19990096 Ver 1_Complete File_19990208

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
4 • •
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NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
February 8, 1999
M.C. Shaffner
NC DOT
2125 Cloverdale Avenue
Winston-Salem, NC 27103
Dear Mr. Shaffner:
Subject: SR 1217
DWQ # 990096
Stokes County
On February 8, 1999, your application for a 401 Water Quality Certification for
paving SR 1217 in Stokes County was received by the N.C. Division of Water Quality.
The Division will begin to review the project for eventual decision. However, please be
aware that beginning January 1, 1999 that the N.C. General Assembly passed legislation
requiring payment of a fee of $200.00 for this project. The 401 Certification cannot be
issued until this fee is paid. Presently the Department of Transportation and Environment
and Natural Resources are developing a process so these fees will not have to be paid
separately for each project. We anticipate that this agreement will be finalized early in
1999. However until this agreement is completed we will not be able to complete our
action on your request. Until that time, your application will remain on hold as
incomplete.
Please call Cyndi Bell at 919-733-1786 if you have any questions.
gnnoo eel
R. Do ey
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cc: Central Files
Winston-Salem DWQ Regional Office
Raleigh Field Office US Army Corps of Engineers
Cyndi Bell
John Dorney
Wetlands/401 Unit 4401 Reedy Creek Road Raleigh, North Carolina 27607
Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer 507o recycled,'I0-7o post consumer paper
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JAMES B. HUNT JR.
GOVERNOR
DEPARTMENT OF TMNSPORTATION
February 4, 1999
Stokes County - SR 1217
STATE OF NORTH CAROLINA
DIVISION OF HIGHWAYS
E. NoRm TOLSON
SECRETARY
SUBJECT: Drainage Permits - Division of Water Quality
Mr. John Dorney Attn: Cindy Bell
Water Quality Planning
Division of Water Quality
NC DEHNR
4401 Reedy Creek Road
Raleigh, NC 27607
Dear Cindy Bell,

In an effort to obtain the necessary drainage permits, we are providing a package of design plans for
the paving of Tom Smith Road (SR 1217) in Stokes County. In order to pave Tom Smith Road it will be
necessary to replace, add, and/or extend the drainage pipes on this road.
By copy of this letter, we are also seeking approval from the NC Wildlife Resources Commission as
well as the US Army Corps of Engineer, therefore we are submitting the enclosed material to them.
If you have any questions, comments or need additional information after reviewing this material,
please contact our office at [phone]. Thank you for your cooperation in this matter.
Respectfully,
O'Shalner 6-
District Engineer
MCS:Iaj
Enclosures
Mr. D.B. Waters, Division Engineer
Mr. David Spainhour, Stokes County Maintenance Engineer
File
Division of Highways • Division Nine • District Two • 2125 Cloverdale Avenue, Winston-Salem, NC 27103
Telephone [phone] Fax [phone] • Courier Box 13-12-04

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i
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 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: NC DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: 2125 CLOVERDALE AVENUE
SUBDIVISION NAME
CITY: WINSTON-SALEM STATE: NC
ZIP CODE: 27103
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME): (WORK) :
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICAL, ADDRESS,
PHONE: M.C SHAFFNER
2125 CLOVERDALE AVENUE
WINSTON-SALEM, NC 27103 [phone]
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: STOKES NEAREST TOWN OR CITY: GAP
SPECIFIC LOCATION (INCLUDING ROAD NUMBERS, LANDMARKS, ETC.):
FROM GAP NC, TAKE NC66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE LEFT.
6. IMPACTED OR NEAREST STREAM/RIVER: DAN RIVER
RIVER BASIN: ROANOKE RIVER BASIN
1
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER (SA),
HIGH QYALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES ® NO ? IF YES, EXPLAIN: OUR PROJECT IS
WITHIN A WATER SUPPLY WATERSHED PROTECTED AREA.
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? N/A
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES ? NO ® 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 ® IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: N/A
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
N/A
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
N/A
FILLING: 0
FLOODING: 0
DRAINAGE: 0
EXCAVATION: 0
OTHER: 0
TOTAL ACRES TO BE IMPACTED:
n
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: FT. AFTER: _
WIDTH BEFORE (based on normal high water contours):
WIDTH AFTER: FT.
AVERAGE DEPTH BEFORE: FT. AFTER:
FT.
Fr.
FT.
2
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION ? PLACEMENT OF PIPE IN CHANNEL E]
CHANNEL EXCAVATION ? CONSTRUCTION OF A DAM/FLOODING ?
11
OTHER ? EXPLAIN:
IF CONTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY): GRADE, BASE, PAVE TOM SMITH ROAD (SR 1217) IN STOKES COUNTY.
13. PURPOSE OF PROPOSED WORK: TO IMPROVE ROAD CONDITIOINS
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT
IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS): THIS ROAD WILL BE STABILIZED IN THE UPCOMING MONTHS
(FISCAL YEAR 1999-2000) BECAUSE OF SAFETY FACTORS. THE CAREFUL WORK OF
THE NCDOT FORCES WILL MINIMIZE IMPACTS TO WETLAND AND/OR TROUT
STREAMS.
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:
AGENCIES.)
02-04-99
(ATTACH RESPONSES FROM THESE
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: 02-04-99
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?
YES E] NO ® (IF NO, GO TO 18)
3
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 STAE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT,, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREED, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
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 DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND US OF SURROUNDING PROPERTY? N/A
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
4
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTON 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.

Al Z-V- f
OWNER'S/AGENT SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION LETTER FROM THE OWNER IS PROVIDED (I 8g.))
5
ROCK INLET PROTECTION:
896.01 TYPE A ......................... ? OR A I1
896.02 TYPE B ........................:. ......... B LE OR B +)
896.03 TYPE C ...................................................... C , Q.] J, OR C I 897.01 ROCK PIPE INLET PROTECTION.........

