33159_NC DOT_20030127

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previoapermit#
❑New C'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 ,i s, State ( ZIP ,� T! L
Phone # Fax # ( )
Authorized Agent
Affected ❑ CW ❑ EW E PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ElUBA ❑I N/A
ElPWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body ----
Type of Project/ Activity
(Scale: )
Pier (dock) length
Platforms ..
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel —
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing _
Other— --
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
�
..
--
I �..
'
f l�
I
C,-'
G.
`
t *
�
'
--
!
r
�
^F
i1r
_
-
i
f
i
I
--;-
i
—I
1
.....
---
I
i
I
I
I
i
I i
l
_
❑
See
note
on
back
regarding
!
} 2
River
(!
Basin
rf
rules.
r-'
+.
t
i t
r''1
((
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit Officer's Signature
! /h 1 �`
I�furi-n�gDate'
Lfxpiratio ate_
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
landowners).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythat 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 / 1-888-4RCOAST
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)
www.nccoastalmanagement.net
Revised 10/05/01

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Donna D. Moffitt, Director William G. Ross Jr., Secretary
January 29, 2003
NC Department of Transportation
ATTN: Mr. Clay Willis
113 Airport Drive, Suite 100
Edenton, NC 27932
Dear Mr. Willis:
Attached is General Permit #C-33159 to replace culvert in Tyrrell County adjacent to the
Albemarle Sound at SR 1210 (Cemetery Road) at the crossing of an unnamed canal 0.25 miles
north of Columbia.
In order to validate this permit, please sign all three (3) copies 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,
Bill Arrington
D.O.T. Field Representative
BA/srk
Enclosures
151-B Hwy. 24, Hestron Plaza II, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post consumer Paper

9CAMA / ;K DREDGE do FILL
NY 33159
GENERAL PERM 1 T
Previous 41
permit #
g1New ❑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 C7P , Q00'
Applicant Name ,n CI7
❑ Rules attached.
Project Location: CountyT,r�
nn
Address j 3 /i Il r tT r+ Or.
Street Address/ State Road/rrLott #(s)
Ci c1 State IK - ZIP Z% 3Z
tYC-iFcl �_
�r� 5 a o Ccll(1tiF �iii Cc/?�la% Z
Phone # !�Sh-79 77 Fax # ( )
Subdivision 1"1 "5 /�JE r4li c f CG /u ���1/'! C
Authorized Agent C 0 y
City ZIP
Affected ❑ Cw ❑ Ew X PTA ❑ ES APTS
Phone # ( ) River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
Adj. Wtr. Body h2 / Vkt r' S C u V r\ nat /man /unkn)
El PWS: 1-1 FC:
Q �---'
ORW: yes no no PNA yes Crit. Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length rr � _
Platforms)L^, In �: ZX! ST c f / l� X rf Lt IFY--- - —�
Finger pier(s)
i
Groin length L L�
number
Bulkhead/ Riprap length
avg distance offshore V-�r
max distance offshore
Basin, channel _-----------_ -
--
i
4I
Ildozing .
�i: I '
Othel><d
yes --
i
yes
Moratorium: n/a
yes no
fyes nono
J
k
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bu
Shoreline Length
SAV: not sure
Sandbags: not sure
Photos:
Waiver Attached:
(Scaled '� <<tL', ' J)
A building permit may be required by: El See note on back regarding River Basing rules.
Notes/ Special Conditions rt v� V.4 O Ly� Y� %�✓� Ci t f e /❑ d .e/ e K n << I tQ el 6k I � -
Agent or Aqfplicant Printed Name
Signature ** Please read ompliance statement on back of permit"
/pp i Sz os V2JP
Application Fee(s) Check #
Permit
.0
112616
re 1160. iCZVIM
LorA Planning Jurisdiction Rover File Name

