19970593 Ver 1_COMPLETE FILE_19970703

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state of North Carolina
Department of ~nvlronment I
Health and Natural Resources
Division of Water Quality

James B. Hunt, Jr., Govemor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E.. Director

August 5, 1997
Yancey County
WQC 40 1 Project #970593

APPROVAL of 401 Water Quality Certification

Mr. K.A. Wilson
N.C. Dept of Transportation
P.O. Box 3279
Asheville, NC 28802

Dear Mr. Wilson:

You have our approval, in accordance with the attached conditions, to place fill n1'aierw~ 0.04 acres or
wetlands or waterS for the purpose of improving SR 1368. as you described,in your applic$tOQdated 26 June
1997. After reviewing your application, we have decided that this fill is covered by General Water Quality
Certification Number 3102. This Certification allows you to use Nationwide Permit N~r 13 when it is
issued by the Corps of Engineers. In addition, you should get any other. f~eral, state or l~ pennits before
you go ahead with your project including (but not limited to) Sediment apdErosion ContrOl, Coastal
Stonnwater, Non-Discharge and Water Supply Watershed regulations. Also this approval will expire when
the accompanying 404 or CAMA pennit expires unless otherwise specified in the General Certification.
This approval is only valid for the purpose and design that you desCribed in your application. If you
r':' change your project, you must notify us and you may be required to send us a new application. If total
wetland fills for this project (now or in the fu~) exceed one acre, compensatOry~tigation may be ~uired
as described in ISA NCAC 2H .OSQQ (h). For this-approval to be valid, you must follow,mc"conditfits .
listed in the attached certification. .. .of '" ' .
If you do not accept any of the conditions of this certification, 'You. may ask for an adj~dicatory'hea4ni;~:
You must act within 60 days of the date that you receive this letter. To ask for a MIring, ~e1\a a written "
,~ petition whlth conforms to t::haprer 150B of the North Carolina General Statutes to the Office of
. . Adininistrative Hearings, P.O. Box 27447, EaJ.eigh, N.C. 27611-7447. This certification and its conditiom~
are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act If you have any questions, please telephone John Dorney at 919-733-1786.

Attachment

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cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
Asheville DWQ Regional Office
Mr. John Dorney
Central Files

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970593.ltr

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Division r Quall1r"l Environmenta1.Sclences Branch ,
Environmental Sciences Bran eedy CIRd., Ral,igh, NC:27607 Telephone [phone] FAX # [phone]
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TO:

PRINT NAMES:
Reviewer:
JOHN DORNEY WQ SUPV.:
ENVIRONMENTAL SCIENCES BRANCH DATE:

SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS

Ml!OOR'ANDUM

.,'o'o"EACH ITEM MUST BE ANSWERED (USE N / A FOR NOT APPLICABLE) .,'dd,

PERMIT YR: 97 PERMIT NO: 0000593
APPLICANT NAME: DOT-SR 1368
PROJECT TYPE: PAVING
COE_1f :
RCD FROM CDA: DOT
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REG OFFICE: ARO

COUNTY: YANCEY

PERMIT TYPE: ~ !J 1..00 13
DOT_If :
DATE_FRM_CDA: 07/03/97

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RIVER_AND_SUB_BASIN_If: 0403

STR INDEX NO: 7-3-17

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STREAM CLASS: C --r~ I~" .
WL IMPACT?: Y/N WL TYPE: AI(~
WL_RE.QUESTED: WL ACR EST? @y ,.o4-,q..a,te,4J
WL_SCORE(If): AlLer WATER IMPACTED BY FILL?~
MITIGATION?, Y~ MITIGATION_TYPE, ;;/~
MITIGATION_SIZE: Al/~ DID YOU REQUEST MORE INFO?: ~
IS WETLAND RATING SHEET ATTACHED?: Yt)
HAVE PROJECT CHANGES/CONDITIONS BEEN DISC ED WITH APPLICANT?: Y/N AJ/~
RECOMMENDATION (Circle One): ISSUE ISSUE/COND DENY
COMMENTS:
J~~ ~ ~ .97-itu-c<' "6 .f12. /3.W3
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P.O. Box 3279
Asheville, N.C.

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June 26, 1997

Mr. David Baker
U.S. Army Corp of Engineers
Regulatory Field Office
151 Patton Ave. Rm. 143
Asheville, NC. 28801-5006

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Subject: S.R. 1368, Yancey Co.

Dear Mr. Baker:

We are providing a package of design sketches concerning wetlands that
will be impacted by this project. We have enclosed a completed N. C. D. E. M.
application for your use.
We are planning on replacing or extending several pipes in unnamed
tributaries flowing into Roland Branch and are also proposing three channel
changes in Roland Branch. This stream is a designated trout stream. We will bel,
working within the twenty five foot buffer zone of this stream but will not be
encroaching past the existing shoulder except for these channel changes.
By copy of this letter, we are seeking comments from Mr. Edward Ingle,
Area Roadside Environmental Engineer and Mr. Richard Phillips, LQ Regional
Engineer.
If you have any comments or questions concerning this project, please
contact J.N. Jarrett or myself of this office at 704-298-2741.
Thank you for your cooperation and assistance in this matter.

