NCDOT - 70434

❑CAMA / ❑ DREDGE & FILL N0 70434 A B C D
GENERAL PERMIT Previous permit #
[]New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
El Rules attached.
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s) _
City State ZIP _-
Phone # ( ) E-Mail Subdivision
Authorized Agent City_ ZIP _
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin _
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn)
❑ PWS:
ORW: yes / no PNA yes / no Closest Maj. Wtr. Body —
I Type of Project/ Activity
Pier (dock) length _
Fixed Platform(s)
Floating Platform(s) _
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 'n4)
Moratorium: n/a yes no.
Photos: yes) no
Waiver Attached: yes no\
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Pril
Name
7 � '
(Scale: )
❑ See note on back regarding River Basin rules.
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
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules Other:
"euse 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 28557
252-808-2808/ 1-888-411COAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
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 - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

LAMA / ❑ DREDGE & FILL ! o . j 04
G NERAL PERMIT Previous permit # A — c D
19 lew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality 0 —7 (/ -�
and the Coastal Resources Commission in area of environmental concern pursuant to 15A NCAC I I
C91(i es attached.
Applicant Name Project Location: County �" +' 1C o l
Address 1`r� Street Address/ State Road/ Lot #(s) �� 3� 9 t✓f"'1"' i
Cityr^e-. —State d ZIP
Phone #� ���j _-P�j �'' ���'�-•1�A� ,J"✓ Subdivision _
( E-Mail J
Authorized Agent J—' Y n
Affected ❑ CW ❑ EW RfTA ❑ ES LSfTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes/ no
City %'iP_V r ' ZIP ( r�
Phone # ( ) River Basin
Adj. Wtr. Body � � � n 6- nat man IQ
Closest Maj. Wtr. Body.
Type of Project/ Activity�—
l-�- 0'' x kf ' j o ny ep,4, k'�Y 1 �f -er. (Scale: Nr14 )
Pier
Fixe<
Float
Fingc
Groi
Bulk
Basir
Boat
Boat
Beac
Othr
Shor
SAV
Mor
Phoi
Wai,
■i�■■■
■�iIN
■■iii■■■i■
■■■■
w■�w■
M
_..
,■
i
iw�i
cubic yards
IMEMEMMOMEMOm-
ramp
■■■■■■■■■■■■■�I■■■■■■■■■w■■■■■■■■■■■■■■■
■w■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■w■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
:1 Bulldozing
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
dine Length
not sure a►
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■�■■■N■■■
yes
M■■E■■■■■■
,=
EE.E.EMEMOMENIMMEMEMEMEMMEM
A building permit may be required by: �A yr t o `" I LJ aee note on back regarding River Basin rules.
( Note Local Planning jurisdiction)/j� j r� �
Notes/ Special Conditions aL A `�- I A X, � -� �/►r n � 'rZ c� ��'1 � A
i�.G i •, J f XAa^ t..Pe ¢ ��V •�`T1,� %11.` !- feel .�"y y f e•�
')_J e
Agent or Applicant Printed Name
:h
Signature ** Please read compliance statement on back of permit
Application Fee(s)
14<LP4'% �f 'V/'kr.:
J T.e�6's, e ^ --
Permit Officer's Printed mew
'Jew
Signature
Check # Issuing Date
Expiration Date

NC Division of Coastal Mgt. Application Computer Sheet, Page 3 of 4)
Applicant: N L Pc - -% ©
Date: "7 —!
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
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)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
D� tM W `fib
Dredge Fill � oth [}Other ❑
Dredge ['Fill D'Both [g-"Otlier ❑
�r
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastalmanagement.not revised:02115/10

M■ I
APPIJCA110N for
Msler DweloDment rermlt
(last revised 12127/06)
North Carolina DIVISION OF COASTAL MANAGEMENT
- --- - --- - -- ----- - ---- ------------------ ---- --- -
1. Primary Applicant/ Landowner Information
rBusiness Name
Project Name (if applicable)
North Carolina Department Of Transportation
SR 1329 Pipe Replacement WBS#: 26.206911
Applicant 1 First Name
MI Last Name
Jay
B Johnson
Applicant 2: First Name
MI Last Name
If additional applicants. please attach an additional page(s) with names listed.
Mailing Address
PO Box
City
State
,1587
Greenville
NC
ZIP
Country
----------
Phone No.
No.
278351587
USA
252 - 439 - 2821 ext.
T252- 930 - 3341
Street Address (if different from above)
City
State
ZIP
Email
[e-mail]
2. Agent(Contractor Information
Business Name
Agent/ Contractor 1: First Name
MI
Last Name
Agent/ Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box
City
State
ZIP
Phone No. 1
ext.
Phone No. 2
ext.
FAX No.
Contractor #
Street Address (d different h-om above)
City
State
ZIP
Email
<Form continues on back>
RECEIVED
JUN 2 7 2018
252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagemont.nret'uD CITE