N/A PIPE OUTLET ENERGY DISSIPATOR.. .
eeae
N/A DRAINAGE TURNOUT ...............
N/A RIP-RAP LINED DITCH ............. ..-----
N/A STREAM .................
GENERAL NOTES:
STGKES CO.
I. ROADWAY ALIGNMENT AND PR0RERTY?E4N1 08
ARE BASED ON COUNTY TAX i [ D
2. TYPE "B" SILT BASINS WILL BE
6'x 3'x 3' UNLESS OTHERWISE NOTED ON PLANS.
3. THE INSTALLATION ORDER OF EROSION CONTROL
MEASURES SHOULD BE AS FOLLOWS:
A. TEMPORARY SILT BASINS SHALL BE
INSTALLED PRIOR TO CLEARING AND
GRUBBING.
B. SILT FENCES AND TEMPORARY SILT
DITCHES SHALL BE INSTALLED AFTER
CLEARING AND BEFORE GRADING.
C. TEMPORARY STONE DITCH CHECKS
SHALL BE INSTALLED AS SOON AS
THE DITCHL NE IS ESTABLISHED.
D. PIPE OUTLET AND INLET PROTECTION
WILL BE DONE AS SOON AS THE PIPE
IS INSTALLED.
E. SEEDING AND OTHER PERMANENT
EROSION CONTROL MEASURES ARE
TO BE IMPLEMENTED AS SOON AS
PRACTICAL.
4. ADDITIONAL EROSION-CONTROL DEVICES WILL BE
INSTALLED AS NEEDED IN THE FIELD OR AS
DIRECTED BY THE ENGINEER.

SR: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
SCALE: I" =100' APPROVED BY DRAWN BY: AEG

DATE: 10-23-98 M.C. SHAFFNER, DISTRICT ENGINEER
REVISED:
EROSION CONTROL / RIGHT-OF-WAY PLANS
MAP LENGTH: 0.80 MILE(S) T 1 OF 4
STOKES COUNTY
SECONDARY ROAD
CONSTRUCTION PLAN
SR: 1217 NAME: TOM SMITH ROAD
TOWNSHIP: 4UAKER GAP
PROPOSED FISCAL YR:1999-2000
PRIORITY NO: 36-R
EROSION CONTROL
DETAILS AiiD
SPECIFICATIONS
STD# DESCRIPTION SYMBOL
N/A HIGH POINT / WATER FLOW DIREC'°ION .................... X -op-
245.01 SILT BASIN TYPE A ........................ ..
245.02 SILT BASIN TYPE B ............................... 7TTT7
245.03 TEMPORARY SILT DITCH ................................... .. L_TTSD _
245.05 TEMPORARY DIVERSION DITCH .................................... TD
100.01B STORM DRAINAGE PIPE ..............................
890.05 TEMP. SLOPE DRAIN W/ EARTH BERM ......................... --No-

892.01 TEMPORARY ROCK SEDIMENT DAN( TYPE A ..............
892.02 TEMPORARY ROCK SEDIMENT DAM TYPE B ..............
892.04 TEMPORARY ROCK SILT CHECK TYPE A .....................
893.01 TEMPORARY SILT FENCE .....................................
894.01 ROCK SILT SCREEN ....................... f
895.10 TEMPORARY ROCK SILTCHECK TYPE B ...................... ,
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S.R: 1?17 COUNTY: STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL 1 RIGHT-OF-WAY PLANS
SCALE: F'= 100' DRAWN BY: AEG PAGE: OF

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PROPOSED DRAINAGE CROSS LINE TREATMENT
ALONG:TOM SMITH ROAD SR:1217, STOKES COUNTY
LOCATED: FROM GAP NC, TAKE NC 66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE
LEFT.

STATION EXISTING
DESCRIPTION
LGTH/DIAM/TYPE REPLACEMENT
DESCRIPTION
LGTH/DIAM/TYPE
SECTION TYPE
LEFT/RIGHT

COVER
SKEW
(APPROX)
24+00 20'-15"RCP 40'-18"RCP FILL/FILL MIN 1' 90°
48+75 NONE 401-18"RCP FILL/FILL MIN 1' 90,

CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
01-81 PAVEMENT WIDTH 0'-8'
20'
PLAN VIEW
EP CL EP
FILL I
I FILL_
I
1 SKEW = 90°
STATION = 24+00 1
1
Lon( O 1
FL W 8O
1§
10 l
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EXISTING: 20'-15"RCP
I
PROPOSED: 40'-18"RCP i
COVER: MIN I' I
I
DRAWN BY: LAJ COUNTY: STOKES
I
I
1
APPROVED BY: M.C. SHAFFNER CAL
DISTRICT ENGINEER
DRAINAGE PERMIT STA. 24+00

SR 1217
NAME: TOM SMITH ROAD
DRAWING 1 OF 2
CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH 0'-8'
?0%8"__
20'
PLAN VIEW
EP CL EP
FILL I
I FILL_
I
I SKEW = 90°
STATION = 48+75 I
00
o
FL W -? 1§8o
0°
O
EXISTING: NONE I
PROPOSED: 40'- l 8"RCP
COVER: MIN I' I
DRAWN BY: LAJ COUNTY: STOKES
I
I
I
APPROVED BY: M.C. SHAFFNER CAL,
DISTRICT ENGINEER
t
DRAINAGE PERMIT STA. 48+75

