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Home My WebLink AboutNCDOT (4)❑CAMA/ ❑DREDGE & FILL GENERAL PERMIT Previous permit# A B C D ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued As authorized by the State of North Carolina, Department of Environment and Natural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ❑ Rules attached. Applicant Name Address City Phone # ( ) Authorized Agent Affected ❑ CW AEC(s): ❑ OEA ❑ PWS: ORW: yes / no Project Location: County Street Address/ State Road/ Lot #(s) State ZIP E-Mail Subdivision City ZIP EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin ❑ HHF ❑ I ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn) PNA yes / no Closest Maj. Wtr. Body MEMEME ME No NONE Agent or Applicant Printed Name Permit Officer's Printed Name Signature ** Please read compliance statement on back of permit" Signature Application Fee(s) Check # Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian Iandowner(s) . The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief, certifythat this project is consistentwith 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 Resources. Contact the Division of Water Resources 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 Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28 252-808-2808/ 1-888-4 K,OAST Fax: 25J-247-3330 (Serves: Carteret, Craven, Onslow - North of New River Inlet- and Pamlico Counties) Elizabeth City District 1367 U.S. 17 South Elizabeth City, NC 27909 252-264-3901 Fax: 252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax:910-395-3964 (Serves: Brunswick, New Hanover, Onslow - South of New River Inlet - and Pender Counties) http://www.nccoastalmanagement.net/ Revised 08/27/ 14 19&MA / EL�&EDGE & FILL GNERAL PERMIT ILNew ❑Modification ❑Complete Reissue ❑Partial Reissue N° 67487 A B (0 D Previous permit # -- Date previous permit issued T- 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 5:;Kle4 attached �) Applicant Name I" CVO Project Location: County c '/' Address J - a • 16-')c- )S-r - Ci6�p''CtrState ' ZIP�-_ Phone # (} E-Mail Authorized Agent J �e `�� I N✓"may' N'ew- ❑ EW ❑ PTA ❑ ES ❑ PTS Affected AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ❑ PWS: ORW: yes / no PNA yes / no Street Address/ State Road/ Lot #(s) -ri- / 7 0 o/ -n pvI 0. F ,t izi A,r4 o-14 -re, 11 C7 Subdivision City ` !� C ZIP a-ef Phone # ( ) River Basin W, '17 -t G•k Adj. Wtr. Body T- �` / '^r C"" nat gla /unkn) Closest Maj. Wtr. Body � �` ' v e'e- ... ■■■■ 1111MEEMOMM ■■■■■■■■■■■■■■ ■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ - • ... - = _ ■■■■■■X■M■■N ■�■■��■■�■■■■■��►a■■��■■■■■■■■■ ■■■■■■ \ E�J■`:�ll�'1:ili■■LL�t.'�■■[llsrl�:�7iiiii■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■ ■ ■■■ MENIOUr ■ ■n■► n /1 ► ■ 0 MM ■ ■■ ME ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■: ■■■: '■■■■: ■■■■: ■■■■■■■■■■■■■■■■ ■■■.■....■■.....■......■ ................ ? ■■■■■■■■■■■■■■■■■� :■■■■■■■■■■■■MEMO■M■Elm Agent or Applicant Printed Name Signature Please read compliance statement on back of permit Application Fee(s) Check # Permit Officer's Print d Name Signature Issuing Date Expiration Date 3c,1_Y��9'�C�3��`f i.��.1�:}, ,, ?�a�p„-i,i.{_ 6" •3 }.^; y �1,g3y.Z:tj pays... �y^r �:.�r� Applicant: f l L ,ao '� & ® 6-7 Al 7 Date: 7-9k—JJ Describe below the HABITAT disturbances for the application, All values should Hatch the name, and units ofineaszarernent fov nd in yoarPabitat code sheet. Habitat Name DISi"URS TYPE Choose One TOTAL Sq. Ft. (Applied for. Disturbance total includes any anticipated restoration or temp 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) F►NAL. Feet (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) �1d✓�"� Dredge [Fill ❑ Both ❑ Other ElQ/ G J t, Dredge Fill ❑ Both ❑ Other ❑ Z Dredge ❑ Fill ❑ Both ►� Other ❑ �g I 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 ❑ 252-808-2808 :: 1-888-4RCO AST :: www.rnccoastalmanacement.net revised: 02/15110 M