Sincerely yours,

k. A. LOjs~

District Engineer

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cc: Mr. Eric Galamb, Div. of Environmental Management
Mr. Mark S. Davis, Western Mt. Region Coordinator

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DEM ID:

CORPS ACTION ID:

NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): ,

PRE-CONSTRUCTION NOTIFICATION APPLICATION

FOR NATIONWIDE PERMITS THAT REQUIRE:

1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT

SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY-ADDRESSES SHEET). SEVEN
(7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF_ENVIRONMENTAL MANAGEMENT
(SEE AGENCY AD~RESSES SHEET). PLEASE PRINT.

1. OWNERS NAME:

fJ. c. beer;- OF TRAf.5fOR11\TIO~

2. MAILING ADDRESS:

p.o. ea~ 3t79

SUBDIVISION NAME:

CITY: ASftEVlLLE

l880Z.

STATE:

NC

ZIP CODE:

PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE) :

sf<. (36e ,

FRED A-\fERS

RD.

'fAMCEY

3.

TELEPHONE NUMBER (HOME):

(WORK) :

CO.
198-l14-f

4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:

(<.,4. WlLSoU / C DIST EN6R)
P.o. BO~ 3l.7?

lq8-l14- (

AsftEVCLLE. NC

ZB80Z.

5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE) :
COUNTY: 'fA-fJcey NEAREST TOWN OR CITY: .BU~fJ.SV(LLe:

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SPECIFIC LOCATION (INCLUDE ROAD

NUMBERS, LANDMARKS, ETC.):

SR (3'&\ FRED ~E.RS f\d., (-=ROM SR (33' f\UN14!1JG

J..!ORTHEASTERL,

fO(< o.~l MfLES TO E.O.M.

6. IMPACTED OR NEAREST STREAM/RIVER:

RoLMiD BRfWdi

RIVER BASIN:

CAt-lE Rot V ER

7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW)yOUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES [~ NO [] IF YES, EXPLAIN:

RoLM-LD 6AAf.(cH- (5 A DES(GtJATEl) TROUT STReAM ,

7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF.50ASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [] NO [vJ

7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR
LIST OF COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?

N(p..

8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [] NO [vi IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION) :

8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [] NO [vi IF YES, DESCRIBE ANTICIPATED WORK:

9a.

ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:

5

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9b.

ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:

O. 15 A-L

2

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lOa. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:

FILLING:

O.oz.

EXCAVATION:

(],OZ

FLOODING:

OTHER:

DRAINAGE:

TOTAL ACRES TO BE IMPACTED:

0.04 A-c

lOb. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION) :

LENGTH BEFORE: 100 FT AFTER: 'to FT
WIDTH BEFORE (based on normal high water contours) : 5' FT
WIDTH AFTER: 5 FT
AVERAGE DEPTH BEFORE: i- FT AFTER: i:- FT

(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)

OPEN CHANNEL RELOCATION:

./

PLACEMENT OF PIPE IN CHANNEL:

CHANNE~, EXCAVATION:

'tJ'I'
OTHER: -1

11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE
WATERSHED DRAINING TO THE POND? ~rA

CONSTRUCTION OF A DAM/FLOODING:

WHAT IS THE EXPECTED POND SURFACE AREA? N(A

12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) :

f>IPES 10 aE R~E>LACED IFJ R.o<..AAD at:. 8, U~UAMS> TR{eU~(E5 Fto~(146
. IM1"O (1": ~E6 ffio~(JSE.() Cftf\Nf-.LEL cHANGES ,"" RGWJD BR.

13. PURPOSE OF PROPOSED WORK: TO FAC.{UTATE. TffE= W(CE~(/..!.G: AND
PAVlUCi. OF SR 13&fr, fRED A'iER5 Rt>.

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14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS) :
(.sEE::. (l.) ItLL t<<JUTtfJ.E AtJ.D N~( MEASURES' 10 CCWrr<<1L
E:((JS(()~ Al'iD SED(M~7itTIOU WfLL BE OTTLl~ED; SILl fENCES, RO~
Sf I T cHEQ::S ftI.J () .BA5r (..is' ( fJ. Dt It.HES ~

15. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE
(USFWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL HABITAT
IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE
CONTACTED: ~ 10 f.(,.c..lJ.l.f{.C. '-z'-91 (ATTACH RESPONSES
FROM THESE AGEN IES.)