SR 1217
NAME: TOM SMITH ROAD
DRAWING 2 OF 2
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 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.
L OWNERS NAME: NC DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: 2125 CLOVERDALE AVENUE
SUBDIVISION NAME
CITY: WINSTON-SALEM STATE: NC ZIP CODE: 27103
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME): (WORK) :
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICAL, ADDRESS,
PHONE: M.C SHAFFNER
2125 CLOVERDALE AVENUE
WINSTON-SALEM NC 27103 [phone]
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: STOKES NEAREST TOWN OR CITY: GAP
SPECIFIC LOCATION (INCLUDING ROAD NUMBERS, LANDMARKS, ETC.):
FROM GAP NC, TAKE NC66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE LEFT.
6. IMPACTED OR NEAREST STREAM/RIVER: DAN RIVER
RIVER BASIN: ROANOKE RIVER BASIN
1
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER (SA),
HIGH QYALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES ® NO ? IF YES, EXPLAIN: OUR PROJECT IS
WITHIN A WATER SUPPLY WATERSHED PROTECTED AREA.
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? N/A
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES ? NO ® 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 ® IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: N/A
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
N/A
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
N/A
FILLING: 0 EXCAVATION: 0
FLOODING: 0 OTHER: 0
DRAINAGE: 0 TOTAL ACRES TO BE IMPACTED: 0
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.
2
(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 ? EXPLAIN:
11. IF CONTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY): GRADE, BASE, PAVE TOM SMITH ROAD (SR 1217) IN STOKES COUNTY.
13. PURPOSE OF PROPOSED WORK: TO IMPROVE ROAD CONDITIOINS
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT
IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS): THIS ROAD WILL BE STABILIZED IN THE UPCOMING MONTHS
(FISCAL YEAR 1999-2000) BECAUSE OF SAFETY FACTORS THE CAREFUL WORK OF
THE NCDOT FORCES WILL MINIMIZE IMPACTS TO WETLAND AND/OR TROUT
STREAMS.
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: 02-04-99
AGENCIES.)
(ATTACH RESPONSES FROM THESE
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: 02-04-99
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 STAE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREED, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
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 DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND US OF SURROUNDING PROPERTY? N/A
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
4
NOTE: WETLANDS OR WATERS OF THE US. MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTON 404 CORPS OF ENGINEERS PERMIT,
3 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.

4ef Z - `/- f
OWNER'S/AGENT SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION LETTER FROM THE OWNER IS PROVIDED (I 8g.))
5
VICINITY MAP
ROCK INLET PROTECTION:
896.01 TYPE A ..................................................... A OR A .?1
896.02 TYPE $ ................:...:..... ....................... BE OR B)
896.03 TYPE C ...................................................... C 0 OR C f,
897.01 ROCK PIPE INLET PROTECTION.........
N/A PIPE OUTLET ENERGY DISSIPATOR.. e
eeee
NIA DRAINAGE TURNOUT....
N/A RIP-RAP LINED DITCH ........................
1-FFFf•Ff-?
N/A STREAM ..............................
STOKES COUNTY
SECONDARY ROAD
CONSTRUCTION PLAN
SR: 1217 NAME: TOM SMITH ROAD
TOWNSHIP: QUAKER GAP
PROPOSED FISCAL YR:1999-2000
PRIORITY NO: 36-R
EROSION CONTROL
DETAILS Ali-D
SPECIFICATIONS
STD# DESCRIPTION SYMBOL
NIA HIGH POINT / WATER FLOW DIREC 0ION .................... --*'- X ??
245.01 SILT BASIN TYPE A .................................
245.02 SILT BASIN TYPE B...' .......................... 777?7?7
245.03 TEMPORARY SILT DITCH ................................................. _TSD _
245.05 TEMPORARY DIVERSION DITCH .................................... _TD
100.01B STORM DRAINAGE PIPE ......................................
.............. 077,1
890.05 TEMP. SLOPE DRAIN W/ EARTH BERM .......................... ?
892.01 TEMPORARY ROCK SEDIMENT DANI TYPE A ..............
892.02 TEMPORARY ROCK SEDIMENT DAM TYPE B ..............
892.04 TEMPORARY ROCK SILT CHECK TYPE A .....................
893.01 TEMPORARY SILT FENCE .................................................
894.01 ROCK SILT SCREEN ........................................ f

895.10 TEMPORARY ROCK SILTCHECK TYPE B ......................

M ERA_ S:
I STGKES CO.
1. ROADWAY ALIGNMENT AND PRORERTY2 L'$
ARE BASED ON COUNTY TAX i A Nr• D
2. TYPE "B" SILT BASINS WILL BE C
6' x 3' x 3' UNLESS OTHERWISE NOTED ON PLANS.
3. THE INSTALLATION ORDER OF EROSION CONTROL
MEASURES SHOULD BE AS FOLLOWS:
A. TEMPORARY SILT BASINS SHALL BE
INSTALLED PRIOR TO CLEARING AND
GRUBBING.
B. SILT FENCES AND TEMPORARY SILT
DITCHES SHALL BE INSTALLED AFTER
CLEARING AND BEFORE GRADING.
C. TEMPORARY STONE DITCH CHECKS
SHALL BE INSTALLED AS SOON AS
THE DITCHLINE IS ESTABLISHED.
D. PIPE OUTLET AND INLET PROTECTION
WILL BE DONE AS SOON AS THE PIPE
IS INSTALLED.
E. SEEDING AND OTHER PERMANENT
EROSION CONTROL MEASURES ARE
TO BE IMPLEMENTED AS SOON AS
PRACTICAL.
4. ADDITIONAL EROSION CONTROL DEVICES WILL BE
INSTALLED AS NEEDED IN THE FIELD OR AS
DIRECTED BY THE ENGINEER.

