74765D - Brunswick

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GE9YERAL PERMIT
iXNew - .Modification ❑Complete Reissue ❑Partial Reissue
No. 74765
A B C
Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality /1 /-
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
gRNn15W IGK C `O- 4-Ty Rules attached.
Applicant Name c/o Wl"iAM pi"i'VLX Project Location: County OF. un15 &,41 CK
Address PO f) Oy( 2 4 -1
City 1250LI V IA State ZIP ;t g4 2-2
Street Address/ State Road/ Lot #(s) /VC 'DOT R 0 W
SmA i N o r H WX '74 11b IEASr
Phone # ( ) A11A E-Mail ^t A Subdivision - 1//,A
Authorized Agent L 4 G — K. 114 W ILL IA KS /OLUA G`-ity I— FLAW D ZIP 28451
Affected ❑ CW ❑ EW )(PTA ❑ ES )<PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
PWS:
ORW: yes / (1O PNA yes /efroD
Fing
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Basin
Boat
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Adj. Wtr. Body N OOD C-9 E I-K & /man /unkn)
Closest Maj. Wtr. Body T Wy CRcr-K --P CF R
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A building permit may be required by: 1?rztANS ► i i c IL Cou.V'ry ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) p
Notes/ Special Conditions L7 � N , I (aD(� A IL o-r"y-y— FEo Ei-1 L.-, S-rA-M X
LOCAL Fr-G►w1.M1oNS. ALATNOR•\ZATIONTA-r— LA FRM T►-ACi1NDW'DWR
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e Please read compliance statement on back of permit
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Application Fee(s) Check #
I111La-¢ Mr, C��1
Permit Officer's Printed ame .
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Signature 441
I2/t q /2011 I;2119' %ozo
Issuing Date EY *ration Date
* _r WORK HAS v'T SrARTF-o

LMG
LAND MANAGEMENT GROUP
a DAVEY company
November 13, 2019
TO: Mr. Tyler McGuire
NC Division of Coastal Management
127 Cardinal Drive Extension
Wilmington, NC 28405
RE: CAMA General Permit 0.1600 Application
Highway 74/76 Transmission Water Main
Applicant: Brunswick County
Dear Tyler:
On behalf of Brunswick County, Land Management Group is submitting a CAMA General Permit
application for the installation of a 12" water main under a Public Trust waterbody, Hood Creek,
in Brunswick County. This crossing is part of the Highway 74/76 Transmission Water Main project,
which will run 8,665 linear feet of water main along the south side of Highway 74/76 from Old Maco
Road to Mintz Road in the northeastern part of Brunswick County. The purpose of the project is to
provide this section of Brunswick County with a safe and reliable water supply. It will connect two
disjointed water lines together and will improve flow and pressure to residents. The line will be
installed within a NCDOT Right -of -Way and the County has applied for an encroachment agreement
from NC DOT.
This application requests CAMA General Permit 0.1600 to authorize the installation of the water line
underneath this public trust waters via directional drilling. The entry and exit points for the directional
drill will be located outside of the public trust waters boundaries and the pipe will be located a
minimum of 6 feet below the bottom of the creek. LMG delineated wetlands within the project area
and we have requested a site meeting with Gary Beecher of the US Army Corps of Engineers to review
the line. Section 404/401 permits are being requested from the US Army Corps of Engineers and the
NC Division of Water Resources for temporary wetland impacts proposed within the larger project
area.
The adjacent riparian landowners to the crossings at the location of the public trust waters have been
notified and copies of the notification letters are included in this application. The "green card
receipts" from these certified mail notifications are enclosed and the green cards will be forwarded
to your office as soon as they are received. If you have any questions, or would like to discuss the
application, please do not hesitate to call.
DECEIVED
www.lmgroup.net • [e-mail] • Phone: [phone] • Fax: [phone] NOV 18 2019
3805 Wrightsville Ave., Suite 15, Wilmington, NC 28403
DCM WILMINGTON, NC

Applicant: Brunswick County
c/o William Pinnix, P.E.
P.O. Box 249
Bolivia, NC 28422
Thank you for your assistance.
Sincerely,
1
I
Kim Williams
Environmental Scientist
Encl.
Cc: William Pinnix, Brunswick County
Phil Norris, Norris and Tunstall Consulting Engineers
RECEIVED
NOV 18 Z019
DCM WILMINGTON, NC

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Brunswick County c/o William Pinnix, P.E.
Mailing Address: PO Box 249
Bolivia, NC 28422
Phone Number: 910-253-2408
Email Address: [e-mail]
I certify that I have authorized Land Management Group
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Installation of 12" water main
under Public Trust Waters AEC (Hood Creek) via directional bore.
at my property located at NC DOT Right of Way; south of Hwy 74/76
in Brunswick
County.
l furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
Print or Type Name
Title 0
/l -5' 1 7019
Date
RECEIVED
This certification is valid through 3 / / 2(12 / NOV 18 2019
DCM WILMINGTON, NC

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RECEIVED
NOV 18 2019
DCM WILMINGTON, NC

■ Complete items 1, 2, and 3.
■ 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 mailpiq e.
or on the front if space permits.
1. Article Addressed too:
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❑ Insured Mail
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Domestic Return Receipt
RECEIVED
NOV 20 2019
DCM WILMINGTON, NC

LMG
LAND MANAGEMENT GROUP
alk
a DAVEY. company
November 13, 2019
TO: Emory and Melodie Dorsey
PO Box 426
Leland, NC 28451
RE: Notification of CAMA General Permit 0.1600 Application
Highway 74/76 Transmission Water Main
Applicant: Brunswick County
Dear Mr. and Mrs. Dorsey
This letter serves to notify you of work proposed by Brunswick County within a NC DOT Right of Way in
Leland, NC, adjacent to your property. Specifically, the County is planning to install a water line under a
public trust waterbody, Hood Creek. Because this proposed work is located within an Area of
Environmental Concern as regulated by the NC Coastal Area Management Act (CAMA), a CAMA Permit is
required. As an adjacent riparian landowner, you are required by the CAMA permit application process
to be notified. I have enclosed the CAMA permit application materials as they have been submitted to
the local Division of Coastal Management office for your review. Should you have any objections to this
proposal, please send your written comments within 10 days of your receipt of this notice to:
Mr. Tyler McGuire
NC Division of Coastal Management
127 Cardinal Drive Extension
Wilmington, NC 28405
[e-mail]
Comments will be considered by the NC Department of Coastal Management in reaching a final decision
on the application. No comment within 10 days of your receipt of this notice will be considered as no
objection. If you have any questions on this project, please call me at 910-452-0001, or e-mail me at
[e-mail].
Sincerely, _
Kim Williams
Environmental Scientist
Encl.
RECEIVED
Cc: Mr. Tyler McGuire, NC DCM DCM WILMINGTON, NC
www.lmgroup.net • [e-mail] • Phone: [phone] • Fax: [phone]
3805 Wrightsville Ave., Suite 15, Wilmington, NC 28403

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Map Source: World Street Map
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Brunswick County, NC
Map Date: 4/29/19
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LAND MANAGEMENT GROUP
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Wilmington, NC 28403
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LMG19.025 Wilmington, NC 28403
[phone]