DEPARTMENT OF TRANSPORTATION
DIVISION 01 OFFICE
113 AIRPORT DRIVE, SUITE 100
EDENTON, NC 27932
Pay
Pay NCDENR, CAMA
to the 3411 ARENDELL ST.
Order of P.O. BOX 769
MOREHEAD CITY, NC 28557
DATE 01/02/2003
66-1059 STATE TREASURER, RALEIGH, NORTH CAROLINA
531 PAYABLE AT PAR THROUGH FEDERAL RESERVE SYSTEM
# # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # # #
0000089 28ii' I:053110594i: 1111DD011IE41110
DOIIAR444444444444 ONE ZERO ZERO PERIOD ZERO ZERO
dAU 10 Zl0 SIGNATU

e„a STATE u
wm�
STATE OF NORTH CAROLINA
JAN 0 E REPO
COAST:A;- r�nf:f+ur ;
MO(�EI-iE=:�u
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
December 31, 2002
Sc�
Bill Arrington Ne �b a� k�
Division of Coastal Management
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
Dear Mr. Arrington,
This letter is requesting a general permit .23 be issued for a pipe culvert
replacement in Tyrrell County within a water body that is classified as Public Trust
Waters by the Division of Coastal Management. The project is located approximately
0.25 miles north of Columbia on SR 1210 (Cemetery Rd.). The pipe replacement will
occur in a canal that runs under SR 1210 and drains into the Scuppernong River
approximately 0.5 miles downstream of the pipe crossing. The tributary is located in the
Pasquotank drainage basin; sub -basin 03-01-53. This tributary is classified by the
Division of Water Quality as a class C Sw water. This means that these waters are
protected for secondary recreation, fishing, wildlife, fish and aquatic life propagation and
survival. The supplemental classification of Sw (Swamp waters) refers to waters that are
generally have low flow velocities, low pH and dissolved oxygen. There are no
restrictions on watershed development or types of discharges. Included with this request
are the MP-1 and MP-5 forms along with a location map and drawings depicted the
proposed work. A $100.00 dollar check is also included to cover the cost of the permit
process. I will be glad to meet the DCM representative on site for a project review. This
can be schedule by calling Clay Willis at 252-482-7977. Thanks for you efforts in this
matter, if any additional information is needed please contact me at the provided phone
number.
Sincerely,
Don Conner, P.E.
Division Engineer, Division One
4%+"d'
Clay illis
Environmental Officer, Division One
113 Airport Dr., Suite 100, Edenton, NC 27932 —Phone: [phone] Fax: [phone]

� yr
•r..",;;rf...._
_a
rr,,.
�,
A "
N35°-56:5
;<
wM
,
' -1`135a5
: �.�•"•`
G 2
r
_
�
(E)
Pipe Location
f �NGi
1
N35 555 .�'
�
t
.......
�
_
" rat ♦ .h ...,..:.
•
\ .
it
co uMBIN1
` I�
1
`, u.V1'�y1L�fll!•
Pikng4
CO14bMBIA'
�^^
'
C
swim —�,
u: x. o I
r1
e
ridg� 1�1.•%I
.•
`ice*
i♦ � �
_ ,
!'
%
�
f_:..
a
-
J
11
'
94
1
fly
....
.. .. cs, •
��
NN
Cp
—
r8M
3-1) 1 opotluaaS copynght V 1999 DeLorme Yarmouth, M 04096 Source Data: USGS , 850 ft Scale: I : 20,800 Detail: 13-3 Datum: WGS84

01/21/2003 12:02 DIVISION 1 EDENTON 4 82522473330
1
FAX
TO: Bill Arrington
e
Phone [phone]
Fox Phone [phone],930
CC:
NO.488 D01
Date 01121103
INumber of pages including cover sheet
'ROM: Clay Willis
N.C. Dept. of
Transportation
Phone [phone]
Fax Phone 25"2-8722
REMARKS: Q Urgent For your review ❑ Reply ASAP ❑ Please Comment
Bill,
This is the overhead view of the pipe replacement for SR 1210 (Cemetary Rd) in Tyrrell County.
Let me know if you need any additional information or have any questions. I can be reached at
252.482-7977 or cell at 252.339.0112
Thanks,
Clay Willis
Environmental Supervisor
NCDOT
113 Airport Dr. Suite 100
Edenton, NC 27932