WI WruUn8Nror Mslor Development Permit (last revised 12/27106) v North Carolina DIVISION OF COASTAL MANAGEMENT 1. Primary Applicant Landowner Information Business Name Department Of Transportation Project Name (if applicable) SR 1300 Pipe Replacement WBS#: 2CR.10161.14 Applicant 1: First Name Jay MI B Last Name Johnson Applicant 2: First Name MI Last Name If additional applicants, please attach an additional page(s) with names listed. Mailing Address PO Box 1587 City Greenville State NC ZIP 27835 1587 Country USA Phone No. 252 - 439 - 2800 ext. FAX No. 252 - 830 - 3341 Street Address (if different from above) City State ZIP Email jbjohnson@ncdot.gov 2. Agent(Contractor Information Business Name Agent/ Contractor 1: First Name MI Last Name Agent/ Contractor 2: First Name MI Last Name Mailing Address PO Box City State ZIP 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> RECC `•.' D JUN 2 9 2015 252-808-2808 :: 1-888-4RCOAST :: www.nccoastalmanagement.not Form DCM MP-1 (Page 2 of 4) APPLICATION for Major Development Permit 3. Project Location County (can be multiple) Street Address State Rd. # Carteret SR 1300 Merrimon Rd Subdivision Name City State Zip Phone No. Lot No.(s) (if many, attach additional page with list) - ext. I I , a. In which NC river basin is the project located? b. Name of body of water nearest to proposed project White Oak North River c. Is the water body identified in (b) above, natural or manmade? d. Name the closest major water body to the proposed project site. ®Natural ❑Manmade ❑Unknown North River e. Is proposed work within city limits or planning jurisdiction? f. If applicable, list the planning jurisdiction or city limit the proposed ❑Yes ®No work falls within. 4. Site Description a. Total length of shoreline on the tract (ft.) b. Size of entire tract (sq.ft.) 20' 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) 3' ❑NHW or ®NWL e. Vegetation on tract Maintained Grasses f. Man-made features and uses now on tract Asphalt Road g. Identify and describe the existing land uses adjacent to the proposed project site. Agriculture and Residences 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 ®NA If yes, by whom? I. Is the proposed project located in a National Registered Historic District or does it involve a ❑Yes [:]No ®NA National Register listed or eligible property? <Form continues on next page> - 252-808-2808 .. 1.888-4RCOAST .. www.nccoastatmanagement.net Form DCM MP-1 (Page 3 of 4) APPLICATION for Major Development Permit m. (i) Are there wetlands on the site? ®Yes []No (ii) Are there coastal wetlands on the site? NYes []No (iii) If yes to either (i) or (ii) above, has a delineation been conducted? NYes ❑No (Attach documentation, if available) n. Describe existing wastewater treatment facilities. N/A o. Describe existing drinking water supply source. N/A p. Describe existing storm water management or treatment systems. N/A 5. Activities and Impacts a. Will the project be for commercial, public, or private use? ❑Commercial NPublic/Govemment ❑Private/Community b. Give a brief description of purpose, use, and daily operations of the project when complete. The existing 40' long 18" RCP will be replaced by a 44' long 30" CAAP. The proposed pipe will keep the roadway from collapsing, thus preventing 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. Typical roadway construction equipment will be uised, 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 e. Are the proposed activities maintenance of an existing project, new work, or both? Maintenance f. What is the approximate total disturbed land area resulting from the proposed project? 450 NSq.Ft or ❑Acres g. Will the proposed project encroach on any public easement, public accessway or other area []Yes ❑No NNA 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 stonnwater be discharged into a wetland? []Yes NNo ❑NA If yes, will this discharged water be of the same salinity as the receiving water? ❑Yes ❑No ❑NA j. Is there any mitigation proposed? ❑Yes NNo ❑NA If yes, attach a mitigation proposal. <Form continues on back> JUN 2 9 1015 252-808-2808 .. 