NOTE: This is not a survey. All boundaries and distances are considered -
approximate. This represents a preliminary sketch prepared from field notes.
��r ,,` + }�► A survey of delineated areas and review and approval by the U.S. Army
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Map Date: 4/29/19 3805 Wrightsville Avenue
LMG 19.025 Wilmington, NC 28403
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RECEIVED
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
DATE: September 17, 2019
NOV 19 2019
DCM WILMINGTON, NC
JAWS H. TROGDON, III
SECRETARY
TO: NCDOT, AGC, CAPA, ATSSA and NCDOT approved Trainers
00wSigned by:
FROM: Steve Kite, PE, State Work Zone Engineer skvj �&
E27CEXE1DFC442._.
SUBJECT: Revised Work Zone Certification Requirements
The Work Zone Traffic Control Section has revamped its certification programs
to include Work Zone Installer requirements for those responsible for the setup
and installation of traffic control devices within all highway right of way.
Below are the new requirements for the Work Zone Installer certifications.
Work Zone Installer Certification (New): Imulementation Date -June 1.2020
All personnel responsible for the setup and installation of Work Zone Traffic
Control devices inside the highway right of way are required to be qualified and
trained Work Zone Installers. Training for this certification is provided by
NCDOT approved training resources and by private entities that have been pre -
approved to train themselves. It is the responsibility of each employer to ensure
accurate records are maintained. NCDOT will not keep records or issue cards on
the Certification/Recertification of employees. Upon award of contract and
before work begins, the Contractor shall provide the Engineer the work zone
installer certifications with expiration dates for employees. A card issued by the
certifying firm that shows the dates of certification/expiration or the employer
certification will suffice.
Recertification Requirements- Work Zone Installers shall be recertified every 4
years. The date is based on when they were issued their certification (card or
certificate) from the approved training agency or employer.
Virginia/South Carolina Certifications- If they have been certified in Virginia
or South Carolina, we will accept that certification for a period of 1 year. After
the year, the Work Zone Installer is required to be re -certified in North
Carolina. RECEIVED
Mailing Address: Telephone: [phone] Location:
NC DEPARTMENT OF TRANSPORTATION Fax: [phone] N. GRE_ENFIELD PARKWAY
TRANSPORTATION MOBILITY & SAFETY DIVISION Customer Service. 1-977-368-4968 NO VG f P'7 W9 27529
1561 MIl. ASERVICE CENTER 1
RALEIGK NC 27699-1561 Website: www.ncdot.gov
DCM WILMINGTON, NC

Self -Certification- Companies that perform internal training for their
employees and do not train outside their company are allowed to self -certify
their employees provided the following requirements are met. The company
must have an NCDOT approved Certified Trainer as defined below perform the
Installer training.
Self -Certification Trainer
The Self Certification trainer shall be a Certified Work Zone Supervisor with a
minimum of 8 years of highway/traffic control experience with 4 years as a Certified
Work Zone Supervisor. The trainer will also be required to recertify with an outside
training agency every 4 years.
Any company desiring to train and certify Work Zone Installers shall submit their trainer as
well as their training materials and certification exam to the Work Zone Traffic Control
Section for approval. The Work Zone Traffic Control Section reserves the right to keep a
copy of these training materials and certification exam for comparison purposes.
The exam must have a minimum of 25 questions on Division I 1 of the
Specifications and Roadway Standard Drawings, a minimum of 15 questions on
proper methods/best practices of installation/removal of traffic control devices, and
a minimum of 10 questions on the use of Changeable Message Signs, Work Zone
Presence Lighting, Digital Speed Limit Signs, Sequential Flashing Lights, High
Visibility Devices, portable traffic signals/AFADS. The exam format will be
approved by NCDOT. Each installer must score 70 or above to be certified.
Retesting is permissible until the employee scores 70 or above.
The above requirements will become effective June 1, 2020 and if anyone has
any questions, feel free to contact me at skiteamcdot.gov or Roger Garrett at
[e-mail].
Cc:
Joe Hummer, PE, Traffic Management Engineer
Victor Barbour, PE, Carolina's AGC President
Chris P. Fresa, President Carolina's ATSSA Chapter
Ellis Powell, PE, CAPA President
Lamar Sylvester, PE State Construction Engineer
Division Engineers
NCDOT Approved Training Companies

COUNTY OF BRUNSWICK
ENGINEERING SERVICES
Post Office Box 249
20 Referendum Drive NE • Bolivia, North Carolina 28422
Building G
October 4, 2019
Mr. Benjamin T. Hughes, P.E.
District Engineer
NCDOT District 3 Office
300 Division Drive
Wilmington, NC 28401
Re: Bond Release Agreement
Project: US Hwy 74/76 Water Main
NCDOT Encroachment E033-010-00321
Old Maco Road
Dear Mr. Hughes:
The County of Brunswick is in the process of permitting the US Hwy 74/76 Water Main
from Old Maco Road East to the warehouse on Hwy. 74/76.
The County agrees NOT to release their Contractor's pay and performance bond until
NCDOT has approved and signed off on the completed work for this encroachment. We
understand that in doing so, a separate bond will not be required.
Sincerely,
p0e=Y yP*d by Wm. L ftrdX P.E.
ON: ­us'
®ty W nwlcl¢n�nly�c.pov.
Wm. L. Pinnix, P.E. EwNllsn.pYM1O'9wn **County. N.C-.
ouEnpMalnp oepamnnK CN=IMm. L
Plnnhc PE
Cate: 201'110.04 1717:45-04W
William L. Pinnix, P.E.
County Engineer
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NT# 18127
VERIFICATION OF COMPLIANCE WITH
ENVIRONMENTAL REGULATIONS
(Check Appropriate Box)
Permits from the N.C. Department of Environment and Natural Resources and the
U.S. Army Corp of Engineers are not required for this project. However, all applicable
federal and state regulations have been followed.
The required permits from the N.C. DeMieent of Environment and Natural Resources
and the U.S. Army Corp of Engineers boboairdted-for this project. Copies of
permits and Completion Certificates are attached.
Once permits are obtained the copies will be forwarded.
All applicable NPDES Stormwater Permit requirements have been met for this project.
(The applicant should contact the N.C. Division of Water Quality in Raleigh to determine
if a stormwater permit is required.)
0 The project is in compliance with all applicable sedimentation and erosion control laws
and regulations.
Project Name
Township:
Project Engineer.
Project Contact:
Hwy 74-76 Water Main
County: Brunswick
Norris & Tunstall Consulting Engineers. P.C. phone No.: 910-287-5900
J. Phillip Norris, P.E.
g�1" CAaO
Applicant's Name: William L. Pinnix, P.E.
-bliuvourvtn
Date Submitted: /
Form VCER- I
June 1, 2006
zip

NU 18127
National Pollutant Elimination System (NPDES)
Stormwater Permit Compliance Certification
I William L. Pinnix , a duly authorized representative of
Brunswick County , an industrial/commercial/residential
facility requesting attachment to a North Carolina Department of Transportation
highway drainage system at 74-76 E
in
Brunswick County County, do hereby certify the following:
Check appropriate box and circle type of facility
✓0 The Industrial / Commercial / Residential facility does not require an
NPDES stormwater permit.
❑ The Industrial / Commercial / Residential facility does require an NPDES
stormwater permit. The permit has been obtained and a Stormwater
Pollution Prevention Plan (SPPP) is in place. Appropriate structural
stormwater best management practices (BMP) are designed and installed as
required by the Department of Environment and Natural Resources (DENR)
and/or the local governing agency. All structural stormwater BMP's are
located outside of NCDOT right —of-way.
I understand if the Department of Transportation determines the facility is not in
compliance with NPDES stormwater requirements, the Department will report the
noncompliance to the DENR Division of Water Quality. I also understand that
falsification of this certification may result in penalty of law against the facility
and me as prescribed in the North Carolina General Statutes.
Signature: I_A )5�; - � L . —
Date:
Note: If the applicant has a question as to whether an NPDES stormwater permit is
required, he or she may contact the N.C. Division of Water Quality in Raleigh at
[phone] (ask for Stormwater and General Permits Unit).
Form NPDES-1
May 22, 2006