SR: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
SCALE: 1"=100' APPROVED BY DRAWN BY: AEG

DATE: 10-23-98 M.C. SHAFFNER, DISTRICT ENGINEER
REVISED:
EROSION CONTROL / RIGHT-OF-WAY PLANS
MAP LENGTH: 0.80 MILE(S) T 1 OF 4

I 'STIRT PROSECT
Y - 20 t Do
9
M.7??Juvr2S ?If?ucr!JI, ~?°?'
5
Al,
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r
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7 iy-51:7?
0
'c"
S.R: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL 1 RIGHT-OF-WAY PLANS
SCALE: 1"=100' DRAWN BY: AEG PAGE: a OF
ii ° ' - ,?? \r li ?? °\• ? ?CY ?' \ ,A -??-? \• '? Orb
_ ? Flsh _
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J ? i -? \ I • / '. ? _ ? I ??-' ?O .? u ?._ ? iii' ?j / ??\ ?\ j ?y > ?--?//?\ •? • ?f L? ,??:'?,
\` l / l/l) I, .• 1 r^ /'?? _?f , 1 mil/ 1'\\1( .? ? ? ??°,?;?`--., ??,?;. `"7 ,?/f ???i'
70
_ / ,?'. ? ? \o ._ .?./ ?- ? ?' ? _ r r ' j I l? (iii ???? ?`` ? U. ` ??(' \ \\???? `??\ ?,l (^ _ i? \-..I / ??11?/ "? i "\, ' rte--?`-r-^• ? \ ? °o `.
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0p ` Ilo.. 010 `, -/`, 4-!Y\ ?fl \/?/y;? y,. //7?.'$TOV¢R? 11 Q1f `1 1?\?\? / I?\\ t??1 i`l\
/v i
J/?. ?\ .. - ?(? /i - ` .a o \\ \ ??.^.., ?,i•1 ?;")??.r--? "?' \ \. \??\ .gam., $ ?`
114b
\ , r \-' \ J ?• ,\?10 ?" ! ' i i /'093 ?/'•
//a/ co95\ o ?\ \ ref / ?; 1 IC, \ ??\ / :?I\ I\ ?"? ? r \:
_ ?\ i , \\ \ % ?? / (,` fJl? Q `rt \\ q ) .ate
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it.
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1159
vii
j , /ice \I ? • ? .."' ?_ _? i /? ' . , !! ij ?-? . ' ? ?.
PROPOSED DRAINAGE CROSS LINE TREATMENT
ALONG:TOM SMITH ROAD SR:1217, STOKES COUNTY
LOCATED: FROM GAP NC, TAKE NC 66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE
3 LEFT.

STATION EXISTING
DESCRIPTION
LGTH/DIAM/TYPE REPLACEMENT
DESCRIPTION
LGTH/DIAM/TYPE
SECTION TYPE
LEFT/RIGHT

COVER
SKEW
(APPROX)
24+00 20'-15"RCP 40'-18 "RCP FILL/FILL MIN 1' 90°
48+75 NONE 40'-18"RCP FILL/FILL MIN 1' 90°

CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH 0'-8'
20'
PLAN VIEW
EP CL EP
FILL I
FILL_
I
I SKEW = 90°
STATION = 24+00 I
00
FL W 18O
CIO I
0
EXISTING: 20'-15"RCP
i
PROPOSED: 40'- 1 8"RCP
I
COVER: MIN I'
I
DRAWN BY: LAJ COUNTY: STOKES
I
I
I
APPROVED BY: M.C. SHAFFNER NAME: TOM SMITH ROAD
DISTRICT ENGINEER
DRAINAGE PERMIT STA. 24+00

SR 1217

DRAWING 1 OF 2
CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH 0'-8'
20'
PLAN VIEW
EP CL EP
FILL I
I FILL_
I
1 SKEW = 90°
STATION = 48+75
FL
8O
Lonfl?o 0 I
0§
0 I
1
EXISTING: NONE
I
PROPOSED: 40'-18"RCP
COVER: MIN V DRAINAGE PERMIT STA. 48+75
1
DRAWN BY: LAJ COUNTY: STOKES
I
I
APPROVED BY: M.C. SHAFFNER NAME: TOM SMITH ROAD
DISTRICT ENGINEER

DRAINAGE PERMIT STA. 48+75

SR 1217

DRAWING 2 OF 2
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 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: NC DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: 2125 CLOVERDALE AVENUE
SUBDIVISION NAME
CITY: WINSTON-SALEM STATE: NC ZIP CODE: 27103
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME):
(WORK) :
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICAL, ADDRESS,
PHONE: M.C SHAFFNER
2125 CLOVERDALE AVENUE
WINSTON-SALEM NC 27103 [phone]
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: STOKES NEAREST TOWN OR CITY: GAP
SPECIFIC LOCATION (INCLUDING ROAD NUMBERS, LANDMARKS, ETC.):
FROM GAP NC, TAKE NC66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE LEFT.
6. IMPACTED OR NEAREST STREAM/RIVER: DAN RIVER
RIVER BASIN: ROANOKE RIVER BASIN
1
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER (SA),
HIGH QYALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES ® NO ? IF YES, EXPLAIN: OUR PROJECT IS
WITHIN A WATER SUPPLY WATERSHED PROTECTED AREA.
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? N/A
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES ? NO ® 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 ® IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: N/A
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
N/A
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
N/A
FILLING: 0 EXCAVATION:- 0
FLOODING: 0 OTHER: 0
DRAINAGE: 0 TOTAL ACRES TO BE IMPACTED: 0
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.
(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 ? EXPLAIN:
11. IF CONTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY): GRADE, BASE, PAVE TOM SMITH ROAD (SR 1217) IN STOKES COUNTY.
13. PURPOSE OF PROPOSED WORK: TO IMPROVE ROAD CONDITIOINS
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT
IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS): THIS ROAD WILL BE STABILIZED IN THE UPCOMING MONTHS
(FISCAL YEAR 1999-2000) BECAUSE OF SAFETY FACTORS THE CAREFUL WORK OF _
THE NCDOT FORCES WILL MINIMIZE IMPACTS TO WETLAND AND/OR TROUT
STREAMS.
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:
AGENCIES.)
02-04-99
(ATTACH RESPONSES FROM THESE
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: 02-04-99
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 STAE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETI; DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREED, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
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 i 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 DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND US OF SURROUNDING PROPERTY? N/A
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
4
NOTE: WETLANDS OR WATERS OF THE U. S. MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTON 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OFA 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.