1-888-4RCOAST .. www.nccoastalmanagement.net Form DCM MP-1 (Page 4 of 4) APPLICATION for Major Development Permit 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) — (t) are always applicable to any major development application. Please consult the application instruction booklet on how to properly prepare the required items below. a. A project narrative. b. An accurate, dated work plat (including plan view and cross -sectional drawings) drawn to scale. Please give the present status of the proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish between work completed and proposed. c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site. 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 Carrington Mortgage Service LLC Phone No. Address 1610 E St Andrew PI B150, Santa Ana CA 92705 Name Richard E Arthur Phone No. Address 3137 Hwy 70 East, Beaufort NC 28516 Name Elton W Ellis Jr Phone No. Address 1384 Merrimon Rd, Beaufort NC 28516 g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates. h. Signed consultant or agent authorization form, if applicable. i. Wetland delineation, if necessary. j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner) k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act. 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. 1 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 June 15, 2015 Print Name Jay B. Johnson Signature RECEIVED Please indicate application attachments pertaining to your pr posed project. JUN 2 9 2015 ®DCM MP-2 Excavation and Fill Information ®DCM MP-5 Bridges and Culverts ❑DCM MP-3 Upland Development ❑DCM MP-4 Structures Information 252-808-2808 .. 1-888-4RCOAST . www.nccoastalmanagement.net Form DCM MP-2 EXCAVATION and FILL (Except for bridges and culverts) Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint Application that relate to this proposed project. Please include all supplemental information. Describe below the purpose of proposed excavation and/or fill activities. All values should be given in feet. Access Other Channel (NLW or Canal Boat Basin Boat Ramp Rock Groin Rock Breakwater (excluding shoreline NWL) stabilization Length Width Avg. Existing NA NA Depth Final Project NA NA Depth 1. EXCAVATION ®This section not applicable a. Amount of material to be excavated from below NHW or NWL in b. Type of material to be excavated. cubic yards. c. (i) Does the area to be excavated include coastal wetlands/marsh 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 (SIB), ❑Yes ❑No ❑NA 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: RECEIVED JUN 2 9 2015 252-808-2808 :: 1-888-4RCOAST :: www_nccoastalmana ement.net revised: 12/26/06 Form DCM MP-2 (Excavation and Fill, Page 2 of 2) 3. SHORELINE STABILIZATION ❑This section not applicable (if development is a wood groin, use MP-4 — Structures) a. Type of shoreline stabilization: b. Length: 20' ❑Bulkhead SRiprap ❑Breakwater/Sill ❑Other: Width: 4' c. Average distance waterward of NHW or NWL: 2' d. Maximum distance waterward of NHW or NWL: 2' e. Type of stabilization material: RipRap g. Number of square feet of fill to be placed below water level. Bulkhead backfill Riprap 20 Breakwater/Sill Other i. Source of fill material. f. (i) Has there been shoreline erosion during preceding 12 months? ❑Yes SNo ❑NA (ii) If yes, state amount of erosion and source of erosion amount information. h. Type of fill material. Sand C 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 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)? NCDOT BMP's Typical road construction equipment c. (i) Will navigational aids be required as a result of the project? ❑Yes NNo ❑NA (ii) If yes, explain what type and how they will be implemented. June 15, 2015 Date SR 1300 Pipe Replacement WBS#: 2CR.10161.14 Project Name d. (i) Will wetlands be crossed in transporting equipment to project site? ❑Yes SNo ❑NA (ii) If yes, explain steps that will be taken to avoid or minimize environmental impacts. Jay B.Johnson Applicant N e FL(-'t1VED JUN Applicant natu 5 252-808-2808 :: 1-888-4RCOAST :: wwvv.nccoastalmanag_ement.net revised: 12/26/06 FOIM OCM MP-5 BRIDGES and CULVERTS Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint Application that relate to this proposed project. Please include all supplemental information. 