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STATE OF NORTH CAROLINA
DEPARTNENT OF TRANSPORTATION
ROY COOPER
GOVERNOR
September 24, 2019
COUNTY: Brunswick
SUBJECT: Encroachment Contract E033-010-19-00322 — Brunswick County
Mr. William L. Pinnix, PE
Director of Engineering
Brunswick County
P.O. Box 249
Bolivia, NC 28422
Dear Mr. Pinnix:
JAmEs H. TRomom III
SECRETARY
Attached for your files is a copy of the above -referenced Right of Way Encroachment Contract, properly
executed. This contract covers the following:
Installation of 4,550LF of 12" DR18 C-900 PVC watermain, 650 LF of 12" DR 18 C-900 FPVC
watermain by directional drill and trenching and (6) fire hydrants along US 74-76 E in Brunswick
County.
APPROVED SUBJECT TO: Attached Special Provisions and any other permits required to work within
the wetlands inside NCDOT's rights of way.
Carl Barclay, MPA, PE
State Utilities Manager
DOOUSigned by:
CiAAA56AED5487...
Larry D. Sanders, MGIST, PE
State Encroachments Engineer
LDS/j ds
Attachment
Mailing Address: Telephone: [phone]
NC DEPARTMENT OF TRANSPORTATION Fax. [phone]
1555 MAIL, SERVICE CENTER Customer Service: 1-877-3684968
RALEIGH, NC 27699-1555
Website: www.ncdot.gov
Location:
1020 BIRCH RIDGE DRIVE
RALEIGH, NC 27610

SPECIAL PROVISIONS
R/W 16.2
Brunswick County
E033-010-19-00322
WORK ZONE TRAFFIC CONTROL QUALIFICATIONS AND TRAINING PROGRAM
All personnel performing any activity inside the highway right of way are required to be familiar
with the NCDOT Maintenance / Utility Traffic Control Guidelines (MUTCG). No specific training
course or test is required for qualification in the Maintenance /Utility Traffic Control Guidelines
(MUTCG).
All flagging, spotting, or operating Automated Flagger Assist Devices (AFAD) inside the highway
right of way requires qualified and trained Work Zone Flaggers. Training for this certification is
provided by NCDOT approved training resources and by private entities that have been pre -
approved to train themselves.
All personnel in charge of overseeing work zone Temporary Traffic Control operations and
installations inside the highway right of way are required to be qualified and trained Work Zone
Supervisors. Training for this certification is provided by NCDOT approved training resources.
For questions and/or additional information regarding this training program please refer to our
web site at https://connect.ncdot.zov/proiects/WZTC/Pages/Training.aspx or call J.S. (Steve) Kite,
PE at [phone] or skite(a)ncdot.gov or Roger Garrett at [phone] or
rmgarrett(a-%ncdot.gov, both with the NCDOT Work Zone Traffic Control Section.
1. The encroaching party shall notify the District Engineer's office at telephone [phone] prior to
beginning construction and after construction is complete.
2. An executed copy of this encroachment agreement shall be present at the construction site at all times
during construction. If safety or traffic conditions warrant such an action, NCDOT reserves the right to
further limit, restrict or suspend operations within the right of way.
3. NCDOT does not guarantee the right of way on this road, nor will it be responsible for any claim for
damages brought about by any property owner by reason of this installation.
4. The encroaching party is required to contact the appropriate Utility Companies involved and make
satisfactory arrangements to adjust the utilities in conflict with the proposed work prior to beginning
construction.
5. Excavation within 1000 feet of a signalized intersection will require notification by the encroaching party
to the Division Traffic Engineer at telephone number [phone]. All traffic signal or detection
cables must be located prior to excavation. Cost to replace or repair NCDOT signs, signals, or associated
equipment shall be the responsibility of the encroaching party.
6. The encroaching party shall comply with all applicable Federal, State and local environmental
regulations and shall obtain all necessary Federal, State and local environmental permits, including but
not limited to, those related to sediment control, stormwater, wetland, streams, endangered species and
historical sites.
Special Provisions Page 2 of 5 R/W 16.2
Brunswick County
E033-010-19-00322

7. The contractor shall not begin the construction until after the traffic control and erosion control devices
have been installed to the satisfaction of the District Engineer.
8. Trenching, bore pits and/or other excavations shall not be left open or unsafe overnight.
9. The Contractor shall comply with all OSHA requirements and provide a competent person on site to
supervise excavation at all times.
10. All fill areas/backfill shall be compacted to 95% density in accordance with AASHTO T99 as modified
by the NCDOT. All material to a depth of 8 inches below the finished surface of the subgrade shall be
compacted to a density equal to at least 100% of that obtained by compacting a sample of the material in
accordance with AASHTO T99 as modified by the Department. The subgrade shall be compacted at a
moisture content which is approximately that required to produce the maximum density indicated by the
above test method. The contractor shall dry or add moisture to the subgrade when required to provide a
uniformly compacted and acceptable subgrade.
11. Vegetative cover shall be established on all disturbed areas in accordance with the recommendations of
the Division Roadside Environmental Engineer.
12. Proper temporary and permanent measures shall be used to control erosion and sedimentation in
accordance with all local, State and Federal regulations.
13. All materials and workmanship shall conform to the NCDOT Standards and Specifications for Roads and
Structures.
14. Strict compliance with the Policies and Procedures for Accommodating Utilities on Higahway Rights o
w� manual shall be required.
15. The resetting of the Control of Access fence shall be in accordance with the applicable NCDOT standard
and as directed by the District Engineer.
16. Excavation material shall not be placed on pavement. Drainage structures shall not be blocked with
excavation materials. Any drainage structure disturbed or damaged shall be restored to its original
condition as directed by the District Engineer.
17. Any disturbed guardrail shall be reset according to the applicable standard or as directed by the District
Engineer.
18. All driveways altered during construction shall be returned to a state comparable with the condition of
the driveways prior to construction.
19. Right of Way monuments disturbed during construction shall be referenced by a registered Land
Surveyor and reset after construction.
20. All roadway signs that are removed due to construction shall be reinstalled as soon as possible.
21. The party of the second part agrees to provide traffic control devices, lane closures, road closures,
positive protection and/or any other warning or positive protection devices necessary for the safety of
road users during construction and subsequent maintenance. This shall be performed in conformance
with the latest NCDOT Roadway Standard Drawings and Standard Specifications for Roads and
Structures and amendments or supplements thereto. When there is no guidance provided in the NCDOT
Roadway Standard Drawings and Standard Speci ications for Roads and Structures, comply with the
Manual on Uni onn Traic Control Devices for Streets and Highway and amendments or supplements
Special Provisions Page 3 of 5 R/W 16.2
Brunswick County
E033-010-19-00322

