19981258 Ver 1_Complete File_20100726

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
0 )VA
NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
December 31, 1998
Mr. George Teague
NC DOT
515 Camp Road
Salisbury, NC 28147
Dear Mr. Teague:
Re: Bridge # 141
Stanly County
DWQ # 981258
The Division of Water Quality has reviewed your submittal for a 404/401 Permit for replacing
bridge # 141 in Stanly County. Your application was not complete since the total amount of impact and
mitigation was not included in the application. This information is needed by DWQ in order for us to
decide whether this project is approvable.
I can be reached at 919-733-1786 if you have any questions. Until this information is
received, I will request (by copy of this letter) that the Corps of Engineers place this project on hold.
Also, the project will be placed on hold for our processing due to incomplete information (15A NCAC
2H .0507(a)(4)). Your processing time will begin once we receive a complete application.
Sincerely,
Attachment
cc: Mooresville DWQ Regional Office
Wilmington District of Corps of Engineers
Asheville Field Office Corps of Engineers
John Dorney
Central Files
R. Dorney
')ater
Qua
lity Certi ica /on Program
981258.hld
Division of Water Quality • Non-Discharge Branch
4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer • 50% recycled/10% post consumer paper

Mr. Steve Lund
U. S. Army Corps of Engineers
151 Patton Avcnue, Room 143
Ashevili,. N.C. 28801-5006
Dear Mr. Lund:
? C/
Dec. 15, 1998
515 Camp Rd.
Salisba,y, N. C. 28147
The North Carolina Department of Transportation Bridge Maintenance Unit, proposes the following
project for your review. We believe this project can be accomplished under Nationwide # 26.
COUNTY: Stanly County; Bridge # 141
ROUTE: S.R. 1231
STREAM: Pole Branch Creek
DESCRIPTION: Bridge #68-141 Replaced with 3 lines of 66" X 51" CMPA. Not located in wetlands.
Less than 0.007 acres of Rip Rap fill in waters. Drainage area is 0.67 square miles.
The average daily flow is 0.67 C.F.S.
We have attached a site location map, and a sketch of planned activities. A stringent erosion and
sedimentation control program will be implemented during the project construction and every effort will
be made to complete work in a timely manner.
Our personnel are available to assist with your evaluation of this project, if necessary. Should you have
any questions, please call me at 704-639-7555.
Sincerely,
George ?. Teague
Bridge Maintenance Supt.
GLT/des
attach.
DEM ID:
CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): _?b
PRE-CONSTRUCTION NOTIFICATIONS APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATIONS FOR SECTION 301 CERTIFICATION
3) COORDINATION WITH THE N. C. 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 TC THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME: NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: BRIDGE MAINTENANCE UNIT
515 CAMP RD.
SALISBURY, N.C. 28147
PROJECT LOCATION ADDRESS. (INCLUDING SUBDIVISION NAME) S? q n I .? CO .
Bc ? 11-I? 5? ? 1131 ?vcc PO,t acgnc? C?eck
TELEPHONE NUMBER (HOME)
(WORK) 704-639-7555
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL. ADDRESS.
AND PHONE NO.
GEORGE L. TEAGUE
BRIDGE MAINTENANCE SUPERINTENDENT
515 CAMP RD.
SALISBURY, N.C. 28147
704-639-7555
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: 5? qn\y NEAREST TOWN OR CITY: MA\ k e m g r1 t
SPECIFIC LOCATION, (INCLUDING ROAD NUMBERS NAMES, LANDMARKS, ETC.):
5R 1? 31 A cc oss Po1?? ?c? C c? tk 1?0 or?? SR 1?3 a:
6. IMPACTED OR NEAREST STREAM/RIVER: N\t '46 9C crom`C
RIVER BASIN: a ?C\y?
z.
7a. IS PROJECT LOCATED NEAR WATER CLASSIFED AS TROUT, TIDAL SALTWATER (SA),
HIGH QUALITY WATERS (HQW). OUTSTANDING RESOURCE WATERS (ORM. WATER
SUPPLY (WS-I OR WS-II)? YES ( ) NO (,4 IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ( ) NO (/)
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?
NI
ga. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES( ) NO (A IF YES. PROVIDE ACTION I.D. NUMBER OF THE
PREVIOUS PERMIT AND Airy ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY" Gl
401 CERTIFICATION):
gb. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES( ) NO J, IF YES. DESCRIBE ANTICIPATED WORK:
` 9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:-CJ-.'3 S o r rtr
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: 13
FLOODING:
DRAINAGE: O
EXCAVATION:
OTHER: 0
TOTAL ACRES TO BE IIvIPACTED:J6AL
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: k /.A FT. AFTER: FT.
WIDTH BEFORE (BASED ON NORMAL HIGH WATER CONTOURS): FT.
WIDTH AFTER: FT.
AVERAGE DEPTH BEFORE:- FT. AFTER:- - FT.
3.
10b. (2) STREANI CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPL i?
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: j CONSTRUCTION OF A DAM/FLOODING:
OTHERS: 1 cl 47*% . n ?-6 W 3- Q: r? _ rC4 A %N S ?
11. IF CONSTRUC LION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? N 11 1 ? _
WHAT IS THE EXPECTED POND SURFACE AREA? N / A
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPN1EivT'1D BE USED (ATTACH PLAINS: 8'/" X I1" DRAWINGS ONLY): RcW? aC c
tk cc
13. PURPOSE OF WORK:
???ac? 0\? ?t?,ti.?cr hr??4c ??) •?h I?ti r a?
0 ' s l " cr"Y
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
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: (ATTACH RESPONSES FROM THESE AGENCIES.)
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) (SEE AGENCY ADDRESSES SHEET) REGARDING THE PRESENCE OF HISTIRIC
PROPERTIES IN THE PERMIT AREA WHICH MAY BE AFFECTED BY THE PROPOSED
PROJECT. DATE CONTACTED:
- 17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND? YES (v) NO " ) (IF NO, GO TO 18)
17. 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 (CIS
17. b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE? YES ( ) NO ( )
IF ANSWER TO I -To 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 ADI IINSTRATION, 116 WEST JONES STREET, RALEIGH.
NORTH CAROLINA 27603-8003, TELEPHONE NO. 919-733-6369.
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITIES INVOLVES THE DISCHARGE OF EXCAVATED MATERIALS
INTO WETLANDS:
a. WETLANDS 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* '= 50'
OR 1" = 100' OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED
BY PROJECT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LnUSE OF SURROUNDING PROPERTY? W Boa S an?
? V 'r (.T,\ q n
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE U.S. MAY NOT BE IN PACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER THE ISSUANCE OR WAIVER OF A 101 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.
OW S / A E SIGNAtURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION
LETTER FROM THE OWNER IS PROVIDED (18g.) )
25' 1 580 000 FEET 154 155 156 - 35'22'30"
S? `? 3 \ l%?` (( 7914
Oak(ime?
590 000
FEET
3913
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North Carolina 4"111 1 09
Department of Transportation
Division of Highways
George L. Teague ('l
Z Bridge Maintenance Superintendent 6M
515 Camp Rd. - [phone] l
r'
SaUsbury, NC 28147 Fax [phone]
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s? ?Z3 \
S?C'gK??Y Ch
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1 ?.
North Carolina
Department of Transportation
Division of Highways
George L. Teague
Bridge Maintenance Superintendent
515 Camp Rd. `?• [phone]
Salisbury, NC 28147 y1 Fax [phone]