-- - - - /-.--1
L-1-
'A'17 11 A V I )
slii►�w�� �
C.\'. CAHOON JR. ��`f'-1'1.AND Af:RrS t[1iYACTSsf) _ .U173
TOTAL WETLAND AREA IN R/NV=.05918
DR 182 �.
G4, PC 750
IOP
•mil
1`1 ti l
a
�4
• . ��NF �9�y� tsB o 6
1t11i�� 41f �
UF6CA Koi4'% 108" tie*
--
\- S1.( tll li t):�IKI
tlt c-,1)
x- IS441U
NC Department of Transportation
Division of Highways
COUNTY: TYREELL
QUAD: COLUMBIA EAST AND WEST
BASIN: PASQUAOTANK
PROJEMCENIETARY (SR-1210�
DATE: JANUARY 16, 2002
SCALE: V - as,
PERMIT DRAWING: of

0 500 1,000 2,000 Feet
I i I i I

Form DCM-MP-1
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]
c. Project name (if any)
Pipe Culvert Replacement in Cucklemaker
Swamp -
No7E: Permit u4ff be issued in name of fan&wner(s), andl- project
name.
2. LOCATION OF PROPOSED
PROJECT
a. County Tyrrell
b. City, town, community or landmark
JAN U 6 RE.CD
Columbia
c. Street address or secondary road number
SR 1210
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) Scuppernong River
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.
Replace one existing 96-inch culvert pipe with
one 108-inch aluminum pipe.
b. Is the proposed activity maintenance of an existing
project, new work, or both? maintenance
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. The Purpose of this proiect is to maintain
the conveyance of water in the tributary from the
east side of SR 1210 to the west side. The pipe will
serve to keep SR 1210 from floodin2 durin2 rain
events and maintain a better hydraulic
connectivity. This work will be accomplished by
excavating the old pipe out with a backhoe, and
front end loader. The new pipe will be put in and
the surrounding ground stabilized.
4. LAND AND WATER
CHARACTERISTICS
a. Size of entire tract the area is approximately 90 feet
by 60 feet includes paved roadway surface.
Revised 03/95

b. Size of individual lot(s) N/A
C. Approximate elevation of tract above
d. Soil type(s) and texture(s) of tract
Do (Dorovan muck)
IJAN`F,�
or NWL
e. Vegetation on tract bald cyprus, sweetgum, green
ash willow oak; various roadside grasses such as
panic grass fescue beggar tick, and red clover.
f. Man-made features now on tract SR 1210
g. What is the CAMA Land Use Plan land classification
of the site? (consult the (ocalland use plan.)
Conservation
Developed
X Rural
Transitional
Community
Other
h. How is the tract zoned by local government?
NCDOT right-of-way
i. Is the proposed project consistent with the applicable
zoning? X Yes No
(Attackzo-ng comphance eerhi-te, if apphcadle)
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) Other
If yes, has a delineation been conducted? Yes
(Attach doaementation, if available)
in. 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.) None
o. Describe existing drinking water supply source.
None
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.
•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.

Form DCM-MP-1
Name Pocosin Lakes National Wildlife Refugee
Address P.O. Box 1969
Phone Manteo, N.C. 27954
Name J. Edwards Pinner
Address 3604 Davis Avenue
Phone Chesapeake, Virginia 27949
Name M.V. Cahoon Jr.
Address P.O. Box 323
Phone Chesapeake, Virginia 27949
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.
USACOE NW 18 Permit # 200310024
• 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 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 conditions
and restrictions contained in the permit.
JAN 0 E RECD
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 _� day of Via✓. , 2003.
Print Name Clay Willis
Signature I�1_ � eVal ;.
Landowner or d_wdwdJgent
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. Pfease sign and date each attachment in the space
provided at the bottom of each form
Revised 03/95

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.
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)?
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
m. 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 to Scuppernong River
b. Number of culverts proposed
c. Type of culvert (construction material, style)
Aluminium arch pipe culvert
d. Will proposed culvert replace an existing bridge?
Yes X No
If yes,
(1) Length of existing bridge
(2) Width of existing bridge
Revised 03/95