thereto. Information as to the above rules and regulations may be obtained from the NCDOT Division
Engineer.
22. All lanes of traffic are to be open during the hours of 6:00 A.M. to 9:00 A.M. and from 4:00 P.M. to 6:00
P.M., or as designated by the District Engineer. Traffic shall be maintained at all times.
23. Ingress and egress shall be maintained to all businesses and dwellings affected by the project. Special
attention shall be paid to police and fire stations, fire hydrants and hospitals.
24. Any work requiring equipment or personnel within 5' of the edge of any travel lane of an undivided
facility and within 10' of the edge of any travel lane of a divided facility shall require a lane closure with
appropriate tapers.
25. Work requiring lane or shoulder closures shall not be performed on both sides of the road simultaneously
within the same area.
26. No access, parking or material storage shall be allowed along or from C/A Roadway. No parking or
material storage shall be allowed along the shoulders of any state- maintained roadway.
27. During non -working hours, equipment shall be parked as close to the right of way line as possible and be
properly barricaded in order not to have any equipment obstruction within the Clear Recovery Area.
28. Directional drilling methods have not been given statewide approval for use on NCDOT right of way.
Under no condition shall jetting alone or wet boring with water of utility pipelines be allowed.
Directional boring using jetting with a Bentonite (or equivalent material) slurry is approved at a
minimum depth of ten (10) feet below the pavement surface [fifteen (15') feet below the surface of
partial and/or full control of access roads] and two (2) feet below any ditch line. Directional boring is
not allowed in embankment material. Directional boring is allowed beneath embankment material in
naturally occurring soil. Any parallel installation utilizing the directional boring method shall be made at
a minimum depth of three (3') feet (cover) below the ground surface and outside the theoretical 1:1 slope
from the existing edge of pavement except where the parallel installation crosses a paved roadway. All
directional bores shall maintain ten (10) feet minimum (clear) horizontal distance from the nearest part of
any structure, including but not limited to bridges, footings, pipe culverts or box culverts. All directional
bores shall maintain ten (10) feet minimum (clear) vertical distance from the nearest part of pipe culverts
or box culverts. Directional bores are not allowed beneath bridge footings, culvert wingwall footings or
retaining walls. The tip of the drill string shall have a cutter head. Detection wire shall be installed with
non-ferrous material. Any changes shall be submitted to the District Engineer for approval prior to
construction. For multiple conduit installations (including perpendicular & parallel installations), install
conduits with five (5) feet minimum (clear) horizontal separation between each conduit or install
multiple conduits within a single duct. An overbore shall not be more than two (2") inches greater
than the diameter of the pipe or encasement. An overbore exceeding two (2") inches greater than
the diameter of the pipe or encasement will be considered if the encroachment agreement includes
a statement signed and sealed by a licensed North Carolina Professional Engineer indicating that
an overbore in excess of two (2") inches of the diameter of the pipe or encasement will arch and no
damage will be done to the pavement or sub -grade. HDPE pipe installed by directional boring shall
not be connected to existing pipe or fittings for one (1) week from the time of installation to allow
tensional stresses to relax.
29. All utility access points, such as manholes, splice boxes and junction boxes shall be located at or outside
the right of way line. Manholes, splice boxes, junction boxes and vaults shall not be placed in the ditch
line, side slopes of the ditches or in the pavement. All manholes, splice boxes, junction boxes and vaults
and covers shall be flush with the ground when located within the vehicle recovery area.
Special Provisions Page 4 of 5 R/W 16.2
Brunswick County
E033-010-19-00322

30. All utility facilities, including manholes, valve boxes, meter boxes, splice boxes, junction boxes, vaults
and access covers, within NCDOT right of way shall have been designed for HS-20 loading rated for
continuous traffic. A listing of currently approved manholes and vaults is available at
https://apps.dot.state.nc.us/vendor/approvedproducts. If any proposed structure is not of a design pre -
approved by NCDOT, the encroaching party shall submit details and design calculations signed and
sealed by a Professional Engineer for approval prior to construction.
31. Any pavement replacement or repair required due to this installation shall be the responsibility of the
encroaching party. Pavement repair or replacement shall be in accordance with the requirements of and
to the satisfaction of the District Engineer
32. Any utility marker required shall be as close to the Right of Way line as possible. If it is not feasible to
install markers at or near right of way specific written approval shall be obtained from NCDOT prior to
installation.
33. Note that this review is intended for the general conformance with the policies and procedures
concerning the protection of current and potential future facilities located within the NCDOT rights of
way and easements. This review and associated plan comments in no way construes any design, design
change, or change in the intent of the design by the Owner, Design Engineer, or any of their
representatives.
34. Lane closures on Stella Drive shall be limited to one lane at a time to allow continual access to the
properties served by Stella Drive. Traffic control for this lane closure shall require hand flaggers and
shall comply with hand -flagging procedures described in the Manual on Uniform Traffic Control Devices
which cover dead-end (no outlet) roads.
35. The radius at the Stella road intersection shall be milled and fill throughout. See image below.
Special Provisions Page 5 of 5 R/W 16.2
Brunswick County
E033-010-19-00322

Special Provisions Page 6 of 5 R/W 16.2
Brunswick County
E033-010-19-00322

NT# 18127
STATE PROJECT
ROUTE 74-76 E FEDERAL PROJECT
DEPARTMENT OF TRANSPORTATION
-AND-
Brunswick County
STATE OF NORTH CAROLINA
COUNTY Brunswick
RIGHT OF WAY
ENCROACHMENT AGREEMENT
INTERSTATE AND OTHER CONTROLLED
ACCESS HIGHWAYS
THIS AGREEMENT, made and entered into this the day of 20 by and between the Department
of Transportation, party of the first part; and Brunswick
party of the second part,
WITNESSETH
THAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designated as
Route(s) 74-76 E
74-76 E & Maco Rd (NC-87)
with the construction and/or erection of:
, located Approximately 1/2 mi SE from the intersection of
550 LF of 12" DR18 C-900 PVC watermain, 650 LF of 12" DR18 C-900 FPVC
watermain by directional drill, 10'x10'x4' drill pit, 10'x10'x4' receiving pit (6) fire hydrant assembly, & an open cut & asphalt
pavement patch on Stella Drive SR 1726 (within R/W of US 74-76)
WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the party of
the first part in the exercise of authority conferred upon it by statute, is willing to permit the encroachment within the limits of the
right of way as indicated, subject to the conditions of this agreement;
NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the right
and privilege to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which are
made a part hereof upon the following conditions, to wit:
That the installation, operation, and maintenance of the above described facility will be accomplished in accordance with
the party of the first part's latest POLICIES AND PROCEDURES FOR ACCOMMODATING UTILITIES ON HIGHWAY
RIGHTS -OF -WAY, and such revisions and amendments thereto as may be in effect at the date of this agreement. Information
as to these policies and procedures may be obtained from the Division Engineer or State Utility Agent of the party of the first
part.
That the said party of the second part hereby agrees that access for servicing its facilities will be limited to access via (a)
frontage roads where provided, (b) nearby or adjacent public roads and street, or (c) trails along or near the highway right of
way lines, connecting only to an intersecting road; from any one or all of which entry may be made to the outer portion of the
highway right of way. The parry of the second part's rights of access to the through -traffic roadways and ramps shall be subject
to the same rules and regulations as apply to the general public, except if an emergency situation occurs, and the usual means
of access for service operation as herein provided will not permit the immediate action required by the party of the second part
in making emergency repairs as required for the safety and welfare of the public, the party of the second part shall have a
temporary right of access to and from the through -traffic roadways and ramps as necessary to accomplish the required
emergency repairs, provided that the party of the second part complies with the regulations established by the party of the first
part for policing and control to protect the highway users.
That the said party of the second part binds and obligates himself to install and maintain the encroaching facility in such
safe and proper condition that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the
proper maintenance thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its
roadways and structures necessary due to the installation and existence of the facilities of the party of the second part, and if at
any time the party of the first part shall require the removal of or changes in the location of the said facilities, that the said party
of the second part binds himself, his successors and assigns, to promptly remove or alter the said facilities, in order to conform
to the said requirement, without any cost to the party of the first part.
That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs,
signal lights, flagmen and other warning devices for the protection of traffic in conformance with the latest Manual on Uniform
Traffic Control Devices for Streets and Highways and Amendments or Supplements thereto. Information as to the above rules
FORM R/W 16.2
Rev. July 1, 1977 Page 1 of 3