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Mr. Steve Lund
U. S. Army Corps of Engineers
151 Patton Avenue, Room 143
Aslicville, N.C. 28801-5006
Dear Mr. Lund:
Dec. 15, 1998
515 Camp Rd.
Salisbury, N. C. 28147
The North Carolina Department of Transportation Bridge Maintenance Unit, proposes the following;
project for your review. We believe this project can be accomplished under Nationwide # 26.
COUNTY: Stanly County, Bridge # 141
ROUTE: S.R. 1231
STREAM: Pole Branch Creek
DESCRIPTION: Bridge #68-111 Replaced with 3 lines of 66" X 51" CMPA. Not located in wetlands.
Less than 0.007 acres of Rip Rap fill in waters. Drainage area is 0.67 square miles.
The average daily flow is 0.67 C.F.S.
We have attached a site location map, and a sketch of planned activities. A stringent erosion and
sedimentation control program will be implemented during the project construction and every effort will
be made to complete Nvork in a timely manner.
Our personnel are available to assist with your evaluation of this project, if necessary. Should you have
any questions, please call nic at 704-639-7555.
Sincerely,
George ?. Teague
Bridge Maintenance Supt.
GLT/des
attach.
DEM ID:
CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): _?b
PRE-CONSTRUCTION NOTIFICATIONS APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATIONS FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE N. C. 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: NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: BRIDGE MAINTENANCE UNIT
51 S CAMP RD.
SALISBURY, N.C. 28147
PROJECT LOCATION ADDRESS. (INCLUDING SUBDIVISION NAME) Cg'
Bc 1131 vv cf N f_ %C rAh c?\ Cr ttc
3. TELEPHONE NUMBER (HOME) (WORK) 704-639-7555
IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL. ADDRESS,
AND PHONE NO.
GEORGE L. TEAGUE
BRIDGE MAINTENANCE SUPERINTENDENT
515 CAMP RD.
SALISBURY, N.C. 28147
704-639-7555
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: 5i o n\ j NEAREST TOWN OR CITY: ? 1 {? e m g r I Q
SPECIFIC LOCATION, (INCLUDING ROAD NUMBERS, NAMES, LANDMARKSETC.):
SR 17131 Ac_roSr N'\' RcR?c?. Cc'tv - 110' NCAl U'1111
6. IMPACTED OR NEAREST STREAM/RIVER: NN'_ Qc ?a?c Wreck
RIVER BASIN: \ a? ?
2.
7a. IS PROJECT LOCATED NEAR WATER CLASSIFED AS TROUT, TIDAL SALTWATER (SA).
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW). WATER
SUPPLY (WS-I OR WS-II)? YES ( ) NO (.? IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ( ) NO (h
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) A
8a. HAVE ANY SECTION 404 PEIZA41TS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES( ) NO (A IF YES. PROVIDE ACTION I.D. NUT BER OF THE
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 (A IF YES. DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:_O_. a 5 gCrt,r
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: O
FLOODING: O
EXCAVATION: O
OTHER: 0
DRAINAGE: O TOTAL ACRES TO BE IMPACTED: N U n c
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: FT. AFTER: FT.
WIDTH BEFORE (BASED ON NORMAL HIGH WATER CONTOURS): FT.
WIDTH AFTER: FT.
AVERAGE DEPTH BEFORE:- - FT. AFTER:- - FT.
3.
10b. (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: v/ CONSTRUCTION OF A DANUFLOODING:
OTHERS: I \Uc?rs.CS ?' K(J-(C?? Can SOP?d
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? N I A
WHAT IS THE EXPECTED POND SURFACE AREA? N / A
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPME'N iG BE USED (ATTACH PLANS: 8'/" X 11" DRAWINGS ONLY): R?p? ac c
13. PURPOSE OF WORK: (Zc??acc 0\? ??r?.?cr hr'??4? ??•??. ???tr at
_ b'1 k 5 I " C V?^Y ?a
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
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: (ATTACH RESPONSES FROM THESE AGENCIES.)
{ 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:
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND? YES (v) NO ' ) (IF NO, GO TO 18)
4.
17. 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
17. b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADNIIMS'I'RA"PION 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 NIS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADINIINSTRATION, 116 WEST JONES STREET, RALEIGH.
NORTH CAROLINA 27603-8003, TELEPHONE NO. 919-733-6369.
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITIES INVOLVES THE DISCHARGE OF EXCAVATED MATERIALS
INTO WETLANDS:
a. WETLANDS DELINEATION MAP SHOWING ALL WETLANDS. STREANIS. LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18,
21, 26, 29, AND 38). ALL STREAMS (INTERMITTENT AND PERNIANENT) ON THE
PROPERTY MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE I"=50'
OR F'= 100' OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED
BY PROJECT.
c. IF DELINEATION WAS PERFORNIED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORNIWATER NIANAGENIENT PLAN IF REQUIRED.
c. ?yHAT IS L nUSE OF SURROUNDING PROPERTY?
W ?o? r ah?
?C a r ft.,
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
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 401 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.
-Aw-Z,A,zap",?
0W S / A E Al-URE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION
LETTER FROM THE OWNER IS PROVIDED (18g.) )
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Department of Transportation
Division of Highways
George L. Teague
Z Bridge Maintenance Superintendent aM?4?
515 Camp Rd. - [phone] -'% -
Salisbury, NC 28147 Fu [phone] 6.i[
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North Carolina
Department of Transportation
Division of Highways
George L. Teague
Bridge Maintenance Superintendent
515 Camp Rd. ! [phone]
Salisbury, NC 28147 ! Fax [phone]
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Mr. Steve Lund
U. S. Army Corps of Engineers
151 Patton Avenue. Roam 1.13
Asheville, N.C. 28801-500
Dear Mr. Lund:
_
A
Dec. 15, 1998
515 Camp Rd.
Salisbury, N. C. 28147
The North Carolina Department of Transportation Bridge Maintenance Unit, proposes the following
project for your review. We believe this project can be accomplished under Nationwide # 26.
COUNTY: Stanly County; Bridge # 111
ROUTE: S.R. 1231
STREAM: Pole Branch Creek
DESCRIPTION: Bridge #68-111 Replaced with 3 lines of 66" X 51" CMPA. Not located in wetlands.
Less than 0.007 acres of Rip Rap fill in waters. Drainage area is 0.67 square miles.
The average daily flow is 0.67 C.F.S.
We have attached a site location map, and a sketch of planned activities. A stringent erosion and
sedimentation control program will be implemented during the project constriction and every effort will
be made to complete work in a timely manner.
Our personnel are available to assist with your evaluation of this project, if necessary. Should you have
any questions, please call me at 704-639-7555.
Sincerely,
George . Teague
Bridge Maintenance Supt.
GLT/des
attach.
DEM ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): _?b
PRE-CONSTRUCTION NOTIFICATIONS APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATIONS FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE N. C. 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 EN`?IRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME: NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: BRIDGE MAINTENANCE UNIT
515 CAMP RD.
SALISBURY, N.C. 28147
PROJECT LOCATION ADDRESS. (INCLUDING SUBDIVISION NAME) S} q n I .? CO .
Bc ?LI? s? 1131 vv cc P41c ?cGnc? Cc
3. TELEPHONE NUMBER (HOME) (WORK) 704-639-7555
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL. ADDRESS.
AND PHONE NO.
GEORGE L. TEAGUE
BRIDGE MAINTENANCE SUPERINTENDENT
515 CAMP RD.
SALISBURY, N.C. 28147
704-639-7555
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: S? g r\ I NEAREST TOWN OR CITY: F?, e m g c 2
SPECIFIC LOCATION, (INCLUDING ROAD NUMBERS, NAMES, LANDMARKSETC.):
SR 1? 31 A cco.rC RcRrc`• C ft-tk ; 1?0 N oA\, U'1111
6. IMPACTED OR NEAREST STREAM/RIVER: NN'_ 'Rc"agt Crec,lc
RIVER BASIN:__ 1 a d \6Yy .
z.
7a. IS PROJECT LOCATED NEAR WATER CLASSIFED AS TROUT, TIDAL SALTWATER (SA).
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW). WATER
SUPPLY (WS-I OR WS-II)? YES ( ) NO (4 IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONNIENTAL CONCERN (AEC)? YES ( ) NO (/)
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?
NI ?\
8a. HAVE ANY SECTION 401 PERNIITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES( ) NO k4 IF YES. PROVIDE ACT ION I.D. NUMBER OF THE
PREVIOUS PERNIIT AND ANY ADDITIONAL INFORMAI'ION (INCLUDE PHOTOCOPY OF
401 CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES( ) NO CA IF YES. DESCRIBE ANTICIPATED WORK:
9a. ESTINIATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:-O-.'3 S o c rt,t
9b. ESTINIATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
0,4 fvz
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: O
FLOODING: O
DRAINAGE: O
EXCAVATION: Q
OTHER:
TOTAL ACRES TO BE INIPACTED:-N-t1h c
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: k / A FT. AFTER: FT.
WIDTH BEFORE (BASED ON NORMAL HIGH WATER CONTOURS): FT.
WIDTH AFTER: FT.
AVERAGE DEPTH BEFORE:- FT. AFTER:- FT.
3.
10b. (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:
OTHERS: 1 1Gcna '?IASS- 31 K:(ZI -C?? 4th S?0(1??
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? _L I F\
WHAT IS THE EXPECTED POND SURFACE AREA? N / A
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MEC.'HrVJICAL
EQUIPMENT '1 O BE USED (ATTACH PLANS: 3 '/" X 11" DRAWINGS ONLY): R cw a C c
v\1 CmN
13. PURPOSE OF WORK: L-p\ac c. 0
c 01 51 " c Y""Y
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
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: (ATTACH RESPONSES FROM THESE AGENCIES.)
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:
- 17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND? YES (o NO ' ) (IF NO, GO TO 13)
17. 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 (CIS
17. b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTIv1L' NT OF ADNUNISTRATION STATE CLEARINGHOUSE? YES ( ) NO ( )
IF ANSWER TO lib IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL IvIANAGEMENT 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 ADI IINSTRATION, 116 WEST JONES STREET, RALEIGH.
NORTH CAROLINA 27603-3003, TELEPHONE NO. 919-733-6369.
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITIES INVOLVES THE DISCHARGE OF EXCAVATED MATERIALS
INTO WETLANDS:
a. WETLANDS DELINEATION NIAP 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. NIAP SCALES SHOULD BE I"=50'
OR 1" = 100' OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED
BY PROJECT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORNIWATER MANAGEMENT PLAN IF REQUIRED.
e. rT IS LA USE OF SURROUNDING PROPERTY'? W Qoa T atrA
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
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 101 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.
ON S / A E SIGNAf`URE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION
LETTER FROM THE OWNER IS PROVIDED (18g.) )
154 155 156 -- -35'22'30"
25' 1 580 000 FEET
Oak GwCh,?''?-' -
590 000
FEET
\ 1 ?V
j .-
39
13
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'Ch s? T A
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aj?iei 'Mill
d ` 14` ?s12
cem
Jl ?• O ?'? _ _ / \ / / - ; 3911
big -
North Carolina ?!? b '% , _ 7900
Department of Transportations
Division of Highways
George L. Teague r( -_
Z Bridge Maintenance Superintendent `!? yr em s' ?L
[phone]
515 Can Rd.
u NC 28147 Fax [phone]r ?, • ?1? / 1'
Sahib /
Q?; Sgt RAP\?c?{?.?n?
a yt a VAS
s? ?z31
S A- 'Y Ce