16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) (SEE AGENCY ADDRESSES SHEET) REGARDING THE PRESENCE OF HISTORIC
PROPERTIES IN THE PERMIT AREA WHICH MAY BE AFFECTED BY THE PROPOSED
PROJECT. DATE CONTACTED: N fA '

.:'
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND? ,

YES [J NO [~(IF NO, GO TO 18)

a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONMENTAL
POLICY ACT?

YES [ ] NO [ ]

b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CA~OLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?

YES [ ] NO [ ]

IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.

> .

QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].

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18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL
INTO WETLANDS:

a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26,
29, AND 38). ALL STREAMS (INTERMITTENT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OR 1
INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE
IMPACTED BY PROJECT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO THE PLACEMENT OF THE DELINEATIOtiLINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY?-

AG~lCUlTURE I RS.S( DEJ..LTAL
,

f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?

N(A

g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.

NOTE: WETLANDS OR WATERS OF THE U.S. MAY NOT BE IMPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM.

K.A .. wc:.2s~ (D<Si EN6R \
OWNER'S/AGENT'S SIGNATURE

6- zr: -77
DATE

(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (lBg.))

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N.C. DEPARTMENT OF TRANSPORTATION

DIVISOf\1 OF. HIGHWAYS

SECOND~RY ROAD SURVEY

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(368 FRED h'lERS RD.

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DATE b-(~-97 SCALE 111.::50
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IG-=t- 4Q __. _.. ~O~J;~ (M P_______ --.--------
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.E.ROJECT:

~R I ~b8

PO,'_ E DAJ A
WORK ORDER;

COUNIY: 'jAfJC~Y _QWNE_R OF POI E= REA e CTC
DISTANCE FROM
CENTER OF
PROPOSED PROJECT
STATION LEFT RIGHT !NOTES ,
Z/ +OZ- 15/ feWER ~ TELE
53 +oZ- 15 ,. " II
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Std. :If

245.03
245.05
893.01
890.05
245.01
245.02
892.04
895.10
892.01
892.02
897.01
894.01
245.04

896.01

896.02

896.03

EROSION CONTROL
DETAILS AND
SPECIFICATIONS

Desr,ription

Symbol

Paoe
~

Temporary Silt Ditch ...__......................... -TSO- ___ VI. 2
Temporary Diversion ............................. _ m _ ___ VI _ 4
Temporary Silt Fence ...................... Iii III _n_____ VI _ 6
Temporary Slope Drain with Earth Berm .......... I-e::---,= VI _ 8
Silt Basin Type A .................................. -E)' ____________ VI. 10
Silt Basin Type B ........................................... ~ ___ VI. 12
Temporary Rock Silt Check Type-A ..........~ n____n___ VI. 14
Temporary Rock Silt Check Type-B ............ ~ --n___n___ VI _ 16
Temporary Rock Sediment Dam Type-A ............ ~ ___ VI _ 18
Temporary Rock Sediment Dam Type-B... C) -----mm VI _ 20
Rock Pipe Inlet Protection ................................ ~J: _n VI. 22
R~~k Silt S~reen ......................................... J --~.~~~:n___ VI - 24
Stilling BaSin ...................................................__ ~ __n_ VI _ 26

Rock Inlet Protection:
Type A ............................... A [j.~ OR .. A) _u__ VI _ 30
Type B ............................... B [j.. OR .. B ] _____ VI _ 32
Type C............................... C [j.. OR .. C] ____ VI _ 34

PIPE- OUTLET EfJER6j D(SSAPn-!o/<..
ERa s 10 ~ co~mo l MA m t-J G
fl BER GLAss RoV( f-J G
VI-I

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March, 1993

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ROADWAY DITCH AND MEDIAN LINING GUIDELINES

VIII - 2

March, 1993

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N.C. DEPAf:<TMENT OF TRANSPORTATION

DIVISOf\1 OF. HIGHWAYS

SECOND~RY ROAD SURVEY
(\ r.,~,' 0' 5 Ul\ ""
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PRIORI' 3f
TOWNSIIIP JAcks CREEk
SCALE III ::::0

DATE 6 - (9-97
f\/OTES 45 I Rlw

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DEM ID:

CORPS ACTION ID:

.

NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):

PRE-CONSTRUCTION NOTIFICATION APPLICATION

FOR NATIONWIDE PERMITS THAT REQUIRE:

1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT

SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY-ADDRESSES SHEET). SEVEN
(7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF_ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.

1. OWNERS NAME:

fJ. c. beer:- OF TAAf.lSfOR'Tl\TIO~

2. MAILING ADDRESS:

p.o. ea>< 32-79

SUBDIVISION NAME:

CITY: ASftEVlLLE

STATE:

NC

ZIP CODE:

l8002.

PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE) :

sR (368 ~

FREt) fr"f ERS

RD.

'fAf..{CE Y

3.