Form DCM-MP-5
JAN 0 9 RE'C"D
(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 48 feet
(2) Width of existing culvert 96 inches
(3) Height of the top of the existing culvert above
the MHW or NWL 1 foot
(4) Will all, or a part of, the existing culvert be
removed? (Explain) All of the existing
culvert will be removed
f. Length of proposed culvert 50 feet
g. Width of proposed culvert 108 inches
h. Height of the top of the proposed culvert above the
MHW or NWL 1 foot
i. Will the proposed culvert affect existing water flow?
X Yes No
If yes, explain larger diameter pipe will allow more
water to flow under the roadbed
j. Will the proposed culvert affect existing navigation
potential? Yes X No
If yes, explain
3. EXCAVATION AND FILL
a. Will the placement of the proposed bridge or culvert
require any excavation below the MHW or NWL?
X Yes No
If yes,
(1) Length of area to be excavated 50 feet
(2) Width of area to be excavated 15 feet
(3) Depth of area to be excavated 2 feet
(4) Amount of material to be excavated in cubic
yards 55 cubic yards (1500 cubic feet)
b. Will the placement of the proposed bridge or culvert
require any excavation within: NO
Coastal Wetlands SAVs , Other Wetlands
If yes,
(1) Length of area to be excavated N/A
(2) Width of area to be excavated N/A
(3) Amount of material to be excavated in cubic
yards N/A
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 50 feet
(2) Width of area to be excavated 15 feet
(3) Amount of material to be excavated in cubic
yards 55.5 cubic yards (1500 cubic feet)
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 borrow pit
(2) Dimensions of spoil disposal area
n/a
(3) Do you claim title to the disposal area?
X Yes No
If no, attach a letter granting permission from
the owner.
(4) Will the disposal area be available for future
maintenance? X Yes No
(5) Does the disposal area include any coastal
wetlands (marsh), SAVs, or other wetlands?
Yes X No
If yes, give dimensions if different from (2)
above.
(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
above.
e. 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 MHW
or NWL? X Yes No
If yes,
(1) Length of area to be filled 50 feet
(2) Width of area to be filled 9 feet
(3) Purpose of fill 1 pipe culvert
f. 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 _ SAVs X Other Wetlands
If yes,
Revised 03/95

Form DCM-MP-5
(1) Length of area to be filled 10 feet
(2) Width of area to be filled 15 feet
(3) Purpose of fill 1 pine culvert and rip -ran
across the tops and sides of the pipes
g. 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? X Yes No
If yes,
(1) Length of area to be filled 50 feet
(2) Width of area to be filled 15 feet
(3) Purpose of fill fill on top of 1 pipe culvert for
the road subsurface and surface
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? Yes X No
If yes, explain in detail
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? NC DOT BMP's
f. What type of construction equipment will be used
(for example, dragline, backhoe or hydraulic
dredge)? backhoe. excavator, dumptrucks
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.
Revised 03/95
AN 0 P, REC'O
h. Will the placement of the proposed bridge or culvert
require any shoreline stabilization?
Yes X No
If yes, explain in detail
Alai/
Applicant or Project Name
Signature
Date

I WETLAND
1, %%' 2. ' WETLAND PROPOSED CENTERLINE ELEV. = 10.67
PROP SED ROAD BED E
EYIS'I'ING ROAD BED ELEV. = 10.0'
-nt\r. Jvf.�S.ti�,r.nP
I I
I I
f
I
BOTTOM OF DITCH ELEV. = 0.30 i
{ I
CROSS-SECTION 14+34
CENTERLINE PROPOSED ENTERLINE ELEV. = 10.67
PROPOSEI 120AD BEll I
L'XIS'1'[NG ROAD BEll ELEV. = 10.0---
BOTTOM OF DITCH ELEV
PROPOSE 108" PIPE
PIPE ELEV. = -1.30
END VE1W 14+34
I
WATER ELEV. = 7.1
EXISTING 96" PIPI.-
TO BE REMOVED
wA'reR tiu-.v. � 7.1
PIPE ELEV. _ -1.30
PROPOSED 108" PIPE,
SYMBOLS
_ Proposed
Cross-section
— — — — Existing
Cross-section
SCALE
Horizontal: 1" = 10'
Vertical: 1" = 5'
I NC Department of Transportation
Division of Highways
COUNTY: TYRRELL
BASIN: PASQUOTANK
PROJECT: CEMETARY (SR-1210)
DATE: JANUARY 16, 2002
PERMIT DRAWING: of