North Carolina
Department of Transportation -
Division of Hi* ghways
George L. Teague
Bridge Maintenance Superintendent
515 Camp Rd., [phone]
Salisbury. NC 28147-? Fu [phone]

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a
Mr. Steve Lund
U. S. Anny Corps of Engineers
151 Patton Avenue, Room 143
Asheville, N.C. 23801-5006
Dear Mr. Lund:
Dec. 15, 1993
515 Camp Rd.
Salisbury, N. C. 28147
The North Carolina Department of Transportation Bridge Maintenance Unit, proposes the following
project for your review. We believe this project can be accomplished under Nationwide # 26.
COUNTY: Stanly County; Bridge # 141
ROUTE: S.R. 1231
STREAM: Pole Branch Creek
DESCRIPTION: Bridge 468-141 Replaced with 3 lines of 66" X 51" CMPA. Not located in wetlands.
Less than 0.007 acres of Rip Rap fill in waters. Drainage area is 0.67 square miles.
The average daily flow is 0.67 C.F.S.
We have attached a site location map, and a sketch of planned activities. A stringent erosion and
sedimentation control program will be implemented during the project construction and every effort will
be made to complete work in a timely manner.
Our personnel are available to assist Nvith }'our evaluation of this project, if necessary. Should you have
any questions, please call me at 704-639-7555.
Sincerely,
George . Teague
Bridge Maintenance Supt.
GLT/dcs
attach.