and regulations may be obtained from the Division Engineer of the party of the first part
That the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all
damages and claims for damage that may arise by reason of the installation and maintenance of this encroachment.
That the party of the second part agrees to restore all areas disturbed during installation and maintenance to the
satisfaction of the Division Engineer of the party of the first part. The party of the second part agrees to exercise every
reasonable precaution during construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams,
lakes, reservoirs, other water impoundments, ground surfaces or other property; or pollution of the air. There shall be
compliance with applicable rules and regulations of the North Carolina Division of Environmental Management, North Carolina
Sedimentation Control Commission, and with ordinances and regulations of various counties, municipalities and other official
agencies relating to pollution prevention and control. When any installation or maintenance operation disturbs the ground
surface and existing ground cover, the party of the second part agrees to remove and replace the sod or otherwise reestablish
the grass cover to meet the satisfaction of the Division Engineer of the party of the first part.
That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be
necessary by the Division Engineer of the party of the first part.
That the party of the second part agrees to have available at the construction site, at all times during construction, a copy
of this agreement showing evidence of approval by the party of the first part. The party of the first part reserves the right to stop
all work unless evidence of approval can be shown.
Provided the work contained in this agreement is being performed on a completed highway open to traffic; the party of
the second part agrees to give written notice to the Division Engineer of the party of the first part when all work contained herein
has been completed. Unless specifically requested by the party of the first part, written notice of completion of work on highway
projects under construction will not be required.
That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first
part reserves the right to stop all work until the facility has been brought into compliance or removed from the right of way at no
cost to the party of the first part.
That it is agreed by both parties that this agreement shall become void if actual construction of the work contemplated
herein is not begun within one (1) year from the date of authorization by the party of the first part unless written waiver is
secured by the party of the second part from the party of the first part.
During the performance of this contract, the second party, for itself, its assignees and successors in interest (hereinafter
referred to as the "contractor"), agrees as follows:
a. Compliance with Regulations: The contractor shall comply with the Regulations relative to nondiscrimination in
Federally -assisted programs of the U. S. Department of Transportation, Title 49, Code of Federal Regulations,
Part 21, as they may be amended from time to time, (hereinafter referred to as the Regulations), which are
herein incorporated by reference and made a part of this contract.
b. Nondiscrimination: The contractor, with regard to the work performed by it during the contract, shall not
discriminate on the grounds of race, color, or national origin in the selection and retention of subcontractors,
including procurements of materials and leases of equipment. The contractor shall not participate either directly
or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices
when the contract covers a program set forth in Appendix B of the Regulations.
c. Solicitations for Subcontracts, including Procurements of Materials and Equipment: In all solicitations either by
competitive bidding or negotiation made by the contractor for work to be performed under a subcontract,
including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be
notified by the contractor of the contractor's obligations under this contract and the Regulations relative to
nondiscrimination on the grounds of race, color, or national origin.
d. Information and Reports: The contractor shall provide all information and reports required by the Regulations, or
directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of
information, and its facilities as may be determined by the Department of Transportation or the Federal Highway
Administration to be pertinent to ascertain compliance with such Regulations or directives. Where any
information required of a contractor is in the exclusive possession of another who fails or refuses to furnish this
information, the contractor shall so certify to the Department of Transportation, or the Federal Highway
Page 2 of 3

Administration as appropriate, and shall set forth what efforts it has made to obtain the information.
e. Sanctions for Noncompliance: In the event of the contractor's noncompliance with the nondiscrimination
provisions of this contract, the Department of Transportation shall impose such contract sanctions as it or the
Federal Highway Administration may determine to be appropriate, including, but not limited to,
(1) withholding of payments to the contractor under the contract until the contractor
complies, and/or
(2) cancellation, termination or suspension of the contract, in whole or in part.
Incorporation of Provisions: The contractor shall include the provisions of paragraphs "a" through "f" in every
subcontract, including procurements of materials and leases of equipment, unless exempt by the Regulations, or
directives issued pursuant thereto. The contractor shall take such action with respect to any subcontract or
procurement as the Department of Transportation or the Federal Highway Administration may direct as a means
of enforcing such provisions including sanctions for noncompliance: Provided, however, that, in the event a
contractor becomes involved in, or is threatened with, litigation with a subcontractor or supplier as a result of
such direction, the contractor may request the Department of Transportation to enter into such litigation to
protect the interests of the State, and, in addition, the contractor may request the United States to enter into
such litigation to protect the interests of the United States.
R/W (162) : Party of the Second Part certifies that this agreement is true and accurate copy of the form
R/W (162) incorporating all revisions to date.
IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and year first
above written.
DocuSigned by: DEPARTMENT OF TRANSPORTATION
State Encroachments Engineer
C1AAA5BAED54467... SfMA.VCTCUACl )MiUGN5r)ffxV „)(Xx
TEST OR WITNESS:
��.�L�
Ary—Area
Page 3 of 3
2�ZL
William L. Pinnix, P.E., Director of Eng., Brunswick County
P.O. Box 249 Bolivia, NC 28422
Second Party
�f

I William L. Pinnix
Brunswick County
NT# 18127
National Pollutant Elimination System (NPDES)
Stormwater Permit Compliance Certification
a duly authorized representative of
an industrial/commercial/residential
facility requesting attachment to a North Carolina Department of Transportation
highway drainage system at 74-76 E
Brunswick County
Eff
County, do hereby certify the following:
Check appropriate box and circle type of facility
W1 The Industrial / Commercial / Residential facility does not require an
NPDES stormwater permit.
The Industrial / Commercial / Residential facility does require an NPDES
stormwater permit. The permit has been obtained and a Stormwater
Pollution Prevention Plan (SPPP) is in place. Appropriate structural
stormwater best management practices (BUT) are designed and installed as
required by the Department of Environment and Natural Resources (DENR)
and/or the local governing agency. All structural stormwater B1VIP's are
located outside of NCDOT right —of--way.
I understand if the Department of Transportation determines the facility is not in
compliance with NPDES stormwater requirements, the Department will report the
noncompliance to the DENR Division of Water Quality. I also understand that
falsification of this certification may result in penalty of law against the facility
and me as prescribed in the North Carolina General Statutes.
Signature:
OF
Date: 7 / - --2
Note: If the applicant has a question as to whether an NPDES stormwater permit is
required, he or she may contact the N.C. Division of Water Quality in Raleigh at
[phone] (ask for Stormwater and General Permits Unit).
Form NPDES-I
May 22, 2006