TELEPHONE NUMBER (HOME):

(WORK) :

CO.
198-Z.14-1

4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:

{<:. A. WfLSoU,' C DIST EN6R)
P.o. BOX 3Z.7~

Z.~8-l14-(

AsftEV {LLE. NC

z88tJZ.

5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE) :
COUNTY: 'lAfJCEY NEAREST TOWN OR CITY: .8URIJ.SV(LLE

",,~.~, "

,";
\0

1

...."

.

SPECIFIC LOCATION (INCLUDE ROAD

NUMBERS, LANDMARKS, ETC.):

5R (3~&, FRED AltERS p..d., l~M

SR f 33' RUNf..l(NG

~ORnfEASreRLI

FOR O. <tl t-AfLt:S TIl E.O.M.

6. IMPACTED OR NEAREST STREAM/RIVER:

RoLMiD BRf\f..!CH

RIVER BASIN:

CA~E Rl V ER

7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW)yOUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES [~ NO [] IF YES, EXPLAIN:

RoLA\.1D BAA-Nat (5 It DESrGf.JATED TRoUT STReAM ,

7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF.50ASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [] NO [vJ

7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR
LIST OF COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?

NfA

Sa. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [] NO [vi IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION) :

8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [] NO [vi IF YES, DESCRIBE ANTICIPATED WORK:

9a.

ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:

5

,-."..~: "':"
t ;
h

9b.

ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:

o. (5 A-c.

2

~..

.

lOa. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:

FILLING:

0.02.

EXCAVATION:

0'.02

FLOODING:

OTHER:

DRAINAGE:

TOTAL ACRES TO BE IMPACTED:

0.04- .4C

lOb. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION) :

LENGTH BEFORE: 100 FT AFTER: era
WIDTH BEFORE (based on normal high water contours) : 5'
WIDTH AFTER: 5'
AVERAGE DEPTH BEFORE: z.. FT AFTER: l-

FT

FT

FT

FT

(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)

OPEN CHANNEL RELOCATION:

./

PLACEMENT OF PIPE IN CHANNEL:

CHANNEL EXCAVATION:

CONSTRUCTION OF A DAM/FLOODING:

OTHER:

11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE
WATERSHED DRAINING TO THE POND? ~rA

WHAT IS THE EXPECTED POND SURFACE AREA? N/A

12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) :

rIPs 10 ~E. REPLACED IfJ ~D B~. e, U~f.lAMfS) 1RteUrnR(E.) FC.tJ~/N6
I MTII rr: TItRE,6 PRo paSED a+Af..(~EL cHANGES I ~ R(jCAfJD B R .

13. PURPOSE OF PROPOSED WORK: TO FAC.{UTA-rE. T'ff€: W(CE~(~G' AND
pA\Jrl46, OF SR 136&, FRED A'tERS Rt>.

,.-...:~~ . I'.
t;
I..

3

,~.:-""-

\

, - ---;::~1~"

. .'

.
'.

14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLU~ ANY MEASURES TAKEN TO MINIMIZE WETLANV
IMPACTS) :

GEe=. (z.) ItLl f(JuT1~E MLD N~l MEASURES 10
~<r(..t: A-~D SEO(M~-rn-TION. VJflL BE UTILlZ.ED ;
Sf I T cHSl::5 f\i!f) .BA5rt-iS' (fJ. OnCH-ES-

ccwTf(jL
SILT fEN.CES , ROcfc

15. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE
(USFWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL HABITAT
IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE
CONTACTED: ~ 10 f..(,.c..lJ.,!.f{.C. '-z'-91 (ATTACH RESPONSES
FROM THESE AGEN IES.)

16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) (SEE AGENCY ADDRESSES SHEET) REGARDING THE PRESENCE OF HISTORIC
PROPERTIES IN THE PERMIT AREA WHICH MAY BE AFFECTED BY THE PROPOSED
PROJECT. DATE CONTACTED: N fA .

17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?

YES [] NO [~(IF NO, GO TO 18)

a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONMENTAL
POLICY ACT?

YES [ ] NO [ )

b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?

YES [ ] NO [ )

IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORTH cAROLINA ENVIRONMENTAL POLICY ACT.

QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS,', eAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].

, .

, ~-.'~:' ; ~
I.

4

f

18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL
INTO WETLANDS:

a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26,
29, AND 38). ALL STREAMS (INTERMITTENT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OR 1
INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE
IMPACTED BY PROJECT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO THE PLACEMENT OF THE DELINEATIQ~LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY?- .

AGR.taJlTURE I RaS( DEU-rnL
,

f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?

N(A

g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.

NOTE: WETLANDS OR WATERS OF THE U.S. MAY NOT BE IMPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM.

kit ~Wc:Qs~ ( rxSl ~6R\
,
OWNER'S/AGENT'S SIGNATURE

6- ~-17
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