Al z- y_ s
OWNER'S/AGENT SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION LETTER FROM THE OWNER IS PROVIDED (I 8g.)')
5
VICINITY MAP
ROCK INLET PROTECTION:
896.01 TYPE A ..................................... ............ A ? OR A
896.02 TYPE B ...................................................... B L1 OR B
896.03 TYPE C ........................................ ... C rol
OR C?
U?j
897.01 ROCK PIPE INLET PROTECTION......,.. k
w..r'
N/A PIPE OUTLET ENERGY DISSIPATOR.. :o.

N/A DRAINAGE TURNOUT.

N/A RIP-RAP LINED DITCH .........................
N/A STREAM ............................................
STOKES COUNTY
SECONDARY ROAD
CONSTRUCTION PLAN
SR: 1217 NAME: TOM SMITH ROAD
TOWNSHIP: QUAKER GAP
PROPOSED FISCAL YR:1999-2000
PRIORITY NO: 36-R
EROSION CONTROL
DETAILS AND
SPECIFICATIONS
STD# DESCRIPTION SYMBOL
N/A HIGH POINT / WATER FLOW DIREC-ION .................... -.*a- X -ON-
245.01 SILT BASIN TYPE A ...............................
245.02 SILT BASIN TYPE B ........................... 77777777?
245.03 TEMPORARY SILT DITCH ............................. „ _TSD .
245.05 TEMPORARY DIVERSION DITCH .................................... _TD -
100.01B STORM DRAINAGE PIPE ................................. ....... 0:10CM
890.05 TEMP. SLOPE DRAIN W/ EARTH BERM .....................

892.01 TEMPORARY ROCK SEDIMENT DAM TYPE A ..............
892,02 TEMPORARY ROCK SEDIMENT DANI TYPE B ..............
892.04 TEMPORARY ROCK SILT CHECK TYPE A .....................
893.01 TEMPORARY SILT FENCE ................................................. i
894.01 ROCK SILT SCREEN .......................................................
895.10 TEMPORARY ROCK SILTCHECK TY?E B ......................
J
GENERAL NOTES: Iy1
STGKES CO.
L ROADWAY ALIGNMENT AND PROPER Lbfo8
ARE BASED ON COUNTY TAX i D
2. TYPE "B" SILT BASINS WILL BE
6'x 3'x 3' UNLESS OTHERWISE NOTED ON PLANS.
3. THE INSTALLATION ORDER OF EROSION CONTROL
MEASURES SHOULD BE AS FOLLOWS:
A. TEMPORARY SILT BASINS SHALL BE
INSTALLED PRIOR TO CLEARING AND
GRUBBING.
B. SILT FENCES AND TEMPORARY SILT
DITCHES SHALL BE INSTALLED AFTER
CLEARING AND BEFORE GRADING.
C. TEMPORARY STONE DITCH CHECKS
SHALL BE INSTALLED AS SOON AS
THE DITCHLINE IS ESTABLISHED.
D. PIPE OUTLET AND INLET PROTECTION
WILL BE DONE AS SOON AS THE PIPE
IS INSTALLED.
E. SEEDING AND OTHER PERMANENT
EROSION CONTROL MEASURES ARE
TO BE IMPLEMENTED AS SOON AS
PRACTICAL.
4. ADDITIONAL EROSION-CONTROL DEVICES WILL BE
INSTALLED AS NEEDED IN THE FIELD OR AS
DIRECTED BY THE ENGINEER.

sR: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
SCALE: i" =100' APPROVED BY DRAWN BY: AEG

DATE: 10-23-98 M.C. SH.AFFNER, DISTRICT ENGINEER
REVISED:
EROSION CONTROL / RIGHT-OF-WAY PLANS
MAP LENGTH: 0.80 MILE(S) T 1 OF 4
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S.R: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL / RIGHT-OF-WAY PLANS
SCALE: 1"= LOO' DRAWN BY: AEG T PAGE: a OF I
=N
I
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PROP.
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S.R: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL / RIGHT-OF-WAY PLANS
S
L
CALE: 1"= 100' DRAWN BY: AEG PAGE:3 OF 4
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GUou1 r?Gh? GIs-2 S.
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S.R: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL / RIGHT-OF-WAY PLANS
SCALE: P= LOO' DRAWN BY: AEG PAGE: OF

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1 /I l ?TTf II o, r(?\ ?/
PROPOSED DRAINAGE CROSS LINE TREATMENT
ALONG:TOM SMITH ROAD SR:1217, STOKES COUNTY
LOCATED: FROM GAP NC, TAKE NC 66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE
LEFT.

STATION EXISTING
DESCRIPTION
LGTH/DIAM/TYPE REPLACEMENT
DESCRIPTION
LGTH/DIAM/TYPE
SECTION TYPE
LEFT/RIGHT

COVER
SKEW
(APPROX)
24+00 20'-15"RCP 40'-18"RCP FILL/FILL MIN 1' 90,
48+75 NONE 40'-18"RCP FILL/FILL MIN 1' 90°

CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
0'-8' PAVEMENT WIDTH 0'-8'-
20'
PLAN VIEW
EP CL EP
FILL I
I FILL_
I
I SKEW = 90°
STATION = 24+00
I
O
FL W ? 1gO
Lnfl?o
I
O I
EXISTING: 20'-15"RCP
PROPOSED: 40'-18"RCP
I
COVER: MIN P
I
DRAWN BY: LAJ COUNTY: STOKES
I
I
I
I
APPROVED BY: M.C. SHAFFNER NAME: TOM SMITH ROAD
CIL
DISTRICT ENGINEER
DRAINAGE PERMIT STA. 24+00

