAVEMENT
OPOSED EDGE OF PAVEMENT
_PROPOSED 2:1 SLOPE
lir /
PROPOSED 50LFT OF 48"CMP EXISTING 40LFT OF 36" TO BE REMOVED
CROSS-SECTION
CENTERLINE
PROPOSED 50LFT OF 48"CMP
END VEIW
TOP OF WATER
BOTTOM CANAL
EXISTING 40LFT OF 36" TO BE REMOVED
TOP OF WATER
BOTTOM CANAL
SYMBOLS
Proposed
Cross-section
— — — — . Existing
Cross-section
SCALE
Horizontal: 1" = 10'
Vertical: 1" = 5'
I NC Department of Transportation I
Division of Highways
COUNTY:HYDE
BASIN: TARIPAMLICO
PROJECT:NEWLAND RD. SR(1106)
DATE: OCT.14, 2002
PERMIT DRAWING: of

■ Complete items 1, 2, and 3. Also complete
item 4 if QestriGrted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
Cecil R. Lupton
Rt. 1, Box 21783
Engelhard, NC 27824
A. Signature
X lIn
B. Received by ( Printed Name)
Agent
Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
Se ice Type
ff Certified Mail ❑xpress Mail
❑ Registered Ed -Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) 7001 1940 0005 6573 1351
PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-1540

UNITED STATES POSTAL SERVICE
First -Class Mai;
Postage & Fees Paid
USPS
Permit No. 'G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
Clay Willis
NC Dept. of Transportation
113 Aiiport Drive, Suite 100
Edenton, NC 27932

■ Complete items 1, 2, and 3. Also complete
item 4 if Restrctecl Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
Joseph R. Cox
Rt. 1, Box`21788
Engelhard, NC 27824
A. Si nature
X (o ❑Agent
B. Received by (Printed N e) C. Date of Delivery
7'03
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Se ice Type
ff Certified Mail
❑ xpress Mail
❑ Registered
Return Receipt for Merchandise
❑ Insured Mail
❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
` 2. Article Number 7001 1940 0005 6573 1366
(Transfer from service label)
PS Form 3811, August 2001 Domestic Return fteipt
102595.02-M-1540

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Pe,4,nii No. 6-10
• Sender: Please print your name, address, and 7IP+4 in HS WX 9
Clay Willis
NC Dept. of Transportation
113 Airport Drive, Suite 100
Edenton, NC 27932

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