NCDOT - 64129

64
-'CAMA / - DREDGE & FILL
GENERAL PERMIT
Previous permit #
❑New r 'Modification I -]Complete Reissue
❑JPartial 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 -- State ZIP
Phone # ( ) _ _ Fax # O
Subdivision
—
Authorized Agent --
City ZIP
l
CW EW PTA ES 1 PTS
Affected
Phone #F ( ) River Basin
El OEA HHIH UBA N/A
El
AEC(s):
Adj. Wtr. Body—_ (nat /man /Unkn�
--' PWS:
—
ORW: yes / no PNA yes / no Crit.Hab.
yes / no Closest Maj. Wtr. Body
IType of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length --
number__
Bulkhead/ Ripral
avg distant
max distan
Basin, channel
cubic yard!
Boat ramp
Boathouse/ Boat
Beach Bulldozing
Other
Shoreline Length
SAV: nots
Sandbags: not s
Moratorium:
Photos:
Waiver Attached
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: /v
❑ See note on back regarding River Basin rules.
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 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, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules ❑ Other:
Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888ARCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
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)
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

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Applicant N
Date: -7—
DescribebelowtheHABITATd/sturbancesfortheapplication. All values-should.match_ the naaneandunit.ofineasurement..
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL-Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated .
restoration or
tamp impacts)
FINAL Sq. FL
(Anticipated Anal
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 R Fill [Both [Other ❑
3
Dredge ElFill G'Both ❑ Other [I
0-f
/�iafJh
Dredge ❑ Fill 01 Moth ❑ 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'El

APPLICATION for
Major Development Permit
(last revised 12/27/06)
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Information
Business Name
Department Of Transportation
Project Name (if applicable)
Pipe Replacement on US 70
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
[e-mail]
2. AgenbContractorinformation
' RECEIVED
Business Name
fix'
JUL 17 2014
Agent/ Contractor 1: First Name
MI
Last Name
bC:v:-Y-UD CITY
Agent/ Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box
City
State
ZIP
Phone No. 1
Phone No. 2
-
- ext.
- - ext.
FAX No.
Contractor #
Street Address (if different from above)
City
State
ZIP
Email
F x RECEMD
<Form continues on back> Ys. JUN 3 0 2014
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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
US 70
Subdivision Name
City
State
Zip
Phone No.
Lot No.(s) (if many, attach additional page with list)
- - 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
White Oak
Broad Creek
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
Nelson Bay
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.)
65'
2,225
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
Roadside grasses and coastal marsh
f. Man-made features and uses now on tract
2 existing 36" corrugated metal pipes.
g. Identify and describe the existing land uses adiacent to the proposed project site.
Coastal marsh is adjacent to the site.
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. Hasa 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>
252-803r180 .. 1-868-4RCOAS' . vvvivr.nacoz)kstalni.: naqp_ mT-11i.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? ®Yes []No
(iii) If yes to either (i) or (ii) above, has a delineation been conducted? ®Yes []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 ®Public tGovernment
❑Private/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
The 2 existing 36" corrugated metal pipes are failing and will be replaced with 2 36" corrugated aluminum alloy pipes.
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 used, including but not limited to tracked excavators, dump trot a ed
trucks, backhoes and boom trucks.
d. List all development activities you propose.
JUL 17 2014
Pipe replacement
DC:4: Y.HD CITY
e. Are the proposed activities maintenance of an existing project, new work, or both?
maintenance/pipe to pipe replacement
f. What is the approximate total disturbed land area resulting from the proposed project?
2,225 ®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.
Stormwater now sheetflows through roadside grasses prior to entering coastal wetlands. Proposed disharges will do the
same.
I. Will wastewater or stormwater be discharged into a wetland?
®Yes []No ❑NA
If yes, will this discharged water be of the same salinity as the receiving water?
❑Yes ®No ❑NA
j. Is there any mitigation proposed?
❑Yes ®No ❑NA
If yes, attach a mitigation proposal.
RECEIVED
<Form continues on back> 4
€JUN 30 2014
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DCMMO CITY

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) - (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, 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 Open Grounds Farm Inc. Phone No.
Address P.O. Drawer B, Beaufort NC 28516
Name Phone No.
Address
Name Phone No.
Address
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
h. Signed consultant or agent authorization form, if applicable.
I. Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A. statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure
of public'funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
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 6/18/2014 Print Name Jay B. Johnson
Signature
Please indicate application attachments pertaining to your propo d projece
❑DCM MP-2 Excavation and Fill Information ®DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
❑DCM MP-4 Structures Information
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Form odinrs
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: b. Water body to be crossed by bridge:
❑Commercial ❑PublicJGovernment ❑Private/Community
c. Type of bridge (construction material):
d. Water depth at the proposed crossing at NLW or NWL:
e. (i) Will proposed bridge replace an existing bridge? ❑Yes ❑No f.
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 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 wep I s: QED
waters? ❑Yes []No '
If yes, explain:
JUL 17 2014
2. CULVERTS [I This section not applicable
a. Number of culverts proposed: 2 b. Water body in which the culvert is to be placed:
UT to Broad Creek RECEIVED
JUN 30 2014
< Form continues on back>
DCM MHD CITY
252- 308-2 08 .. 1- 88-41>aOAST :. xvr &-o4 mccaast l; ian.a: Marl", not r vised: M26MG