SR 1217

DRAWING 1 OF 2
CROSS SECTION
c?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH 0'-8'
20'
PLAN VIEW
EP CL EP
FILL I
I FILL_
I SKEW = 90°
STATION = 48+75
00
Q I
FL W 0§8o
",-j I
QQ I
Q I
EXISTING: NONE
I
PROPOSED: 40'-18"RCP
I
COVER: MIN 1'
i
DRAWN BY: LAJ COUNTY: STOKES
I
I
I
I
APPROVED BY: M.C. SHAFFNER CIL.
DISTRICT ENGINEER
DRAINAGE PERMIT STA. 48+75

SR 1217
NAME: TOM SMITH ROAD
DRAWING 2 OF 2

DEM ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) :
a
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 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: NC DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: 2125 CLOVERDALE AVENUE
CITY: WINSTON-SALEM
SUBDIVISION NAME
STATE: NC ZIP CODE: 27103
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME):
(WORK) :
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICAL, ADDRESS,
PHONE: M.C SHAFFNER
2125 CLOVERDALE AVENUE
WINSTON-SALEM, NC 27103 [phone]
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: STOKES NEAREST TOWN OR CITY: GAP
SPECIFIC LOCATION (INCLUDING ROAD NUMBERS, LANDMARKS, ETC.):
FROM GAP NC, TAKE NC66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE LEFT.
6. IMPACTED OR NEAREST STREAM/RIVER: DAN RIVER
RIVER BASIN: ROANOKE RIVER BASIN
1
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER (SA),
HIGH QYALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES ® NO ? IF YES, EXPLAIN: OUR PROJECT IS
WITHIN A WATER SUPPLY WATERSHED PROTECTED AREA.
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? N/A
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES ? NO ® 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 ® IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: N/A
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
N/A
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
N/A
FILLING:
FLOODING:
DRAINAGE:
EXCAVATION: 0
0 OTHER: 0
0 TOTAL ACRES TO BE IMPACTED: 0
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.
2
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM:
OPEN CHANNEL RELOCATION (CHECK ALL THAT APPLY)
? PLACEMENT OF PIPE IN CHANNEL ?
CHANNEL EXCAVATION E3 CONSTRUCTION OF A DA
M/FLOODING ?
OTHER ? EXPLAIN:
11. IF CONTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WAT
ERSHED
14.
15
16.
WHAT IS THE EXPECTED POND SURFACE AREA?
12• DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY): GRADE, BASE, PAVE TOM SMITH ROAD (SR 1217) IN STOKES COUNTY.
13• PURPOSE OF PROPOSED WORK: TO IMPROVE ROAD CONDITIOINS
-------------
STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND OUT
IMPACTS): THIS ROAD WILL BE STABILIZED IN THE UPCOMING MONTHS
(FISCAL YEAR 1999 2000 BECAUSE ft
FETY FACTORS THE THE NCDOT FORCES WILL MINIMIAC'TR r
CAREFUL WORK OF
n u,cr .
?TRFe?ac
YOU ARE REQUIRED TO CONTACT THE U. S. FISH AND WILDLIFE SERVICE (USFW)
AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY ADDRESSE
SHEET) REGARDING THE PRESENCE OF ANY FEDE S
LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL HAB PROPOSED FOR
PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT. TDATE THE
CONTACTED: 02-04-99
AGENCIES.) (ATTACH RESPONSES FROM THESE
YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICE
(SHPO) (SEE AGENCY ADDRESSES SHEET) REGARDING THE PRESENC R
PROPERTIES IN THE PERMIT AREA WHICH MAYBE E OF HISTORIC
PROJECT. DATE CONTACTED: AFFECTED BY THE PROPOSED
02-04-99
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE U
PUBLIC (STATE) LAND? SE OF
YES ? NO ® (IF NO, GO TO 18)
3
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 STAE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREED, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
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 DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND US OF SURROUNDING PROPERTY? N/A
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
4
NOTE: WETLANDS OR WATERS OF THE U. S. MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTON 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.
OWNER'S/AGENT SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION LETTER FROM THE OWNER IS PROVIDED (I 8g.))
ROCK INLET PROTECTION:
896.01 TYPE A ..................................................... A OR A
896.02 TYPE B ................... ......... B L! OR B it
896.03 TYPE C ............................ ... C 0 OR C ?
897.01 ROCK PIPE INLET PROTECTION
.........
N/A PIPE OUTLET ENERGY DISSIPATOR.. C.
N/A DRAINAGE TURNOUT ...........................
N/A RIP-RAP LINED DITCH ..........................
N/A STREAM ..............................
STOKES COUNTY
SECONDARY ROAD
CONSTRUCTION PLAN
SR: 1217 NAME: TOM SMITH ROAD
TOWNSHIP: QUAKER GAP
PROPOSED FISCAL YR:1999-2000
PRIORITY NO: 36-R
EROSION CONTROL
DETAILS AND
SPECIFICATIONS
STD# DESCRIPTION SYMBOL
NIA HIGH POINT / WATER FLOW DIREC77ION .................... ?'- X -No-
245.01 SU-T BASIN TYPE A ..................................
..................
245.02 SMT BASIN TYPE B ............................................................
245.03 TEMPORARY SILT DITCH .................................. _TSD.
245.05 TEMPORARY DIVERSION DITCH .................................... _TD _