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SC® rh backlill material shall meet the
Statewide Bomm Criteria. The trench shall be
backfilled, in accordance with Section 54M of the
latest NCDOT Standard Specifications for Roads
and Structures, which requires the backfil material
to be placed in thicknesses between 4' and.1r. _
loose and compacted to at least 97% of the rhoxinum
density obtained by compacting a sample it accordance
with AASHTO T 180, as modified by the Departnent
SC 34: Any open cutting of pavement shall be repaired using the fdbw" method:
• Pavements shall be cut full depth and removed. "
After trench work is complete, the edges of the emsfing pavement along
the trench shall be recut a minimum of 1' wider on each side of the trench.
tf the pavement is undermined, the edges of the existing pavement along
tfhe french shalt be recut to 1' beyond the undermined portion and the
pavement removed. The design section stated below is to be placed in
those areas
' The pavement repair shall be performed using the following method
and pavement design section:
— 11.0' B25.00 or 825.OB Asphalt Concrete Base Course
(accomplished in 2 rft minimum) according to NCDOT Standard 654.D7_
— Mill the entire area a depth of 2.0, starting from 15' in front of the edge
of the final pavement cut-
- Overlay er&e area (a minimum 5(l' length mechanical overlay) with 2.0'
S9.5C or S9SB Asphalt Concrete Surface Course dux a total aaphatt depth
of 13'- Butt joints are required with no feathering of joints.
All open cuts shall be backfiled, paved and traversable
prior to removing lane closure.
co qa no co ac
11" B25.06 OR B25.00
PAVEMENT REPAIRS ON ROADS TO BE RESURFACED
(PIPE IS PLACED UNDER EXISTING PAVEMENT)
2" S9.5B OR S9.5C
PAVEMENT REPAIRS ON ROADS NOT TO BE RESURFACED
(PIPE IS TO BE PLACED UNDER EXISTING PAVEMENT)
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
ROY COOPER
GOVERNOR
November 14, 2019
Mr. William L. Pinnix, P.E.
Director of Engineering
Brunswick County
P.O. Box 249
Bolivia, NC 28422
RECEIVED
NOV 19 2019
DCM WILMINGTON, NC
JAWS H. TROGDON, III
SECRETARY
SUBJECT: Encroachment Agreement (E033-010-19-00321) along SR 1418 (Old Maco Rd NE) in
Brunswick County (Hwy 74/76 Transmission Water Main)
Dear Sir,
Attached for your files is a copy of Right of Way Encroachment agreement properly executed. This
agreement covers the following:
Install approximately 500 Linear feet of 12-inch C-900 PVC water line installed by open cut and open
trenching. The concrete road that is open cut will be repaired with like type material and depth. The patch
shall be square.
• Time Restriction — Peak Hours Restricted: No lane closures shall be allowed from 6:00am to
9:00am and from 4:00pm to 7:00pm and NO weekend lane closures. (HOURS SUBJECT TO
CHANGE DUE TO TRAFFIC CONDITIONS —NIGHTTIME OPERATIONS WILL BE
REQUIRED WHEN WARRANTED)
• Brunswick County has provided a letter stating that they will not release their contractor's bond
until the NCDOT agrees that the work performed under this permit meets or exceeds NCDOT
standards. The Encroaching Party shall notify NCDOT at 910-398-9100 upon completion of the
work for a final inspection.
• A Pre -Construction meeting is required prior to beginning work. Contact the District office to
schedule.
As per this approval it is subject to this work being done in accordance with the attached plan sheets and
special provisions.
Sincerely,
�000usiflneaDby: J
ri�creon. ; . J .B.00,
Aaron R. LeBeau, Assistant District Engineer
for Chad Kimes, PE, Division Engineer
DCK/arl/jpw
ec: Iris McCombs, NCDOT Brunswick County Maintenance Engineer
State of North Carolina I Department of Transportation I Division 3, District 3
300 Division Drive, Wilmington, NC 28401
Customer Service: [phone] [phone] www.nodot.gov

E033-010-19-00321
ROUTE SR 1418 PROJECT Hwy 74-76 Transmission
DEPARTMENT OF TRANSPORTATION
-AND-
Brunswick County
STATE OF NORTH CAROLINA
COUNTY OF Brunswick
RIGHT OF WAY ENCROACHMENT AGREEMENT
PRIMARY AND SECONDARY HIGHWAYS
NT# 18127
THIS AGREEMENT, made and entered into this the 140 day of November 20 19 by and between the Department
of Transportation, party of the first part; and Brunswick County
party of the second part,
WITNESSETH
THAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designated as
Route(s) SR 1418 (Old Maco Rd NE) located Approximately 1,000 ft SE of the intersection of
74-76 E & NC-87 (Maco Rd)
with the construction and/or erection of: 500 LF of 12" DR18 C-900 PVC watermain
Method of installation: open cut & trench
WHEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the party of
the first part in the exercise of authority conferred upon it by statute, is willing to permit the encroachment within the limits of the
right of way as indicated, subject to the conditions of this agreement;
NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the right
and privilege to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which are
made a part hereof upon the following conditions, to wit:
That the installation, operation, and maintenance of the above described facility will be accomplished in accordance with the party of
the first part's latest POLICIES AND PROCEDURES FOR ACCOMMODATING UTILITIES ON HIGHWAY RIGHTS -OF -WAY, and such
revisions and amendments thereto as may be in effect at the date of this agreement. Information as to these policies and procedures
may be obtained from the Division Engineer or State Utility Agent of the party of the first part.
That the said party of the second part binds and obligates himself to install and maintain the encroaching facility in such safe and
proper condition that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper maintenance
thereof, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways and structures
necessary due to the installation and existence of the facilities of the party of the second part, and if at any time the party of the first part
shall require the removal of or changes in the location of the said facilities, that the said party of the second part binds himself, his
successors and assigns, to promptly remove or alter the said facilities, in order to conform to the said requirement, without any cost to the
party of the first part.
That the party of the second part agrees to provide during construction and any subsequent maintenance proper signs, signal lights,
flagmen and other warning devices for the protection of traffic in conformance with the latest Manual on Uniform Traffic Control Devices
for Streets and Highways and Amendments or Supplements thereto. Information as to the above rules and regulations may be obtained
from the Division Engineer of the party of the first part.
That the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all damages and
claims for damage that may arise by reason of the installation and maintenance of this encroachment.
That the party of the second part agrees to restore all areas disturbed during installation and maintenance to the satisfaction of the
Division Engineer of the party of the first part. The party of the second part agrees to exercise every reasonable precaution during
construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams, lakes, reservoirs, other water
impoundments, ground surfaces or other property; or pollution of the air. There shall be compliance with applicable rules and regulations
of the North Carolina Division of Environmental Management, North Carolina Sedimentation Control Commission, and with ordinances
and regulations of various counties, municipalities and other official agencies relating to pollution prevention and control. When any
installation or maintenance operation disturbs the ground surface and existing ground cover, the party of the second part agrees to
remove and replace the sod or otherwise reestablish the grass cover to meet the satisfaction of the Division Engineer of the party of the
first part,
That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be necessary by the
Division Engineer of the party of the first part.
That the party of the second part agrees to have available at the construction site, at all times during construction, a copy of this
agreement showing evidence of approval by the party of the first part. The party of the first part reserves the right to stop all work unless
FORM RMI 16.1 (Rev. July 1, 1977)