Form GIG MP-5 (Brie.g s and Culverts, Page: 2 of )
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: 50'
h. Height of the top of the proposed culvert above the NHW or NWL.
0
j. Will the proposed culvert affect navigation by reducing or
increasing the existing navigable opening? ❑Yes ®No
If yes, explain:
If yes,
(ii) Length of existing culvert(s): 40'
(iii) Width of existing culvert(s): 36"
(iv) Height of the top of the existing culvert above the NHW or
NWL: 0
(v) Will all, or a part of, the existing culvert be removed?
(Explain) All of the culverts will be removed and
replaced
9• Width of proposed culvert: 36"
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 [I 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: 25'
(iii) Avg. width of area to be excavated: 35'
(iv) Avg. depth of area to be excavated: 1'
(v) Amount of material to be excavated in cubic yards: 35
c. (i) Will the placement of the proposed bridge or culvert require any
high -ground excavation? ®Yes ❑No
If yes,
(ii) Avg. length of area to be excavated: 45'
(iii) Avg. width of area to be excavated: 15'
(iv) Avg. depth of area to be excavated: 5'
(v) Amount of material to be excavated in cubic yards: 125
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 20 ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of the excavation in these areas:
Pipe replacment
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DCM NIP- (Bridges and Culverts, f-l~age a 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 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.
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:
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 ❑SAV ❑SB
OWL ®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,
(u") Avg. length of area to be filled:
(iii) Avg. width of area to be filled: _
(iv) Purpose of fill: JUL 17 %!"4
Y
]DCM MHD CITY
a. Will the proposed project require the relocation of any existing b. Will the proposed project require the construction of any temporary
utility lines? ❑Yes ®No detour structures? ❑Yes ®No
If yes, explain: If yes, explain:
if this portion of the proposed project has already received
approval from local authorities, please attach a copy of the
approval or certification.
��, �tECCIVEU
< Form continues on back>
JUN 3 0 2014
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Form 13CMA PAP-5 (tlxridtjet-i and Cifiverts, Page 4 of)
c. Will the proposed project require any work channels?
❑Yes ®No
If yes, complete Form DCM-MP-2.
d. How will excavated or fill material be kept on site and erosion
controlled?
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, backhoes 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.
6/18/2014
Date
Pipe Replacement on US 70
Project Name
Jay B. Johnson
Applicant Name
QOW
Appli S ature
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355 SOFT.OPEN
WATER IMPACTS
85 SOFT.OPEN
WATER FILL IMPACTS
20 SOFT. COASTAL
WETLAND IMPACTS
EXISTING RIGHT OF WAY
CANAL
PROJECT REFERENCE NO. SHEET NO.
440 SOFT. TOTAL 2CR20161J1 Pl
OPEN WATER IMPACTS
OPEN GROUNDS FARM INC
P.O. DRAWER B
CAMA BEAUFORT. NC 28516
WETLANDS
/
EXISTING EDGE OF PAVEMENT
PROPOSED 50'/ / / /PROPOSED 50'
36 CRAP �/ // / // 36" CAAP
ST ACY
US 70
EXISTING 49
36" CUP
EXISTING 40'
36. CMP
EXISTING EDGE OF PAVEMENT_
CAMA
WETLANDS
OPEN GROUNDS FARM INC.
P.O. DRAWER B
BEAUFORT. NC 28516
EXISTING RIGHT OF WAY
CANAL
UL 1 71014
10, 0' FCF. 10,
GRAPHIC SCALE_.__
DC: `ffHDCITY

Pipe Replacement
US 70
White Oak River Basin
WBS: 2CR.20161.11
Pipe
Replacement
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Pipe Replacement
N 420895.91
E 2775265.21
N 34-52-43
W 76-24-53
N 34.878744
W 76.414719
Pipe Replacement
US 70
White Oak River Basin
WBS: 2CR.20161.11
ARM
CiVED
,JUL 17 2014
DCM-MqD CITY
RECEIVED
2,000 1,000 0 2,000 Feet / ,JUN 3 0 2014
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❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ Collect on Delivery
4. Restricted Delivery! (Extra Fee) ❑Yes
2. Article Number j'cEC
(rmnsferfrom setvicefaW 7012 2920 0002 2388 9720
l Ps Form 3811, July 2013 Domestic Return Receipt
7 2014
DCM Yw CITY
RECENEID
JUN 3 0 2014
DCM--MO CITY

,Q_ •ER: COMPLETE THIS SECTION
■ 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.
o Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
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2. Article Number
(Transfer from service labeo
PS Form 3811, July 2013
'A. nature I r r f i
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X ❑' Addressee
B. Received by (Printed Name) C. Date of Delivery
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11
D. Is deliv dress different Pm 1? ❑ Yes
If YE ter delivery address glow: ❑ No
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3. Service a cam/
ertified Priority Mail Express'"
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ collect on Delivery
4. Restricted Delivery? (Extra Fee) ❑ Yes
7012 2920 0002 2388 9720
Domestic Return Receipt

UNITED STA*4Mq#ffi L%O' ice(►It►i;111liltIT III I It ►`'41 4" First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
Sender: Please print your name, address, and ZIP+4® in this box•
N. C. Dept of Ir3"p"""ion
P. O. Box 1587 1587
Greenville, NC 27835-
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-A .17 2014
DCM MHD CITY
RECEIVED
Y
JUN 30 2014
DCM MIID CITY

Pat McCrory
Governor
July 9, 2014
John E. Skvarla, III
Secretary