100.01B
STORM DRAINAGE PIPE .................................................... loulcm
890.05 TEMP. SLOPE DRAIN W/ EARTH BERM :.........................
892.01 TEMPORARY ROCK SEDIMENT DAM TYPE A ..............
892.02 TEMPORARY ROCK SEDR IENT DANi TYPE B ..............
892.04 TEMPORARY ROCK SILT CHECK TYPE A .....................
893.01 TEMPORARY SILT FENCE ................................................. *
894.01 ROCK SILT SCREEN ................................................ r
895.10 TEMPORARY ROCK SILTCHECK TY?E B ......................
?GENERAL ?
NOTES: j r , STGKES CO.
1. ROADWAY ALIGNMENT AND PRORERi-y2 E4498
ARE BASED ON COUNTY TAX A I I?.
2. TYPE "B'* SILT BASINS WILL BE C
6'x Y x 3' UNLESS OTHERWISE NOTED ON PLANS.
3. THE INSTALLATION ORDER OF EROSION CONTROL
MEASURES SHOULD BE AS FOLLOWS:
A. TEMPORARY SILT BASINS SHALL BE
INSTALLED PRIOR TO CLEARING AND
GRUBBING.
B. SILT FENCES AND TEMPORARY SILT
DITCHES SHALL BE INSTALLED AFTER
CLEARING AND BEFORE GRADING.
C. TEMPORARY STONE DITCH CHECKS
SHALL BE INSTALLED AS SOON AS
THE DITCHLINE IS ESTABLISHED.
D. PIPE OUTLET AND INLET PROTECTION
WILL BE DONE AS SOON AS THE PIPE
IS INSTALLED.
E. SEEDING AND OTHER PERMANENT
EROSION CONTROL MEASURES ARE
TO BE IMPLEMENTED AS SOON AS
PRACTICAL.
4. ADDITIONAL EROSION CONTROL DEVICES WILL BE
INSTALLED AS NEEDED IN THE FIELD OR AS
DIRECTED BY THE ENGINEER.

sR: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
SCALE: 1" =100' APPROVED BY DRAWN BY: AEG

DATE: 10-23-98 M.C. SHAFFNER, DISTRICT ENGINEER REVISED:
EROSION CONTROL / RIGHT-OF-WAY PLANS
MAP LENGTH: 0.80 MILE(S) 1 OF 4

VICINITY MAP
S7A-RT PROTECT
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S.R: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL / RIGHT-OF-WAY PLANS
SCALE: 1 "= 100' DRAWN BY: AEG T PAGE: d _OF 9
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COUNTY: STOKES
S. R: 1217
NAME: TOM SMITH ROAD
EROSION CONTROL / RIGHT-OF-WAY PLANS
SCALE: 1"=100' DRAWN BY: AEG rpAGE-,3 OF 4
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S.R: 1217 COUNTY:- STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL / RIGHT-OF-WAY PLANS
LSCALE: P'=100 DRAWN BY: AEG PAGE: OF
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0

PROPOSED DRAINAGE CROSS LINE TREATMENT
ALONG:TOM SMITH ROAD SR:1217, STOKES COUNTY
LOCATED: FROM GAP NC, TAKE NC 66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE
LEFT.

STATION EXISTING
DESCRIPTION
LGTH/DIAM/TYPE REPLACEMENT
DESCRIPTION
LGTH/DIAM/TYPE
SECTION TYPE
LEFT/RIGHT

COVER
SKEW
(APPROX)
24+00 20'-15"RCP 40'-18"RCP FILL/FILL MIN 1' 90°
48+75 NONE 40'-18"RCP FILL/FILL MIN 1' 90,

CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH 01-8'
20'
PLAN VIEW
EP CL EP
FILL I
I FILL_
I
I SKEW = 90°
STATION = 24+00
°O I
° I
FL W 1§8o
o°
EXISTING: 20'-15"RCP
i
PROPOSED: 40'-18"RCP
I
COVER: MIN I'
DRAWN BY: LAJ COUNTY: STOKES
I
I
I
I
APPROVED BY: M.C. SHAFFNER NAME: TOM SMITH ROAD
Cl DISTRICT ENGINEER

DRAINAGE PERMIT STA. 24+00
SR 1217
DRAWING 1 OF 2
CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH 0'-8,-
20'
v /-??
PLAN VIEW
EP CL EP
FILL
I FILL_
I
I SKEW = 90°
STATION = 48+75
00
O
FL W 1§8o
C1O I
EXISTING: NONE I
PROPOSED: 40'-18"RCP
I
COVER: MIN I'
I
DRAWN BY: LAJ COUNTY: STOKES
I
I
APPROVED BY: M.C. SHAFFNER CAL.
DISTRICT ENGINEER
DRAINAGE PERMIT STA. 48+75