DEM ID:
CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):
?b
PRE-CONSTRUCTION NOTIFICATIONS APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATIONS FOR SECTION 40: CERTIFICATION
3) COORDINATION WITH THE N. C. 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
(') COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL NLANAGEM[ENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME: NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: BRIDGE MAINTENANCE UNIT
515 CAMP RD.
SALISBURY, N.C. 28147
PROJECT LOCATION ADDRESS. (INCLUDING SUBDIVISION NAME)11 S41" k r\ I ? CO .
Bc ? 1?? 5? ? X131 vvcr QO?c Qcgnc? Cce?,?C
TELEPHONE NUMBER (HOME)
(WORK) 704-639-7555
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL. ADDRESS.
AND PHONE NO.
GEORGE L. TEAGUE
BRIDGE MAINTENANCE SUPERINTENDENT
515 CAMP RD.
SALISBURY, N.C. 28147
704-639-7555
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: 5 ? o, n \ ? NEAREST TOWN OR CITY:_ e m q r' Q
SPECIFIC LOCATION, (INCLUDING ROAD NUMBERS, NAMES, LANDMARKS, ETC.):
5R n 31 A cr osc N\,, RcRc?c? C c? ck ' '1o r N orA? TR la3 a
6. IMPACTED OR NEAREST STREAM/RIVER: Po?c QC ??c?C Creck
RIVER BASIN: _1 a d N6IN
2.
7a. IS PROJECT LOCATED NEAR WATER CLASSIFED AS TROUT, TIDAL SALTWATER (SA).
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (OR?N?. WATER
SUPPLY (WS-I OR WS-II)? YES ( ) NO (,f IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A. NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ( ) NO V
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) A
8a. HAVE ANY SECTION 404 PERNIITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES( ) NO (A IF YES. PROVIDE ACTION I.D. NUNIBER OF THE
PREVIOUS PERNI,T AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF
301 CERTIFICATION):
8b. ARE ADDITIONAL PERNIIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES( ) NO (A IF YES. DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:_O _ . a 5 o c r4r
9b. ESTIMATED TOTAL NUNIBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
10a. NUNIBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: O
FLOODING: 4
DRAINAGE: O
EXCAVATION: Q
OTHER:
TOTAL ACRES TO BE IMPACTED: t_
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: k [in FT. AFTER: FT.
WIDTH BEFORE (BASED ON NORMAL HIGH WATER CONTOURS):
WIDTH AFTER: FT.
FT.
AVERAGE DEPTH BEFORE:_ FT. AFTER:_ - FT.
3.
10b. (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-
.-OTHERS:-1
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING 0 THE POND? N f
WHAT IS THE EXPECi'ED POND SURFACE AREA? N / A
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPME:N'T 10 BE USED (ATTACH PLANS: 8 Y" X 11" DRAWINGS ONLY): R?pI ac ?
13. PURPOSE OF WORK:?y??acc W••?? ?i `?ntr at
C 0 S 1 u cr-Y
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
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: (ATTACH RESPONSES FROM THESE AGENCIES.)
{ 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:
- 17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND? YES (V? NO ' ) (IF NO, GO TO 18)
4.
17. 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 (CIS
17. 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 SUBNUT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
CONIPLIANCE 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 DFPARTNIENT OF ADMMINSTRATION, 116 WEST JONES STREET, RALEIGH.
NORTH CAROLINA 27603-8003, TELEPHONE NO. 919-733-6369.
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITIES INVOLVES THE DISCHARGE OF EXCAVATED NIATERIALS
INTO WETLANDS:
a. WETLANDS DELINEATION MAP SHOWING ALL WETLANDS. STREANIS. LADES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14. 18.
21. 26. 29, AND 38). ALL STREANIS (INTERNUTTENT AND PERMANENT) ON THE
PROPERTY MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE I" _ 50'
OR 1" = 100' OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED
BY PROJECT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORNIWATER MANAGEMENT PLAN IF REQUIRED.
c. WHAT IS L USE OF SURROUNDING PROPERTY?
W Boa S g??
Ica r fl, \ QI
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
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 PERNIIT,
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.
?n /Z-1S-7c?
-&,, OW S / A E SIGNAfURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION
LETTER FRONT THE OWNER IS PROVIDED (18g.) )
,55 '56 - T
25' 1 580 000 FEET °54 +-35'22'30"
7914
- 10,
` r Oak (roJ'e
Ch l I
o /' T/ f \ Ir 590 000
FEET
tZ33
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39 13
12 77
altiier?' 1lill - i \ _ I
J912
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1 it ?-=? J•? Cem - - ?- 1I'-J ''
?-- ? - ,/ '_ - - -_ 7911
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Z,
_l
North Carolina ??-? 3909
Department of Transportation
Division of Highways ?a //? __
George L. Teague
-Z Bridge Maintenance Superintendent
_ [phone]
515 Camp Rd. Fax [phone]
Salisbury, NC 28147 \ ? '. ? ? ? t / ??\. ?- ?/
North Carolina
VAS Department of Transportation
SQ 1 3 \ Division of Hi°hways
George L. Teague
5 q ?\ Y Cb Bridge Maintenance Superintendent
515 Camp Rd. [phone]
Salisbury , NC 28147 ? ?V Fax [phone]
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CC\/c
v C Mr. Steve Lund
U. S. Army Corps of Engineers
151 Patton Avenue, Room 143
Asheville. N.C. 23301-5006
Dear Mr. Lund:

Dec. 15, 1993
515 Camp Rd.
Salisbury, N. C. 23147
The North Carolina Department of Transportation Bridge Maintenance Unit, proposes the following
project for your review. We believe this project can be accomplished under Nationwide # 26.
COUNTY: Stanly County; Bridge # 141
ROUTE: S.R. 1231
STREAM: Pole Branch Creek
DESCRIPTION: Bridge 468-141 Replaced with 3 lines of 66" X 51" CNIPA. Not located in wetlands.
Less than 0.007 acres of Rip Rap fill in waters. Drainage area is 0.67 square miles.
The average daily flow is 0.67 C.F.S.
We have attached a site location map, and a sketch of planted activities. A stringent erosion and
sedimentation control program will be implemented during the project construction and every effort will
be made to complete work in a timely manner.
Our personnel are available to assist with your evaluation of this project, if necessary. Should you have
any questions, please call me at 704-639-7555.
Sincerely,
George . Teague
Bridge Maintenance Supt.
GLT/dcs
attach.
DEM ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): ?A
PRE-CONSTRUCTION NOTIFICATIONS APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATIONS FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE N. C. 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: NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: BRIDGE MAINTENANCE UNIT
51 S CAMP RD.
SALISBURY, N.C. 28147
PROJECT LOCATION ADDRESS. (INCLUDING SUBDIVISION NAME)1 Co
?c ? \y? 5? ? X131 ovcc Q41? ?cG?c? Cre?.?C
TELEPHONE NUMBER (HOME)
(WORK) 704-639-7555
IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL. ADDRESS.
AND PHONE NO.
GEORGE L. TEAGUE
BRIDGE MAINTENANCE SUPERINTENDENT
S IS CAMP RD.
SALISBURY, N.C. 28147
704-639-7555
LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: S a r\ y NEAREST TOWN OR CITY: (a {? e m q c' 2
SPECIFIC LOCATION, (INCLUDING ROAD NUMBERS, NAMES, LANDMARKS, ETC.):
R 1-? 31 A cr , rc P'4\" RcRt-c? C ft- k , Vlo ' N orA? SR 1l3 a
6. IMPACTED OR NEAREST STREAM/RIVER: PO?c Qc ?a?t Creck
RIVER BASIN: a d \6
z.
7a. IS PROJECT LOCATED NEAR WATER CLASSIFED AS TROUT, TIDAL SALTWATER (SA),
HIGH QUALITY WATERS (HQW). OUTSTANDING RESOURCE WATERS (ORW). WATER
SUPPLY (WS-I OR WS-II)? YES ( ) NO l4 IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ( ) NO (/)
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?
Sa. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES( ) NO 6VJ IF YES. PROVIDE ACTION I.D. NUMBER OF THE
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 V IF YES. DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: _O_. a S a r-
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: O
FLOODING: O
DRAINAGE: O
EXCAVATION:
OTHER: 0
TOTAL ACRES TO BE IMPACTED:
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: k / A FT. AFTER: FT.
WIDTH BEFORE (BASED ON NORMAL HIGH WATER CONTOURS): FT.
WIDTH AFTER:
FT.
AVERAGE DEPTH BEFORE:_ FT. AFTER:_ - FT.
3.
10b. (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:j
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHERS: 1 1 G crya ?lcn.Ci ?- K(? _ (?? 4th S?0 P??
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? _ N I (\
WHAT IS THE EXPECTED POND SURFACE AREA? N / A
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT'10 BE USED (ATTACH PLANS: 8'/° X 11" DRAWINGS ONLY): R?p1 a?
13. PURPOSE OF WORK: ?,o)(kcc- 0?? ?C?r?,?cr hr?ayc ??1•?? t??tr at
'o . s t 11
C r-y
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
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: (ATTACH RESPONSES FROM THESE AGENCIES.)
t 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:
- 17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND? YES (v? NO ' ) (IF NO, GO TO 18)
17, a. IF YES. DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQULRENIENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ( ) NO (./
17. b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTNIL-NT 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 ADI IINSTRATION, 116 WEST JONES STREET, RALEIGH.
NORTH CAROLINA 27603-8003, TELEPHONE NO. 919-733-6369.
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITIES INVOLVES THE DISCHARGE OF EXCAVATED MATERIALS
INTO WETLANDS:
a. WETLANDS DELINEATION MAP SHOWING ALL WETLANDS. STREANIS. LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14. 18,
21, 26, 29, AND 38). ALL STREAMS (INTERNIITTENT AND PERNIANENT) ON THE
PROPERTY MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE I" _ 50'
OR 1-' = 100' OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED
BY PROJECT.
c. IF DELINEATION WAS PERFORNIED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO PLACENIENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
c. WHAT IS LnUSE OF SURROUNDING PROPERTY? W noA .r gyA
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL"
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
NIANAGENIENT PROGRANI.
, , lid lZ-1,5 7c0
O S / A E ' SIGNAtURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION
LETTER FROM THE OWNER IS PROVIDED (18g.) )
-- T- -
25' 1 580 000 FEET 154 155 _ 156 +-35°22'30"
c ?1 I I `
3914
LD C l? S 14/N
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590 000
- i I p - i - - FEET
1233
]913
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aitiiel NEv - _ J
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I
North Carolina 7909
s Iota` •? , ; -' -_
Department of Transportation
Division of Highways -
George L. Teague
Z Bridge Maintenance superintendent eM "
[phone]
515 Camp Rd. - gyt [phone]
Salisbury, NC 28147 J??J 14
Sk?,r?Y Ce