1. BRIDGES ®This section not applicable a. Is the proposed bridge: ❑Commercial ❑Public/Government ❑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: i. Will the proposed bridge affect existing water flow? ❑Yes []No If yes, explain: b. Water body to be crossed by bridge: d. Water depth at the proposed crossing at NLW or NWL: f. (i) Will proposed bridge replace an existing culvert? ❑Yes ❑No If yes, (ii) Length of existing culvert: (iii) Width of existing culvert: (iv) Height of the top of the existing culvert above the NHW or NWL: (v) Will all, or a part of, the existing culvert be removed? (Explain) h Width of proposed bridge: j. Will the proposed bridge affect navigation by reducing or increasing the existing navigable opening? [--]Yes []No If yes, explain: 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: t. CULVERTS El This section not applicable a• Number of culverts proposed: 1 b. Water body in which the culvert is to be placed: Ditch � 2015 < Form continues on back> JUN 2 252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagernent.net revised: 10/26/06 Form ®CM MP-5 (Bridges and Culverts, Page 2 of 4) c. Type of culvert (construction material): Corrugated Aluminum Alloy d. (i) Will proposed culvert replace an existing bridge? e. (i) Will proposed culvert replace an existing culvert? ❑Yes ®No ®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: 44' h. Height of the top of the proposed culvert above the NHW or NWL. .5' j. Will the proposed culvert affect navigation by reducing or increasing the existing navigable opening? ❑Yes ®No If yes, explain: If yes, (ii) Length of existing culvert(s): 40' (iii) Width of existing culvert(s): 18" (iv) Height of the top of the existing culvert above the NHW or NWL: .5' (v) Will all, or a part of, the existing culvert be removed? (Explain) All of the existing culvert will be removed. 9 Width of proposed culvert: 30" i. Depth of culvert to be buried below existing bottom contour. 1' k. Will the proposed culvert affect existing water flow? ❑Yes ®No If yes, explain: 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: 5' (iii) Avg. width of area to be excavated: 5' (iv) Avg. depth of area to be excavated: 1' (v) Amount of material to be excavated in cubic yards: 1 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: 10' (iv) Avg. depth of area to be excavated: 1' (v) Amount of material to be excavated in cubic yards: 14.8 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 (SIB), or other wetlands (WL)? If any boxes are checked, provide the number of square feet affected. ®CW 50 ❑SAV ❑SB ❑WL ❑None (ii) Describe the purpose of the excavation in these areas: Pipe Replacement RECEIVED JUN 2 9 2015 252-808-2808 :: 1-888-4RCOAST :: www.nccoastatmanacefnent.net revised: 10/26/06 Form DCM MP-5 (Bridges 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: Excavated material will be reused on site, any leftover will be taken back to maintenance area. (ii) Dimensions of the spoil disposal area: N/A (iii) Do you claim title to the disposal area? ®Yes ❑No (If no, attach a letter granting permission from the owner.) (iv) Will the disposal area be available for future maintenance? ❑Yes ®No (v) Does the disposal area include any coastal wetlands/marsh (CW), submerged aquatic vegetation (SAVs), other wetlands (WL), or shell bottom (SB)? ❑CW ❑SAV ❑WL ❑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. e. (i) Will the placement of the proposed bridge or culvert result in any fill (other than