N. C. DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
113 Airport Drive, Suite 100
Edenton, NC 27932
11 . 11. . . . 11. 1 1 t Ila 111B Ila
r»s� M.
PO
rL:13L2�41c1Gt: ai
an, Jr.
Ake,'V,-X,27949
° GC �...
SEP
6068503[____

SrA7p o
STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR
September 23, 2002
M.V. Cahoon Jr.
P.O. Box 323
Chesapeake, Virginia 27949
Dear Mr. Cahoon,
SECRETARY
CERTIFIED MAIL
The NC Department of Transportation is proposing to replace a 48 feet long by 96-inch
wide pipe with a 50 feet long by 108-inch wide corrugated alloy aluminum pipe. This
pipe is located on SR 1210 ( Cemetery Road) just north of Columbia. The pipe is located
in a canal that was excavated through a swamp that drains out to the Scuppernong River.
The Division of Coastal Management considers this canal public trust waters. Therefore,
it is provided protect under their jurisdiction. For this reason the NCDOT will apply for a
permit to perform the above 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. This work is being done to aid in the drainage of
the roadway and shoulder section. During periods of heavy rainfall this area holds water
on the shoulder and floods a portion of SR 1210 for extended periods. This causes a
hazard to motorist and damages the structure of the roadway.
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 thirty (30) days to this office.
If you do have objections to the project, please forward your comments to:
Mr. Bill Arrington
NC Division of Coastal Management
3411 Arendell Street
P.O. Box 769
Morehead City, NC 28557
1 13 Airport Dr., Suite 100, Edenton, NC 27932 — Phone: [phone] Fax: [phone]

c-
No response within thirty (30) days will be construed to mean you have no objections.
Thank you for your cooperation.
Sincerely,
Don Conner, P.E.
Division Engineer, Division One
/0 -2 �
Clay Willis
Environmental Officer, Division One
113 Airport Dr., Suite 100, Edenton, NC 27932 — Phone: [phone] Fax: [phone]

,yam/
G 2:{E
Y i
N35°-56'-
rr
j-p i'
1
3G1 (E)
Pipe Rep] acementLocation
�.� M;
• cI
o
e.. .. :G
r•
4:3`•.v.
Foul
\• - x.
41
COLUMBI4,
(BM 5)
i
\ S
-;FcO*MBIA�
1 1
• Oil I. ,i�,.; �. •its"
, � ' , :._is 11
g :1 t•
OR
�p a • j 64; ��
IR
wl
,; •�.�+
� ��•
ice..- ��'�
\� n
Ik
94.
•
or
3-D TopoQuads Copyright 01999 DeLorme Yarmouth, ME 04096 Source Data: USGS ' -- {700 ft Scale: t : 17,600 Detail: 13-5 Datum: WGS84

WETLAND
R W 215, 1 WETLAND PROPOSED CENTERLINE ELEV. = 10.67
PROP SED ROAD BED 1
/ - EXISTING ROAD BEll ELL' V. = 10.0
BOTTOM OF DITCH ELEV. = 0.30
CROSS-SECTION 'i4+34
CENCERLINE PROPOSED ENTERLINE ELEV. = 10.67
PROPOSE fOAD BEll 1
f
L'\IS'I'lNG ROAD BEll ELEV. = 10.0
BOTTOM OF DITCH ELEV
PROPOSE 108" PIPE
PIPE ELEV. = -1.30
EXISTING 96" PIPE
TO BE RENiOVED
END VEIW 14+34
WATER ELEV. = 7.1
EXISTING 96" PII'1:
TO BE REMOVED
WA1'1.7121;1,P:V. _• T1
PIPE ELEV. _ -1.30
PROPOSED 108 PI131-
SYMBOLS
_ Proposed
Cross-section
_ — — Existing
Cross-section
SCALE
Horizontal: 1" = 10'
Vertical: 1" = 5'
NC Department of Transportation
Division of Highways
COUNTY: TYRRELL
BASIN: PASQUOTANK
PROJECT: CEMETARY (SR-1210)
DATE: JANUARY 16, 2002
PERMIT DRAWING: of