North Carolina
Department of Transportation
Division of Hisihways
George L. Teague
Bridge Alaini.enance Superintendent
515 Camp R1. [phone]
Salisbury, NC 28147 ?- _ Fu [phone]

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C Mr. Steve Lund
U. S. Anny Corps of Engineers
151 Patton Avenue, Room 143
Asheville N.C. 28801-5006
Dear Mr. Lund:

Dec. 15, 1998
515 Camp Rd.
Salisbury, N. C. 28137
The North Carolina Department of Transportation Bridge Maintenance Unit, proposes the following
project for your review. We believe this project can be accomplished under Nationwide # 26.
COUNTY: Stanly County, Bridge # 141
ROUTE: S.R. 1231
STREAM: Pole Branch Creek
DESCRIPTION: Bridge #68-111 Replaced with 3 lines of 66" X 51" CMPA. Not located in wetlands.
Less than 0.007 acres of Rip Rap fill in waters. Drainage area is 0.67 square miles.
The average daily flow is 0.67 C.F.S.
We have attached a site location map, and a sketch of planned activities. A stringent erosion and
sedimentation control program will be implemented during the project construction and every effort will
be made to complete work in a timely manner.
Our personnel are available to assist with your evaluation of this project, if necessary. Should you have
any questions, please call me at 703-639-7555.
Sincerely,
George . Teague
Bridge Maintenance Supt.
GLT/des
attach.
DEM ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT 9): _?A
PRE-CONSTRUCTION NOTIFICATIONS APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATIONS FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE N. C. 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: NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: BRIDGE MAINTENANCE UNIT
515 CAMP RD.
SALISBURY, N.C. 28147
PROJECT LOCATION ADDRESS. (INCLUDING SUBDIVISION NAME) S'? q r?' .? Co .
Bc ?y? S? ?13? vv cc P4,t ?crAhC C?e-,k
TELEPHONE NUMBER (HOME)
(WORK) 704-639-7555
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPOR,\TE OFFICIAL, ADDRESS.
AND PHONE NO.
GEORGE L. TEAGUE
BRIDGE MAINTENANCE SUPERINTENDENT
515 CAMP RD.
SALISBURY, N.C. 28147
704-639-7555
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: S? \,r\ \A NEAREST TOWN OR CITY: (a {? e m q e
SPECIFIC LOCATION, (INCLUDING ROAD NUMBERS, NAMES, LANDMARKS, ETC.):
5R 17131 Accost- Po?? RcR?c? c ft-tk • VW N1 3rA?l SR 11-31
6. IIviPACTED OR NEAREST STREAM/RIVER: PoN'c_ QC ?a?C C'rec.k
RIVER BASIN: ? a d \:.l
i.
7a. IS PROJECT LOCATED NEAR WATER CLASSIFED AS TROUT. TIDAL SALTWATER (SA).
HIGH QUALITY WATERS (HQW). OUTSTANDING RESOURCE WATERS (ORW). WATER
SUPPLY (WS-I OR WS-II)? YES ( ) NO (4 IF YES. EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ( ) NO V
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?
Sa. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES( ) NO (A IF YES. PROVIDE ACTION I.D. NUMBER OF THE
PREVIOUS PERNIIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF
401 CERTIFICATION):
Sb. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES ( ) NO (A IF YES. DESCRIBE ANTICIPATED WORK:
` 9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:_O_. a S o c its
9b. ESTIMATED TOTAL NUNIBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
N,% t\e,
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: 13
FLOODING: O
DRAINAGE: O
EXCAVATION:
OTHER:
TOTAL ACRES TO BE IMPACTED: NA c
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: FT. AFTER: FT.
WIDTH BEFORE (BASED ON NORNIAL HIGH WATER CONTOURS): FT.
WIDTH AFTER: FT.
AVERAGE DEPTH BEFORE:- FT. AFTER:- + FT.
3.
10b. (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: CONSTRUCTION OF A DAMIFLOODING:
OTHERS: 1 1 Gcrya ??G.CS K(? -fC?V? 4i? S 10_??
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? N 11 WHAT IS THE EXPECTED POND SURFACE AREA? N / A