excavated material described in Item d above) to be placed below NHW or NWL? ❑Yes ®No If yes, (ii) Avg. length of area to be filled: (iii) Avg. width of area to be filled: (iv) Purpose of fill: (i) Will the placement of the proposed bridge or culvert result in any fill (other than excavated material described in Item d above) to be placed within coastal wetlands/marsh (CW), submerged aquatic vegetation (SAV), shell bottom (SB), or other wetlands (WL)? If any boxes are checked, provide the number of square feet affected. ❑CW ❑SAV ❑SB ❑WL ®None (ii) Describe the purpose of the excavation in these areas: g. (i) Will the placement of the proposed bridge or culvert result in any fill (other than excavated material described in Item d above) to be placed on high -ground? ❑Yes ®No If yes, (ii) Avg. length of area to be filled: (iii) Avg. width of area to be filled: (iv) Purpose of fill: a. Will the proposed project require the relocation of any existing b. Will the proposed project require the construction of any temporary utility lines? ❑Yes ®No detour structures? ❑Yes ®No If yes, explain: If yes, explain: If this portion of the proposed project has already received approval from local authorities, please attach a copy of the RECEIVED approval or certification. < Form continues on back> —, ,-.;,, :-"' 252-808-2808 :: 1-888ARCOAST :: www.nccoastaimanagement.net revised: 10/26/06 Form DCM MP-5 (Bridges and Culverts, Page 4 of 4) C. Will the proposed project require any work channels? d. How will excavated or fill material be kept on site and erosion ❑Yes ®No controlled? If yes, complete Form DCM-MP-2. Use BMP's e. What type of construction equipment will be used (for example, f. Will wetlands be crossed in transporting equipment to project site? dragline, backhoe, or hydraulic dredge)? ❑Yes ®No Typical roadway construction equipment will be used, If yes, explain steps that will be taken to avoid or minimize including but not limited to tracked excavators, dump environmental impacts. trucks, flat-bed trucks, back -hoes and boom trucks. g. Will the placement of the proposed bridge or culvert require any shoreline stabilization? ®Yes ❑No If yes, complete form MP-2, Section 3 for Shoreline Stabilization only. June 15, 2016 Date SR 1300 Pipe Replacement WBS#: 2CR.10161.14 Project Name Jay B.Johnson Applicant Nam l, Applicant Sfr RECEIVED JUN 2 9 201; 252-808-2808 :: 1-888-4RCOAST :: wwwmccoastalmanagement.net revised:10/26/06 ■ 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: A', Clia al F ArAa - 3 I3 7 A J y 70 Ects 8 eCL G A. Signature X Agent A dressee B.11 Received by (Printed Namy�) C. at of elivicery� D. Is delivery address different from item 1? 01Yes If YES, enter delivery address below: I —]No .�ECFIVED 4. Restricted Delivery? (Extra Fwa) El Yes �Il� �� 2. Article Number 7012 2920 0002 2386 6110 "M (transfer from service laben PS Form 3811, July 2013 Domestic Return Receipt COMPLETE• ■ 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: �vn W )5//; s ` k- 13 S"y � e rr i � la►'1 /�C/ A e o, u 4C4 NC J-gs_4, 3. Service Type 1Z Certified Mail® ❑ Priority Mail Express'" ❑ Registered 4q Return Receipt for Merchandise ❑ Insured Mail ❑ Collect on Delivery A. Sign a re � ❑ t� X 121Addressee B. Received by rinted Name) C. D to of Dqlivery ,tZ c 1 �7� 0 /1Tms D. Is delivery address different from item 1? L l Yes If YES, enter delivery address below: ❑ No 3. Service Type jl Certified Mail® ❑ Priority Mail Express" ❑ Registered X Return Receipt for Merchandise ❑ Insured Mail ❑ Collect on Delivery 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7012 2920 0002 2386 6127 (transfer from service label PS Form 3811, July 2013 Domestic Return Receipt ■ 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: / Coxr, rt lion M0,4, pqy e l6, off drew P 13 PS-0 5 and Ana C� �00(-70 - A. Signa e X ❑ Agent ❑ Addressee B. Rece' ed by (Printed Name) C. ate of Delive {-- �j-11—c D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No