ADJACENT RIPARIAN LANDOWNER STATEMENT
( Tyrrell County: Pipe replacement on SR 1210 just North of Columbia)
General Statute 113-229 requires that riparian landowners with property adjoining a
proposed development in an Area of Environmental Concern (AEC) be given thirty (30)
days in which to comment on the proposed development. This form allows the adjacent
riparian landowner to express either: (1) that he objects to the project; or (2) that he does
not object and desires to waive his/her right to the 30-day period so that the processing of
the application can progress more rapidly. Of course, the adjacent riparian landowner
need not sign this form at all if he/she so chooses. No response within 30 days
following receipt of this letter and form will be construed to mean the adjacent
riparian landowner has no objections.
I, , am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the replacement of
a pipe on SR 1210 to solve an existing drainage problem. 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.
are attached.
I have objections to the project as presently proposed and my comments
Signature of Adjacent Landowner
Date:

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
ii ■ Print your name and address on the reverse
so that we can return the card to you.
r ■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Received b (Ple a int Clearly) I B. ate of Delivery
Sig ure
X ❑ Agent
❑ Addressee
0. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
J. Edward Pinner ' JEAN WHOM
3604 Davis Avenue
27949 3. Service Type
Chesapeake, VA
❑Certified Mail El Express Mail
0 Registered ❑ Return Receipt for Merchandise
Insured Mail ❑ C.O.D.
li _�• ^ ^� `~' "_' ' ' +° 4 `Restricted Delivery? (Extra Fee) ❑ Yes
'1'Ariip4��NuLmbe4Copy aee labefy. t
PS Fo rfr-3811, July-340 -- - Domestic eXurn Receipt 102595-00-M-0952
i------ - - - -------- ---- �'' 1�-------------------------------

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

■ 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.
Article Addressed to:
Mr. Mike Bret, Refuge Manager
U.S. Dept. of the Interior
Fish and WildI fe Service
P.O. Box 1969
Manteo. W 27954
A. Received by (Please Print Clearly) I B. Date of Delivery
C. Sig ture
X�C ❑ Agent
Addressee
D. Is ` ivery address different from item 1? ❑Yes
1 U, enter delivery address below: ❑ No
a; .BAN 0 6 RECAV
w
3.
09,'Certified Mail ❑ ress Mail
❑ Registered [E Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number (Copy from service label)
7044_ YtOo 0007
PS Form 3811, July 1999 Domestic Return Receipt 102595-00-M-0952

UNITED STATES POSTAL SERVICE
First -Class Mail
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 Airport Drive, Suite 100
Edenton, NC 27932

■ Complete items 1, 2, and 3. Also comply`.
item 4 if Restricted Delivery is desired. TT
■ Print your name and address on the reverse .
i 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:
M. V. Cahoon, Jr.
PO Box 323
Chesapeake, VA 27949
A. Received by (Please Print Clearly) I B. Date of Delivery
C. Signature
X
❑ Agent
❑ Addressee
D. Is delivery address different from item 1?
❑ Yes
If YES, enter delivery address below:
❑ No
3. Sery a Type
Certified Mail E❑ E%Aress Mail
❑ Registered LYReturn Receipt for
Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee)
❑ Yes
2. Article Number (Copy from service label)
PS Form 3811, July 1999 Domestic Return Receipt 102595-00-M-0952

UNITED STATES POSTAL SERVICE
First -Class Mail
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 Airport Drive, Suite 100
Edenton, NC 27932

JAN 0 6 MET
ADJACENT RIPARIAN LANDOWNER STATEMENT
( Tyrrell County: Pipe replacement on SR 1210 just North of Columbia)
General Statute 113-229 requires that riparian landowners with property adjoining a
proposed development in an Area of Environmental Concern (AEC) be given thirty (30)
days in which to comment on the proposed development. This form allows the adjacent
riparian landowner to express either: (1) that he objects to the project; or (2) that he does
not object and desires to waive his/her right to the 30-day period so that the processing of
the application can progress more rapidly. Of course, the adjacent riparian landowner
need not sign this form at all if he/she so chooses. No response within 30 days
following receipt of this letter and form will be construed to mean the adjacent
riparian landowner has no objections.
1,� �-o�; .� j`1C�°`> am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the replacement of
a pipe on SR 1210 to solve an existing drainage problem. 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).
1/ 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 p' rro�d arild�mmcpts
Signature of Adjacent Landowner
Date: JT