12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT-10 BE USED (ATTACH PLANS: 8'/° X 11" DRAWINGS ONLY):
13. PURPOSEOFWORK:???acc
b0, 51" c
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND ll?IPACTS):
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: (ATTACH RESPONSES FROM THESE AGENCIES.)
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: JL'J? -`tai
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND? YES (,A NO ' ) (IF NO, GO TO 18)
4.
17. 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 (A
17, 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 FRONT THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL NIANAGENIENT 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 ADIIvUNSTRATION, 116 WEST JONES STREET, RALEIGH.
NORTH CAROLINA 27603-8003, TELEPHONE NO. 919-733-6369.
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITIES INVOLVES THE DISCHARGE OF EXCAVATED MATERIALS
INTO WETLANDS:
a. WETLANDS DELINEATION MAP SHOWING ALL WETLANDS. STREAMS. LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERNIIT 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-=50'
OR I- = 100' OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED
BY PROJECT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORNIWATER MANAGEMENT PLAN IF REQUIRED.
e. PAT IS L OF SURROUNDING PROPERTY'?
?a v(`c.?nUSE
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
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 104 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.
lid I Z -15 - l o
OW S / A E SIGNAtURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION
LETTER FROM THE OWNER IS PROVIDED (18g.) )
54 °55 '56 ,b -35'22'30"
25' 1 580 000 FEET °
r- omol?
•?
3914
1616 f,? ??V ? -
- i? --
o
590 000
. --- ?`.
- ` = ? _ ^_ •% C"`C"r- i ? , ? .I - ? II - ` , - ? - FEET
rV?I U.
1,913
attiier?' 1Ii11
- _ i
cem
3J i/ f i
``O --- - - \., _''911
'K2
North Carolina 7909
Department of Transportation -
Division of Highways
George L. Teague o _
Z Bridge Maintenance Superintendent BM?? -
[phone] Y 1=.'
• 515 Camp Rd. - i
Salisbury, NC 28147 Y Fu [phone] J I It O k?? t
8?; ?gc e, . f {
S?ar?Y Ce .
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J
North Carolina
Department of Transportation
Division of Highways
George L. Teague
Bridge Maintenance Superintendent
515 Camp Rd. • -; [phone]
Salisbury, NC 28147 2..?..i Fu [phone]

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Mr. Steve Lund
U. S. Anny Corps of Engineers
151 Patton Avenue, Room 143
Asheville. N.C. 28801-5006
Dear Mr. Lund:

Dzc. 1j, 1998
515 Camp Rd.
Salisbury, N. C. 23147
The North Carolina Department of Transportation Bridge Maintenance Unit, proposes the following
project for your review. We believe this project can be accomplished under Nationwide # 26.
COUNTY: Stanly County, Bridge # 141
ROUTE: S.R. 1231
STREAM: Pole Branch Creek
DESCRIPTION: Bridge #68-141 Replaced with 3 lines of 66" X 51" CMPA. Not located in wetlands.
Less than 0.007 acres of Rip Rap fill in waters. Drainage area is 0.67 square miles.
The average daily flow is 0.67 C.F.S.
We have attached a site location map, and a sketch of planned activities. A stringent erosion and
sedimentation control program will be implemented during the project constriction and every effort will
be made to complete work in a timely manner.
Our personnel are available to assist with your evaluation of this project, if necessary. Should you have
any questions, please call me at 704-639-7555.
Sincerely,
; 'ip
George .Teague
Bridge Maintenance Supt.
GLT/dcs
attach.
DEM ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT 4): Ab
PRE-CONSTRUCTION NOTIFICATIONS APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATIONS FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE N. C. DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF TIIIS COMPLETED FORNI 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 ENVIRONNIENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NANIE: NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: BRIDGE MAINTENANCE UNIT
515 CAMP RD.
SALISBURY, N.C. 28147
PROJECT LOCATION ADDRESS. (INCLUDING SUBDIVISION NANIE)
Bc ? \LI? S? ? 1131 ovcc Qo1t ?cgnc? C?c?,?
TELEPHONE NUMBER (HOME)
(WORK) 704-639-7555
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL. ADDRESS.
AND PHONE NO.
GEORGE L. TEAGUE
BRIDGE MAINTENANCE SUPERINTENDENT
515 CAMP RD.
SALISBURY, N.C. 28147
704-639-7555
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: 5 a r? NEAREST TOWN OR CITY: (a I e m g r I C
SPECIFIC LOCATION, (INCLUDING ROAD NUMBERS, NAMES, LANDMARKS, ETC.):
5R 1J 3 A cc osc N\c Rrnr c?, C fttk ' 1?0 ? ? or?1. SR la3 ?
6. INIPACTED OR NEAREST STREANMVER: Po?? Qc???t Creck
RIVER BASIN: l ck d ?&\h
2.
7a. IS PROJECT LOCATED NEAR WATER CLASSIFED AS TROUT. TIDAL SALTWATER (SA).
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW). WATER
SUPPLY (WS-I OR WS-II)? YES ( ) NO (v f IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES () NO V
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?
Sa. HAVE ANY SECTION 404 PERrvUTS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES () NO (,) IF YES. PROVIDE ACTION I.D. NUMBER OF THE
PREVIOUS PERMIT AI4D ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF
401 CERTIFICATION):
Sb. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES( ) NO (/S IF YES. DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:_O _ . a 5 o C its
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: O
FLOODING: O
EXCAVATION:
OTHER:
DRAINAGE: r3
TOTAL ACRES TO BE IMPACTED: N ?l n c
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: k /.A FT. AFTER: FT.
WIDTH BEFORE (BASED ON NORMAL HIGH WATER CONTOURS): FT.
WIDTH AFTER: FT.
AVERAGE DEPTH BEFORE: FT. AFTER: FT.
3.
10b. (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EEX\CAVATION:- CONSTRUCTION OF A DAIvUFLOODING:
OTHERS: 1 1 U c • na ??G.CS ?- K(? - (CL S ?o? -
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? N I P\
WHAT IS THE EXPECTED POND SURFACE AREA? N / A
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPME'N IO RE USED (ATTACH PLANS: 8'/" X 11" DRAWINGS ONLY):
13. PURPOSEOFWORK:???acc 0\? ?t?r?.?cr 11r?a4? W••?? ?i I?cr at
c 01. S 1 " C YYY
14. STATE REASONS W-1 1Y IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
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: (ATTACH RESPONSES FROM THESE AGENCIES.)
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: M-/5 -`I'?
- 17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND? YES (v? NO - ) (IF NO, GO TO 18)
17. 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 (CIS
17. 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 ENVIRONI NIENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADIIVIINSTRATION, 116 WEST JONES STREET, RALEIGH.
NORTH CAROLINA 27603-8003, TELEPHONE NO. 919-733-6369.
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITIES INVOLVES THE DISCHARGE OF EXCAVATED MATERIALS
INTO WETLANDS:
a. WETLANDS 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-=50'
OR 1" = 100' OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED
BY PROJECT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS L0. OF SURROUNDING PROPERTY? W Boa S an?
?a r tti\ ?USE -
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
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 101 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.
/Z-115-710
0
O S / A ENT' SIGNAtURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION
LETTER FROM THE OWNER IS PROVIDED (18g.) )
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Department of Transportation
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Division of Highways
George L. Teague
Z Bridge Maintenance Superintendent
\ 515 Camp Rd. - [phone]
Salisbury, NC 28147 Fax [phone]

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North Carolina
Department of Transportation --
Division of Highways
George L. Teague
Bridge Maintenance superintendent
515 Camp Rd. ? - [phone]
Salisbury , NC 28147 Fu [phone]