Form DCM MP-1 (Page 2 of 4)
APPLICATION for
Major Development Permit
3. Project Location
County (can be multiple)
Street Address
State Rd. #
Pamlico
SR 1329 (Sanders Rd) 0.7 miles north of SR 1321
1329
Subdivision Name
City
State
Zip
N/A
Whortonsville
NC
28556 -
Phone No.
Lot No.(s) (if many, attach additional page with list)
N/A - - ext.
N/A, I ,
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
Neuse
Brown 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
Pamlico Sound
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.
N/A
4. Site Description
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
55,
N/A
c. Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
N/A,
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 and forest
f. Man-made features and uses now on tract
Asphalt Road
g. Identify and describe the existing land uses adiacent to the proposed project site.
Agriculture and forest
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.nccoastalmanagement.net

Form DCM MP-1 (Page 3 of 4)
m. (i) Are there wetlands on the site?
(ii) Are there coastal wetlands on the site?
(iii) If yes to either (i) or (ii) above, has a delineation been conducted?
(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
APPLICATION for
Major Development Permit
❑Yes ®No
❑Yes ®No
❑Yes ❑No
5. Activities and Impacts
a. Will the project be for commercial, public, or private use? ❑Commercial ®Public/Government
❑Private/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
The 2 existing 40' corrugated metal pipe arches are failing, and will be replaced by a 40' long 15'-4" x 6'5" aluminum box
culvert. The proposed box culvert 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 used, including but not limited to tracked excavators, dump trucks, flat bed
trucks, back hoes and boom trucks.
d. List all development activities you propose.
Pipe replacement
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? 985 ®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.
NIA
�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.
<Form continues on back>
RECEIVED
QUN 2 7 Z018
252-808-2808 .. 1-888-4RCOAST .. www.nccoastaImanagement. not
DCM.MHD CITY

Form DCM MP-1 (Page 4 of 4)
APPLICATION for
Major Development Permit
6. AdditionalInformation
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) - (0 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 Roderick L Sanders and Heirs Phone No
Address 1533 SE 45'" St, Oklahoma City OK 73129
Name Billy Keith Sanders Phone No.
Address 6125 Florence Rd. Merritt NC 28556
Name Florence M Sanders Phone No.
Address 6171 Florence Rd, Merritt NC 28556
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.
F 7, certirication 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 June 4, 2018 Print Name Jay B Johnson
Signature
G
Please indicate application attachments pertaining to your proposed project.
®DCM MP-2 Excavation and Fill Information ®DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
ODCM MP-4 Structures Information
252-808-2808 ., 1-888-4RCOAST .. www.nccoastatmanagement.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
Depth
NA
NA
Final Project
Depth
NA
NA
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 DNA
(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
(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 disposal in these areas.
f. (i) Does the disposal include any area in the water?
❑Yes ❑No DNA
(ii) If yes, how much water area is affected?
RECEIVE®
JUN 2 7 2018
252-808-2808 :: 1-888-4RCOAST :: www.nccoastatmanagqment.net v d: 2/ i6/06

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:
❑Bulkhead ®Riprap ❑Breakwater/Sill ❑Other:
c. Average distance waterward of NHW or NWL: 5'
e. Type of stabilization material
Granite Riprap
g. Number of square feet of fill to be placed below water level.
Bulkhead backfill Riprap 1j 0
Breakwater/Sill Other
i. Source of fill material.
b. Lengtn: si.5. si.o
Width: 2'
d. Maximum distance waterward of NHW or NWL: 8'
f. (i) Has there been shoreline erosion during preceding 12
months?
❑Yes ❑No ®NA
(ii) If yes, state amount of erosion and source of erosion amount
information.
h. Type of fill material.
Sand
4. OTHER FILL ACTIVITIES ®This section not applicable
(Excluding Shoreline Stabilization)
a fil Will fill material be brouaht to the site? ❑Yes ❑No ❑NA b. (i) Will fill material be placed in coastal wetlands/marsh (CW),
If yes, submerged aquatic vegetation (SAV), shell bottom (513), or
u Amount of material to be placed in the water other wetlands (WL) . If any boxes are checked, provide the
() number of square feet affected.
(iii) Dimensions of fill area ❑CW ❑SAV ❑SB
(iv) Purpose of fill 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? d. (i) Will wetlands be crossed in transporting equipment to project
❑Yes ONo ®NA site? ❑Yes ®No ❑NA
(ii) If yes, explain what type and how they will be implemented. (ii) If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
June 4, 2018
Date
SR 1329 Pipe Replacement WBS#: 2B.206911
Project Name
Jay B Johnson
Applicant Na
7l-
Applicant Sign re
252-808-2808 :: 1-888-4RCOAS7 :: www.nccoastalmana_gem®nt.ngt revised: 12/26/06