evidence of approval can be shown.
Provided the work contained in this agreement is being performed on a completed highway open to traffic; the party of the second part
agrees to give written notice to the Division Engineer of the party of the first part when all work contained herein has been completed.
Unless specifically requested by the party of the first part, written notice of completion of work on highway projects under construction will
not be required.
That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of the first part reserves
the right to stop all work until the facility has been brought into compliance or removed from the right of way at no cost to the party of the
first part.
That it is agreed by both parties that this agreement shall become void if actual construction of the work contemplated herein is not
begun within one (1) year from the date of authorization by the party of the first part unless written waiver is secured by the party of the
second part from the party of the first part.
During the performance of this contract, the second party, for itself, its assignees and successors in interest (hereinafter referred to as
the "contractor"), agrees as follows:
a. Compliance with Regulations: The contractor shall comply with the Regulations relative to nondiscrimination in Federally -
assisted programs of the U S Department of Transportation, Title 49, Code of Federal Regulations, Part 21, as they may be
amended from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and
made a part of this contract.
b. Nondiscrimination. The contractor, with regard to the work performed by it during the contract, shall not discriminate on the
grounds of race, color, or national origin in the selection and retention of subcontractors, including procurements of materials
and leases of equipment. The contractor shall not participate either directly or indirectly in the discrimination prohibited by
Section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B
of the Regulations.
c. Solicitations for Subcontracts including Procurements of Materials and Equipment: In all solicitations either by competitive
bidding or negotiation made by the contractor for work to be performed under a subcontract, including procurements of
materials or leases of equipment, each potential subcontractor or supplier shall be notified by the contractor of the
contractor's obligations under this contract and the Regulations relative to nondiscrimination on the grounds of race, color,
or national origin.
d. Information and Reports The contractor shall provide all information and reports required by the Regulations, or directives
issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its
facilities as may be determined by the Department of Transportation or the Federal Highway Administration to be pertinent to
ascertain compliance with such Regulations or directives. Where any information required of a contractor is in the exclusive
possession of another who fails or refuses to furnish this information, the contractor shall so certify to the Department of
Transportation, or the Federal Highway Administration as appropriate, and shall set forth what efforts it has made to obtain
the information.
e. Sanctions for Noncompliance: In the event of the contractor's noncompliance with the nondiscrimination provisions of this
contract, the Department of Transportation shall impose such contract sanctions as it or the Federal Highway Administration
may determine to be appropriate, including, but not limited to,
(1) withholding of payments to the contractor under the contract until the contractor complies, and/or
(2) cancellation, termination or suspension of the contract, in whole or in part.
f. Incorporation of Provisions: The contractor shall include the provisions of paragraphs "a" through "I" in every subcontract,
including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued
pursuant thereto. The contractor shall take such action with respect to any subcontract or procurement as the Department
of Transportation or the Federal Highway Administration may direct as a means of enforcing such provisions including
sanctions for noncompliance: Provided, however, that, in the event a contractor becomes involved in, or is threatened with,
litigation with a subcontractor or supplier as a result of such direction, the contractor may request the Department of
Transportation to enter into such litigation to protect the interests of the State, and, in addition, the contractor may request
the United States to enter into such litigation to protect the interests of the United States.
R/W (151) : Party of the Second Part certifies that this agreement is true and accurate copy of the form
R1W (161) incorporating all revisions to date.
IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and
year first above written.
DEPARTMENT OF TRANSPORTATION
A�
±s�a 00'YTe�e Docu Signed by:
�eJ ti y'f/4 BY: Qom,, B10.06
ml
Aaron R. LeBeau, Assistant District Engineer
TTEST OR WITNESS:
��Jr for Chad Kimes, PE, Division Engineer
%
-\�4
1d t'r'C1 hLi hi i�l �p�ltSt't RO�= William L Pinnix, P.E., Director of Eng., Brunswick County
4c- .fir , ��c- —P.O. Box 249 Bolivia, NC 28422
Second Party
INSTRUCTIONS

Encroachment Agreement Standard Conditions
District Office Contact Information:
300 Division Drive
Wilmington, NC 28401
[phone]
The Standard Conditions in this document apply to this and all encroachment agreements issued by District 3.
SCl A Pre -Construction Meeting is required prior to beginning work. Contact the District Office to schedule.
SC2 If the approved permit encroaches within the limits of an active construction project the encroaching party will be
required to coordinate with the NCDOT contractor as well as secure a hold harmless agreement prior to
commencing work. If the approved permit encroaches within the limits of project in preconstruction, the
encroaching party will be required to coordinate with the Department's Project Development Unit to ensure no
conflicts are created with the installation.
SC3 An Initial Construction Inspection is required after the completion of the work. An Initial Inspection Report will be
issued upon satisfactory completion of the work and begins the one year warranty period. Contact the District Office
to schedule.
SC4 A Final Inspection is required for release of the bond after the one year warranty period. Contact the District Office
to schedule this final inspection. Once the final inspection has been deemed satisfactory by NCDOT, the bond will be
released.
SC5 All bonds will be held for a minimum of one year from the time of the Initial Construction Inspection Acceptance.
SC6 All traffic control, asphalt mixes, structures, construction, workmanship and construction methods, and materials
shall be in compliance with the most -recent versions of the following resources: Manual on Uniform Traffic Control
Devices, Policies and Procedures for Accommodating Utilities on Highway Rights of Way, NCDOT Standard
Specifications for Roads and Structures, NCDOT Roadway Standard Drawings, NCDOT Asphalt Quality Management
System manual, and the approved plans.
SC7 Prior to beginning work, it is the requirement of the Encroaching Party to contact the appropriate Utility Companies
involved and make arrangements to adjust or relocate any utilities that conflict with the proposed work.
SC8 If the work is located within 1/2 mile of a signalized intersection, the Encroaching Party shall contact NCDOT Traffic
Services at [phone] no less than one week prior to beginning work, for the location of all traffic signal and
detection cables. Location is required prior to excavation. Cost to replace or repair NCDOT signs, signals or
associated equipment shall be the responsibility of the Encroaching Party.
SC9 Prior to beginning work, if the area of work is within a municipality limit, it is the responsibility of the Encroaching
Party to notify the municipal authorities.
SC10 The approval of this agreement does not preclude the Encroaching Party from complying with any and all statutes,
rules, regulations, and ordinances that may be imposed by other governmental agencies (local, state, and federal)
which have jurisdiction, including but not limited to, those related to sediment control, stormwater, wetlands,
streams, endangered species, and historical sites.
SC11 All wiring and related work shall conform to the latest edition of the National Electrical Safety Code.
SC12 No alteration of the approved plan will be allowed without written approval by NCDOT.
SC13 The Encroaching Party shall follow any and all revisions shown in RED on attached plan(s).
SC14 A readable, executed copy of this Encroachment Agreement shall be present at the work site at all times while
performing work. NCDOT reserves the right to stop all work unless evidence of approval can be shown. Additionally,
NCDOT reserves the right to further limit, restrict, or suspend operations within the right-of-way.
SC15 All flagging operations within NCDOT right-of-way require qualified and trained Work Zone Flaggers. Qualified and
trained Work Zone Traffic Control Supervisors will be required on significant projects. Training for this certification is
provided by NCDOT approved training sources and by private entities that have been pre -approved. For more
information, visit https://connect.ncdot.gov/projects/WZTC/Poges/Training.aspx or contact Steve Kite, PE with the
NCDOT Work Zone Traffic Control Unit at [phone], or [e-mail].
SC16 No lane closures shall be allowed on State Holidays (day of, day before, and day after) or during Local events.
Division 3, District 3 Updated 05/21/2018