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US ARMY CORPS/ENGRS ID:18282714858 MAY 25'00 9:14 No.001 P.01
c
ARM -1 y - CORPS OF
YJ . S.
ENGINEERS
151 Patton Avenue, Room a 43
Asheville, North Caroli??a 28801-5006
[phone]
1=ax. [phone]
FAX TRANSMJSSION COVER SHEET;
.Datc: May 25 2000
To: Dally 1v NCDlyfl, Wetlands Group
Fax: [phone]
Re: File material or Bride #141 G0198200031
Sender: Steve: Lund
YOU SHOULD RECEIVE 10 PAGE(S), INcLUI)ING THIS COVER SHEET. IF YOUDO
NOT RECEIVE ALL THE PAGES, PLEASE CALL [phone].
Remarks: Decided to just send you the whole file. Hard to tell exactly
how long the pipes are but according to the application, they replace a
17400t long bridge.
US ARMY CORPS/ENGRS ID:18282714858 MAY 25'00 9:14 No.001 P.02
U.S. ARMY CORPS 01" r,1,14%...iLNEERS
WiLM1NGTON DISTRICT
Action Id. 199930310 County Union
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property owner: North Carolina Deparhuent of 'T'ransportation
Address: Bridge Maintenance Unit: Attn: George L. Teague
515 Camp Road
Salisbury, North Carolina 28147
Telcl)lhone No.: 704 639-7555
Si74 and Location of project (water body, road name/number, town, etc.):
Bridge # 141 over Pole Bridge Creek on SR 1231 west of Albemarle, Stanly County,
North Carolina.
I)escription of Activity:
Replace Bridge No. 141 with 3 lines of 66" X Si" corrugated met11 pipe. Place rip-rap at
inlet and outlet ends of the pipe. No wetlands ..=.^,.ctcd.
Applicable Law: ._C-Section 404 (Clean Water Act, 33 U.S.C.1344).
(check all that apply) Section 10 (River and Harbor Act of 1899).
Authorization: 191200031 Regional General Permit Number.
Nationwide Punnit Number.
Your work is authorized by this Regional General (RGP) or Nationwide Permit (NWP) provided it is
accomplished in strict accordance with the attached conditions and your submitted plans. If your activity
is subject to Section 404 (if Section 404 block above is checked), before beginning work you must also
receive a Section 401 water quality certification from the N.C. Division of Environmental Management,
telephone [phone]. For any activity within the twenty coastal counties, before beginning work you
must contact the N.C. Division of Coastal Management, telephone [phone].
Please read and carefully comply with the attached conditions of the RGII or NWP. Any violation of the
conditions of the RGP or the NWP referenced above may subject the permittee to a stop work order, a
restoration order, and/or appropriate legal action.
This Department of the Anny RGP or NWP verification does not relieve the permittee of the responsibility
to obtain any other required Federal, State, or local approvals/permits. The permittee may need to contact
appropriate State and local agencies before beginning wc.:.
If there are any questions regarding this authorization or any of the conditions of the General Permit or
Nationwide Permit, please contact the Corps Regulatory Official specified below.
Date 24 February 1929
Corps Regulatory Official Steve Chapin Telephone No.-- [phone]
Expiration Date of Verification_ 12/31 0z
SURVEY PLATS, FIELD SKE'T'CH, WE'I'1.AND DI:LINF.ATION FORNIS, PROJECT PLANS, ETC., MUST
BE ATTACHED TO TIIE YELLOW (Filar') COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
CUA W Voem 591
Reviled July IV"

ID:18282714858
Dec. 15, 1993
515 Camp Rd.
Salisbury, N. C. 28147
Mr. Steve Lund
U. S. Army Corps of Engineers
151 Patton Avenue, Room 143
Asheville, N.C, 28801-5006
Darr Mr. Lund:
MAY 25'00 9:15 No.001 P.03

HC The North Carolina Department of Transportation Bridge Maintenance Unit, proposes the following

project for your review. We believe this project can be accomplished under Nationwide 4 26.
COUNTY: Stanly County; Bridge it 141
ROUTLI: S.R. 1231
STREAM: Pole t3ranch Creek
DESCR1PT10N: Bridge f168-141 Replaced with 3 lines of 66' X 51" CMPA. Not located in wetlands.
Less than 0.007 acres of Rip ]tap fill in waters. Drainage area is 0,67 square miles.
The average daily flaw is 0.67 C. .S.
We have attached a site location map, and it sketch of planucu activities. A stringent erosion and
sedimentation control program will he implemented during the project constntction and every effort will
be made to complete work in a timely maimer.
Our persotmel are available to assist with your evatrlatiun of this project, if necessary. Should you have
any questions, please call meat 704-639-7555.
Sincerely,
Gcorge . Teague
Bridge Maintenance Supt.
US ARMY CORPS/ENGRS
GLT/des
attach.
US ARMY CORPS/ENGRS ID:18282714858 MAY 25'00 9:15 No.001 P.04
DEM ID: CORPS ACTION ID' _
NATIONWIDE PERMIT REQUESTED (PROVLDF NATIONWIDE PERMIT 4)' U
PRE-CONSTRUCTIOM NOTIFICATIONS APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATIONS FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THF N. C, DIVISION OF COASTAI. MANAGEMENT
SEND THE ORIGINAL. AND (1) COPY OF 'T'HIS COMPLETED FORM TO THE APPROPRIATE
FIELD OFFICE OF THE CORPS OF FNGINEERS (SEE AGENCY ADDRESSES SHEET), SEVEN
(7) COPIES SHOULD DE SENT TO THE N.C. llIVISIC" ^ONNMNTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1, OWNERS NAME.: NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2. MAn.ING ADDRESS: BRIDGE MAINTENANCE UNIT
5 IS CAMP RD.
SALISBURY, N.C. 20147
PROJE'C'T LOCATION ADDRESS. (INCLUDING SUBDIVISTON NAME) -74(An w CO
3, TELEPHONE NUMBER OIOMF) (WORK) 704-639.7555
4. IF APPLICABLE: AGE•NT'S NAME OR RFSPONSrBLE CORPORATE OFFICIAL, ADDRL;SS.
AND PHONE NO.
GEORGE L. TEAGUE
BRIDGE MAINTENANCE SUPERINTENDENT
S IS CAMP RD.
SALISBURY, N.C. 20147
704-639.7555
5. LOCATION OF WORK (PROVIDE- A MAP, PREI'ERABLY A COPY OF USES TOPOGRAPHIC
MAP OR AERIAL. PHOTOGRAPHY WITH SCALE):
COUNTY: 5?? r, \ y NFARF ST TOWN OR CITY: 9, 6 e m g C I C
SPECIFIC LOCATION, (INCLUDING ROAD NUMBERS, NAMES, LANDMARKS, ETC. >:
-5R VIII AC?'oTT pll\ I?cq??? _?Cttk, j 1W0, N erA1, SR 1x33.
G, IMPACI'EU OR NEAREST STREAM/RIVER: PO?c QC ?a?c. Cvmk
IUVER13ASIN: \ - a ){.t'n
US ARMY CORPS/ENGRS ID:18282714858 MAY 25'00 9:16 No.001 P.05
2.
7;1, IS PROJECT LOCATED NEAR WATF,R CLASSIFED AS TROUT, 'I'IDAI, SALTWATER (SA),
IiIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW). WATER
SUPPLY (WS•I OR WS-I1)? YES ( ) NO Nf IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WIT'H.IN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT ARFA OF ENVIRONMENTAL CONCERN (AEC)? YES ( ) NO 44
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST 01;
COASTAL COUNTIES), WHAT IS THE LAM) USE PLAN (LUP) DESIGNATION?
&t. HAVE ANY SECTION 404 PERMITS 13FFN PREVIOUSLY REQUESTED FOR USE. ON'rmS
PROPERTY? YES( ) NO (VI IF YES. PROVIDE ACTION I.D. NUMBER OF 7VE
PIL:VIOUS PERMIT AND ANY ADDITTONAL INI ORMA'C10N (INCLUDE.. PHOTOCOPY OF
401 CERTIFICATION);..._
_..,.. .. --..
$b, ARE ADDITIONAL.. PERMIT REQUESTS F.,VEM. D FOR THIS PROPERTY IN TIM
FUTURE? YES () NO 0 IF YES, DESCRIBE ANTICIPATED WORK:
9a. E•STIMNFED TOTAL. NUMBER OF ACRES 1N TRACT OF LAND:-0_Q S gCt?,I
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
N,41\ . _
IQA. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:
O
FLOODING: O
EXCAVATION: Q
OTHER: ER: 0
DRAINAGE:-_O TOTAL ACRES TO HE IMPACTED: Nat
10b. (1)1TR1rAM CHANNEL TO B1; IWACTFT) RY THE PRQPnSFD PROJECT' OF R -LOCA-1'E1).
PROVTDF DI, TAN?F B=H BL"I-ORL AND AFTER RF.T,QCATTON):
LENGTH BEFORE. FT. AFTER FT.
WIDTH RFFORF. (BASED ON NORMAL HIGH WATEI< LONTOURS):_. . _-_..... Fl',
WIDTH AH rER:_
AVERAGE DEPTH BEFORE:- Fr. AFTER:- _ FT.
US ARMY CORPS/ENGRS ID:18282714858 MAY 25'00 9:16 No.001 P.06
3.
10b. (2) STREAM CHANNEL IMPA(_TS. WILL RESULT FROM; (CHECK ALL'11IAT APPLY)
OPEN CHANNEL RELOCATION:- . „ PLACEMENT OF PIPE IN CHANNI?L:-)--
CHANNEL EXCAVATION:,.. lZ- CONSTRUCTION OF A DAM/PLOODING:___.____
OTHERS: QrAS % s?o (1 ?_._...-
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF TIIE WAITRSHF.D
DRAINING TO TIIE POND? N I A __ WHAT IS THE EXPECTED POND SURFACE ARL•'A7___, JA -