fM ACM MF-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)'
b Water body to be crossed by bridge.
d. Water depth at the proposed crossing at NLW or NWL.
e. (i) Will proposed bridge replace an existing bridge? ❑Yes ❑No f. (i) Will proposed bridge replace an existing culvert? ❑Yes ❑No
If yes, If yes.
(ii) Length of existing bridge (ii) Length of existing culvert:
(iii) Width of existing bridge: (iii) Width of existing culvert:
(iv) Navigation clearance underneath existing bridge: (iv) Height of the top of the existing culvert above the NHW or
(v) Will all, or a part of. the existing bridge be removed? NWL:
(Explain) (v) Will all, or a part of, the existing culvert be removed?
- --- - - - -- -- --- --- -- (Explain)
9 Length of proposed bridge _ h Width of proposed bridge: __
i. Will the proposed bridge affect existing water flow? ❑Yes ❑No j. Will the proposed bridge affect navigation by reducing or
If yes, explain: increasing the existing navigable opening? ❑Yes []No
- - — — - — -- --- - ------------------- --- — If yes, explain.
k- Navigation clearance underneath proposed bridge I Have you contacted the U.S Coast Guard concerning their
approval? ❑Yes ❑No
If yes, explain.
m. Will the proposed bridge cross wetlands containing no navigable n. Height of proposed bridge above wetlands
waters? ❑Yes ❑No
If yes, explain.
2. CULVERTS El This section not applicable
a. Number of culverts proposed: 1 b. Water body in which the culvert is to be placed
U/T Brown Creek
< Form continues on back>
'JUN 2 i ZU18
252-808-2808 :: 1-888-4RCOAST :: www.nccoastatmanagement.net ®Vo

Form ®CM MP-5 (Bridges and Culverts, Page 2 of 4)
c. Type of culvert (construction material)
Aluminum
d. (i) Will proposed culvert replace an existing bridge? a (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: 40'
h. Height of the top of the proposed culvert above the NHW or NWL.
0.5'
). 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): 91"
(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
g. Width of proposed culvert: 15'-4"
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 30', 25'
(iii) Avg width of area to be excavated 7' 7'
(iv) Avg. depth of area to be excavated 1'
(v) Amount of material to be excavated in cubic yards: 15
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: 30'
(iv) Avg. depth of area to be excavated. 7_5'
(v) Amount of material to be excavated in cubic yards: 335
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 ❑SAV ❑SB
OWL ®None
(ii) Describe the purpose of the excavation in these areas.
252-808-2808 :: 1-888-4RCQAST :: www.nccoastaimanag_ement.net revised:10126/06

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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.
e.
9
(ii) Dimensions of the spoil disposal area: N/A
(iii) Do you claim title to the disposal area? ®Yes ❑No (ff no. attach a letter granting permission from the owner)
(iv) Will the disposal area be available for future maintenance? ❑Yes NNo
(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 NNo
If yes, give dimensions if different from (ii) above
(i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed below NHW or NWL? ❑Yes NNo
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 on high -ground? ❑Yes NNo
If yes,
(ii) Avg length of area to be filled:
(iii) Avg. width of area to be filled
(iv) Purpose of fill_
4. GENERAL
a. Will the proposed project require the relocation of any existing
utility lines? ❑Yes NNo
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.
(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:
b. Will the proposed project require the construction of any temporary
detour structures? ❑Yes NNo
If yes, explain:
< Form continues on back>
RECEIVED
JUN 2 7 2018
DCM-MHD CITY
252-808-2808 :: 1-888-4RCOAST :: www.nccoastall nagement.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 matenal 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 4, 2018
Date
SR 1329 Pipe Replacement WBS#: 26.206911
Project Name
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