SC17 , No lane closures or impediment to traffic shall be allowed on weekends without prior written approval from the
District Engineer.
SC18 One lane must be open to traffic; - only one lane closure in each direction. Ingress and egress shall be maintained to
all businesses and dwellings affected by the project. Special attention shall be paid to Police and Fire Stations, fire
hydrants and Hospitals.
SC19 All roadway signs removed during project work shall be reinstalled immediately after completion of work. All
equipment and materials shall be removed from the NCDOT right-of-way when not in use.
SC20 Any work requiring personnel or equipment within 5' of the travel lane on an undivided roadway, or 10' of the travel
lane, on a divided roadway shall require a lane closure per the latest edition of the MUTCD and the NCDOT
Standard Specifications. The more stringent standards shall apply.
SC21 Material shall NOT be unloaded or stockpiled on the roadway at any time without proper lane closure during the
project. Work is not permitted when the shoulder material is wet or during adverse weather conditions.
SC22 All erosion control devices shall be placed as needed prior to disturbance and maintained throughout the project.
All areas disturbed (shoulders, ditches, removed accesses, etc.) shall be graded and seeded within 15 calendar days
with an approved NCDOT seed mixture (all lawn type areas shall be maintained and reseeded as such).
SC23 The placement of curb and gutter is not allowed within shoulder sections of roadway.
SC24 It shall be unlawful to place any highway obstruction, including a driveway headwall, fence, rural mailbox, newspaper
delivery box, or other roadside obstruction, so as to interfere with the traffic or maintenance of the roads and
highways of the state highway system. See North Carolina Administrative Code 19A NCAC 2E.0404.
SC25 Fire Hydrant(s) shall be placed a maximum of 1 foot from the right-of-way line. (STD. 1515.02 in the NCDOT
Roadway Standard Drawings).
SC26 Directional drilling methods have not been given statewide approval for use on NCDOT right-of-way. Under no
condition shall jetting alone or wet boring with water be used for the installation of utility pipelines.
• Directional boring is not allowed in embankment material. Directional boring is allowed beneath embankment
material in naturally occurring soil.
• Any changes shall be submitted to the District Engineer for approval prior to construction.
• Directional bores are not allowed beneath bridge footings, culvert wingwall footings or retaining walls.
• HDPE pipe installed by directional boring shall not be connected to existing pipe or fittings for one (1) week
from the time of installation to allow tensional stresses to relax.
• Directional boring using jetting with a Bentonite (or equivalent material) slurry is approved with the following
conditions:
o Minimum depth of ten (10') feet below the pavement surface of roads with no control of access or
fifteen (15') feet below the surface of roads with partial or full control of access.
o Minimum depth of five (5') feet below any ditch line and/or creek bed.
o Minimum depth of (4') for parallel installations. Must be outside the theoretical 1:1 slope from the
existing edge of pavement except where the parallel installation crosses a paved roadway.
o Minimum horizontal distance of ten (10') feet from the nearest part of any structure, including but not
limited to bridges, footings, pipe culverts, and box culverts.
o Minimum vertical distance of ten (10') feet from the nearest part of pipe culverts or box culverts.
o Tip of the drill string shall have a cutter head and detection wire installed with non-ferrous material.
o All directional drilled piping for sewer force mains and waterlines shall be a minimum of SDR-9.
o Minimum horizontal separation of five (5') feet between each conduit which is part of a multiple
conduit installation (including perpendicular and parallel installations). Alternatively, install multiple
conduits within a single duct.
o Overbores shall not be more than two (2") inches greater than the diameter of the pipe or encasement.
o An overbore exceeding two (2") inches greater than the diameter of the pipe or encasement will be
considered if the encroachment agreement includes a statement signed and sealed by a North Carolina
Registered Professional Engineer indicating that an overbore in excess of two (2") inches of the diameter
of the pipe or encasement will arch and no damage will be done to the pavement or sub -grade.
Division 3, District 3 Updated 05/21/2018

SC27 • All excavations inside the theoretical 1:1 slope from the existing edge of pavement to the bottom of the nearest
trench wall shall be done in accordance with the following conditions:
• Any excavation encroaching upon the theoretical 1:1 slope from the edge of pavement of any NCDOT
maintained road shall require temporary active shoring that must be reviewed and approved by NCDOT
prior to work.
• All trench excavation inside the limits of the theoretical 1:1 slope, as defined by the policy, shall be
completely backfilled and compacted at the end of each construction day. No portion of the trench shall be
left open overnight.
• The length of parallel excavation shall be limited to the length necessary to install and backfill one (1) joint of
pipe at a time.
• Traffic shall be moved to a travel lane outside the limits of a theoretical 1:1 slope from the bottom of the
nearest trench wall to the pavement surface.
• Installation of trench shoring shall be accomplished with minimal over -excavation. Trench boxes shall not
be used as shoring.
• An NCDOT Inspector, the cost of which is to be borne by the Encroaching Party, shall be assigned to this
project if deemed necessary by the Division Engineer.
• The trench backfill material shall meet the Statewide Borrow Criteria. The trench shall be backfilled, in
accordance with Section 540-6 of the latest NCDOT Standard Specifications for Roads and Structures, which
requires the backfill material to be placed in thicknesses between 4" and 8" loose and compacted to at least
97% of the maximum density obtained by compacting a sample in accordance with AASHTO T 180, as
modified by the Department.
• At the first sign of trench failure, a trench shall be immediately backfilled with materials consisting of A-1, A-
3, A-2-4 soils or A-4 soils having a maximum of 45% passing a No. 200 sieve and a maximum P.I. of 6. All
work shall cease, and the Division Engineer shall be contacted. The Encroaching Party shall be required to
repair any damage to the pavement caused by the excavation.
• No part of any pit shall be within three (3) feet of edge of pavement or back of curb.
• Detection tape shall be buried in the trench approximately one foot above the utility or fiber optic cable,
whenever conduit is installed in right-of-way and is not of ferrous material.
SC28 The Encroaching Party shall comply with all OSHA requirements and provide a competent person on site to
supervise excavation at all times.
SC29 Approval is only for work within NCDOT right-of-way, and excludes area(s) within Railroad right-of-way. Approval is
with the understanding that NCDOT does not guarantee the right-of-way on any road.
SC30 The proposed manholes, handholes, valves or other appurtenances shall not be located in the existing ditch line,
front slope of a ditch, or in a manner that would restrict the maintenance or flow of the existing ditch line.
SC31 The Encroaching Party is responsible for any and all damages caused from project work within the right-of-way,
including damage to drainage structures, pavement, vegetation, etc.
SC32 Any plant or vegetation in the NCDOT planted sites that is destroyed or damaged as a result of this encroachment
shall be replaced with plants of like kind or similar shape. Contact the Division Roadside Environmental Engineer at
910-259-4919.
SC33 Any pavement damaged because of settlement of the pavement or damaged by equipment used to perform
encroachment work, shall be re -surfaced to the satisfaction of the District Engineer. This may include the removal of
pavement and a 50' mechanical overlay. All temporary and final pavement markings are the responsibility of the
Encroaching Party.
SC34 Any open cutting of pavement shall be repaired using the following method:
• Pavements shall be cut full depth and removed.
• After trench work is complete, the edges of the existing pavement along the trench shall be recut a
minimum of 1' wider on each side of the trench. If the pavement is undermined, the edges of the existing
pavement along the trench shall be recut to 1' beyond the undermined portion and the pavement removed.
The design section stated below is to be placed in those areas.
• The pavement repair shall be performed using the following method and pavement design section:
Division 3, District 3 Updated 05/21/2018

o 11.0" B25.00 or B25.OB Asphalt Concrete Base Course (accomplished in 2 lifts minimum) according to
NCDOT Standard 654.01.
o Mill the entire area a depth of 2.0", starting from 15' in front of the edge of the final pavement cut.
o Overlay entire area (a minimum 50' length mechanical overlay) with 2.0" S9.5C or S9.5B Asphalt Concrete
Surface Course for a total asphalt depth of 13". Butt joints are required with no feathering of joints.
All open cuts shall be backfilled, paved and traversable prior to removing lane closure.
Division 3, District 3 Updated 05/21/2018

Data Rece/ved
Data
C/wU Flpn
Name o/ Pwm/f llold9r
YM�
CMck Numbar
p -k
r�wunt
Permit Numbar/C--ft
Rciptor RWuiuLRealklcatad
Columnt
Cdumn2
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C.N."
Cdumn9
_. 12R0/XI19
12l'OI2019 _
_ 12rz 19
Dwey Raaaurw GroW ft.
S— d NoM Carobu WRC
c.raus ewWrtg Co _
Nar t:-d imesl«n
&.-M k Carly / W &- Pm
lk#.d Bank
1715
s 400.0O
GP 674705D _ _
GP 974835D
GP 474MM _ _
_
TM. rc 9514
Ebobelio
595DO037240
S 200.00
BB l 9100
D" ce."
FM 5r*
1410
S 700.00
TM. M. 9512