REGLi =4 ` 3. Service Type ® Certified Mail® ❑ Priority Mail Express- 0 Registered 9 Return Receipt for Merchandise ❑ Insured Mail ❑ Collect on Delivery 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number (Transfer from service label) 7 012 2920 0002 2386 6141 PS Form 3811, July 2013 Domestic Return Receipt 9 ISM UNITED STATES POSTAL SERVICE Mrst-Class Mail Postage & Fees Paid USPS. Permit No. G-16 " • Sender: Please print your name, address, and ZIP+4® in this box* NC Department of Transportation - Division of=Highway _ PO Box_ 1587 Greenville NC 27835 H� ■ 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 cans to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: R � U'1Qrd � 1�"771 u r ,3137 14wy ; 70 Ect,4 f3 eCLLk A. Signature X. _ qf Ivery I BIJrLA/b/�n/C"i '.7�LrCl 1It [ 11t- D. Is delivery address different from item 1? ❑PYes If YES, enter delivery address below: ❑ No 3. Service Type la Certified Mail® ❑ Registered ❑ Insured Mail 4. ❑ Priority Mail Express'" iV Retum Receipt for Merchandise ❑ Collect on. Delivery 2...AAlcleNumtier � l - r f ?012i 292A �`0002 �2386 '611U{ (rransfer from seivJce IabeQ PS Form 3811, July 2013 Domestic Return Receipt -_ ❑-Yes - _ UNITED STATES POSTAL SERVICE First -Class Mail -Postage_& Fees Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+40in this box* NC' Department ofTranspoi-tation Division of Highway PO Box 1587 Greenville NC�27835 .I..7 •iiii:•ii:i:i•ifi;ii;i.'�...i;... ... j:��ii.riii�'.ii;i..i iiiil7iifi3.t:).,:..;fie.=:#:S�i:ii••�iii.j::i.iii•'i�T::iiii�:i:: " ■ 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: Me r.1j IP7011 Ae 13eNG A. Signs re ®®�® �� X j97 '. ` ❑21 Addressee B. Received by jPrinted Name) I C. • D to of Dqlivery D. Is delivery address different from item 17 13 Yes If YES, enter delivery address below: ❑ No RE 3. Service Type JQ Certified Mail® ❑ Priority Mail Express- ❑ Registered X Return Receipt for Merchandise ❑ Insured Mail ❑ Collect on Delivery 4. Restricted Delivery? (Extra Fee) ❑ Yes i 2. =Article Number (Transfer from seMce'�abef) 7012 2 9 2 0 00 0 2 `2 3 8 PS Form 3811; -July 2013 Domestic Return Receipt 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* NC Department of Transportati�„ . Division: of Highway PO 80x 1587 Greenville NC27835 '' • Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. m Print your name and address on the reverse . .so that we can return the card to you. m i Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Cc1✓ran �pn % b-D�kj e 4r1c1reL) PI 13 /sa 2. 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'�+ VI +Y1-1v-/---.� k - -_ _'.` CORE O '_a,a,�••--r-' ,ram` \ ; : .+ rl • . {, E .s ° µ—T-•(r• `TI"T�i �" r i`2�_ (� ; _ N �# 'j : 2 �a�a�a r ` . �- �. _- -_ -�.... - - � - t a w� IAi + „1,1 frr+;ln4 z ~ � `l N+! a d;i■ S x r� - p CNEEE.ICANAI - 1 1y�f' a. ^, , �m tc L�, I d.t \ b - _ - 's-,,,,�+i'®.al ..cam, ; `/�v./• --1 l ' ___. " - k �.-{Qz 4 _ in + c is y�•. Il/rlrr+�r+rSn 1� gyp'- ,� •Z �� a� �� ' {: " Of ! t ' I t ::' {I 'r:�cr:•: n-....,.r x� j`��`ti 4 u RECEIV [D ,,+f „ , , , y Id � 1 _�,—.,��•�• �, �,;,. ; , Y _.�,; � W €, � � JUN � 9 2oi5 • ,,; r f +\ (' ``" :�. � • � .i1` � } `' _. '+.' ,� � '� e•' s �-�" � � p,ilEahC Ie•tl:. , LL 7,.'�� j_ }f.!s/isl/ it. �1,/��:� °. ?/�� }Ali�l"et 11•yfiSl' �F� ♦I � � �N�� i�0! �� jb NGDENR North Carolina Department of Environment and Natural Resources Pat McCrory Donald R. van der Vaart Governor Secretary July 9, 2015 NCDOT Attn: Jay Johnson P.O. Box 1587 Greenville, N.C. 27835 Dear Sir or Madam: Attached is General Permit #67487 to construct one 30" X 44' long culverts to replace the existing culvert at SR1300, approximate 0.8 miles north of SR1163, Beaufort, 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 SL/rcb Enclosures 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-28081 FAX 252-247-33301 Internet: www.nccoastalmanagement.net An Equal Opportunity / Affirmative Action Employer