12. DESCRIPTION 017 PROPOSED WORK INCLUDTNG DISCUSSION OF TYPE OF MECHANICAL
1;QUH>MENjT'r0 BE USED (ATTACH PLANS: U/2" X I I" DRAWINGS ONLY): Rcp?q_?,_
sly ?'.••1+c? ??:? A w;?? 3--Vw"? r tk Ld' 5tH C %e A
13. PURPOSE OF WORK:gs? .. 01?. 'S?Yhhtr' pt _ay4 _y1:,? `wcr a?
L tom" ?, 51 " C Y?Y ?A
14. STATE REASONS WHY 1'1' 1S BF11FVFD THAT i nia A, L i v I1 Y MUST BE CARRIED OUT IN
WETLANDS. (INCLUDE ANY MEASLMFS TAKEN TO MINIMI'ZE WHTLAND WTPACTS):
-N IfN
I5. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE. (USFWS)
AND/OR NATIONAL, MARINE FISHLRLES SFRVICF (NMFS) (SEE AGENCY ADDRESSES
SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR PROPOSED FOR
LISTING ENDANGERED OR TIIREATF.NF.D SPECIES OR CRITICAL 11ABTTAT IN THE
PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: (A'11•ACH RESPONSES FROM THESE AGENCIES.)
t 16. YOU ARE REQUIRED 1'0 CONTACT THE STATE HISTORIC PRFSFRVATION OFFICER
(SHPO) (SEE AGENCY ADDRESSES SHEET) REGARDING'1HE PRF.SF.NCE OF HTSTIRTC
PROPERTIES IN THE PEIM T AREA WHICH MAY BE AFFECTED BY THE. PROPOSED
PROJECT. DATE CONTACTED: Ml-l s -y?g
- 17. DOES THE PROJECT INVOLVV. AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND? YES (o NO J (IF NO GO 1.0 18)
US ARMY CORPS/ENGRS ID:18282714858 MAY 25'00 9:17 No.001 P.07
4.
17. a. IF YES, DOES THE PROJECT REQUIRE PREPARA'T'ION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE R.EQUIRF.MENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ( ) NO (A
17. b. IF YES, HAS THE DOCUMENT BEEN R1 VIEWFn THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATL' CLEARJNGHOIJSL•? YES ( ) NO ( )
IF ANSWER TO 17b IS YLS,'ITIEN SUBMIT APPROPR.IATF. DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL. MANAGEMENT REGARI'.I4G
COMPLIANCE WITH THE NORTH CAROLINA rT '•"" 7' ' ' = POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE R -VJFW PROCESS SHOULD BE
DIRECTED TO MS. CI-IRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT 01, ADUZNSTRATION, 116 WEST JONES STREET, RALEIGH.
NORTH CAROLINA 27603-8003, TELEPHONE NO. 919.733-6369.
IS. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITII THIS APPLICATION IF
PROPOSED ACTIVITIES INVOLVES THE: DISCHARGE OF EXCAVATED MATERIALS
INTO WETLANDS:
a. WETLANDS 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 (INTERMIT .NT AND PERMANENT) ON THE
PROPERTY MMLIjS BE• SHOWN ON THE. MAP. MAP SCALES S(IOU"LD BE
OR 1" = 100' OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESRNTIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED
BY PROJECT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT. INCLUDE ALL DATA
SHEETS RELEVANT TO PLACEMENT OF THE DELINEATION LINE.
d. ATTACII A COPY OF THE STORMWATFR MANAGEMENT PL N IF KF:QUIRFD.
c. N AT IS LAN USE OF SURROUNDING PROPERTY?' W oe? S at.?.
Io, r r
c. IFAPPLICABLE, WHAT 1S PROPOSED METHOD OF SEWAGE' DISPOSAL?
v g, SIGNED AND DATED AGENTAUl'I10RJi,,, ,i...-- LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE U.S. MAY NOT BE (Ml?ACTED PRIOR TO:
1) ISSUANCE OF A SEC'T'ION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER TI-TE ISSUANC=E OR WAIVER OF A 401 DIVISION OF ENVIRONMENTAL
MANAGEMENT (WATER QUALITY) CE•RTU;ICATION. AND
3) (IN THE TWENTY COASTAL, COUNTIES ONLY) A LETTER FROM THE NORTH
CAROLINA DIVISION OF COAS'T'AL, MANAGEMENT STATING 1'IIE PROPOSED
ACTIVITY IS CONSISTENT WITH THE- NOR'III CAROLINA COASTAL
MANAGEMENT PROGRAM.
6 ?, , ?z-1s-
4 S / A E '. STGNAT URL DATE
0
(AGENT'S SIGNATURE VALID ONLY IF AU11IORIZATION
LETTER FROM THE OWNER IS PROVIDED (18g) )
US ARMY CORPS/ENGRS ID:18282714858
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.North Carolina
Department of Transportation
Division of Highways
George L. Teague
,,ridge Dtaintenance 5ttperintendcnt
515 Camp Rd - - - [phone]
S.liubury. NC 23147 F#x QW) 639.7582
ii
"^`.' 25' 00 9:17 No. 001 P.08
US ARMY CORPS/ENGRS ID:18282714858 MAY 25'00 9:18 No.001 P.09

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North Carolina
Department of Transportation
Division of Highways
George L. Teague
Prldge hiaintcnance Superinlcndcnt
Sl5t:unp ka. [phone]
SUisbvey. Nc 28147 C-P Fay [phone]
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