SR 1217
NAME: TOM SMITH ROAD
DRAWING 2 OF 2
r
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 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: NC DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: 2125 CLOVERDALE AVENUE
CITY: WINSTON-SALEM
ZIP CODE: 27103
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME):
(WORK) :
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICAL, ADDRESS,
PHONE: M.C SHAFFNER
2125 CLOVERDALE AVENUE
WINSTON-SALEM NC 27103 [phone]
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: STOKES NEAREST TOWN OR CITY
GAP
SPECIFIC LOCATION (INCLUDING ROAD NUMBERS, LANDMARKS, ETC.):
FROM GAP NC, TAKE NC66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE LEFT.
6. IMPACTED OR NEAREST STREAM/RIVER: DAN RIVER
RIVER BASIN: ROANOKE RIVER BASIN
SUBDIVISION NAME
STATE: NC
1
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER (SA),
HIGH QYALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES ® NO ? IF YES, EXPLAIN: OUR PROJECT IS
WITHIN A WATER SUPPLY WATERSHED PROTECTED AREA.
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES E] 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? N/A
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES ? NO ® 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 ® IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: N/A
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
N/A
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
N/A
FILLING: 0 EXCAVATION: 0
FLOODING: 0 OTHER: 0
DRAINAGE: 0 TOTAL ACRES TO BE IMPACTED: 0
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: FT. AFTER:
WIDTH BEFORE (based on normal high water contours):
WIDTH AFTER: FT
AVERAGE DEPTH BEFORE: FT. AFTER:
FT.
FT.
FT.
(2) STREAM CH
ANNELIMPACTS
WILL CHANNEL RESULT FRO
RELOCATION M: (CHECK ALL
THAT CHANNEL EXC E3 PLACEMENT APPLy)
AVATION C7 CONSTRUCTION OF A D E
AI IN CHANNEL
11. IF CONT OTHER ? EXpL E3
RUCTION OF N' AM/FLOODING ?
A POND IS PROPOSED, WHAT IS THE SIZE
WHAT IS THE IZE OF THE WATERSHED
12 EXPECTED POND SURFACE
DESCRIPTION OF P AREA?
MECHANICAL ROPOSED WORK INCL U
ONLY): GAD EQUIPMENT TO BE USED (ATTACH ISCUSSION OF TYPE OF
PAVE TOMS PLANS: 8 I/2" X 11"
MITH ROAD DRAWINGS
(SR 1217) IN STOKES C'pUNTY.
13. PURPOSE OF PROPOSED WORK: TO IMPROVE ROAD
CONDITIOINS
14. STATE
REASONS WHY IT
IS T
IN WETLANDS. (INCLUDE HAT THIS ACTIVITY MUS
IMPACTS): T AD ANY MEASBELIEVED URES TAKEN TO T BE CARRIED OUT
HIS ROAD MINMIIS
FISCAL, YEAR 1999-200p WILL BE STABILIZED WETLAND
STRE CDOT FORCES WILL BECAUSE OF SAFETY IN THE UPCOMING
AMS. MINIMIZE IMPACTS TO W ORS; MONTHS
THE CAREFT n --
15. YOU ARE
AND/OR N ?NALD TO CONTACT THE U.
SHEET) REGARDING SERVICE AND WILDLIFE SERVICE (US
MARINE FISHERIES S. FISH
LISTING END THE PRESENCE OF AIVY (NMFS) (SEE AGENCY FWS)
RESSES
ANGERED OR THREATENED SPECIES
CO OR C TED OR PR ADDOPOSED FOR
PERMIT AREA THAT MAY SPECIES
BE ACTED BY THE PROP CRITICAL HABITAT IN THE
AGENCIES) OSED PROJECT.
16. YOU ARE RE (ATTACH RESPONSES FROM THESE
Y0U (SEE AGENCY HE STATE "IS TO
PROPERTIES DRESSES SHEET RIC PRESERVATION
IN THE PERMIT ) REGARDING THE PRESENCE OFFICER
PROJECT DATE REA WHICH MAY BE ACTED OF HISTORIC
17. CONTACTED:
02-04-99 B I' THE PROPOSED
DOES THE
PUBLIC PROJECT INVOLVE
(STATE) AN EXPENDITU
LAND? ?pp. OF PUB LIC FUNDS
NO ® (IF NO, OR THE USE OF
GO TO 18)
3
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 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 STAE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREED, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
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 DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND US OF SURROUNDING PROPERTY? N/A
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
4
NOTE: WETLANDS OR WATERS OF THE U. S. MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTON 404 CORPS OF ENGINEERS PERMIT,
d 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.

OWNER'S/AGENT SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION LETTER FROM THE OWNER IS PROVIDED (I 8g.))
5
ROCK INLET PROTECTION:
896.01 TYPE A ..................................................... A 17C 11 OR A
896.02 TYPE B ...................................................... BE ORB 11
896.03 TYPE C ......................... ........... C S OR C ,
897.01 ROCK PIPE INLET PROTECTION......... k
w..r'
N/A PIPE OUTLET ENERGY DISSIPATOR.. ;
0*0
N/A DRAINAGE TURNOUT.
N/A RIP-RAP LINED DITCH ........................
NIA STREAM ..................
STOKES COUNTY
SECONDARY ROAD
CONSTRUCTION PLAN
SR: 1217 NAME: TOM SMITH ROAD
TOWNSHIP: QUAKER GAP
PROPOSED FISCAL YR:1999-2000
PRIORITY NO: 36-R
EROSION CONTROL
DETAILS AND
SPECIFICATIONS
STD# DESCRIPTION SYMBOL
N/A HIGH POINT / WATER FLOW DIREC-ION ................... . -""' X ??
245.01 SILT BASINTYPE A ...............................
245.02 SILT BASIN TYPE B .................................
245.03 TEMPORARY SILT DITCH ................................................ . -TSD _
245.05 TEMPORARY DIVERSION DITCH ............................ -TD - C
100.01B STORM DRAINAGE PIPE .........................................
890.05 TEMP. SLOPE DRAIN W/ EARTH BERM .........................

892.01 TEMPORARY ROCK SEDIMENT DAM TYPE A ..............
892.02 TEMPORARY ROCK SEDIMENT DAM TYPE B ..............
892.04 TEMPORARY ROCK SILT CHECK TYPE A .....................
893.01 TEMPORARY SILT FENCE ...................................... h
894.01 ROCK SILT SCREEN ..............................
895.10 TEMPORARY ROCK SILTCHECK TY?E B ......................

L,/ Iti1
GENERAL NOTES: I `
STGKES CO.
1. ROADWAY ALIGNMENT AND PROWRTY2144 98
ARE BASED ON COUNTY TAX [LIT
2. TYPE "B" SILT BASINS WILL BE
6'x 3'x Y UNtiESS OTHERWISE NOTED ON PLANS.
3. THE INSTALLATION ORDER OF EROSION CONTROL
MEASURES SHOULD BE AS FOLLOWS:
A. TEMPORARY SILT BASINS SHALL BE
INSTALLED PRIOR TO CLEARING AND
GRUBBING.
B. SILT FENCES AND TEMPORARY SILT
DITCHES SHALL BE INSTALLED AFTER
CLEARING AND BEFORE GRADING.
C. TEMPORARY STONE DITCH CHECKS
SHALL BE INSTALLED AS SOON AS
THE DITCHLINE IS ESTABLISHED.
D. PIPE OUTLET AND INLET PROTECTION
WILL BE DONE AS SOON AS THE PIPE
IS INSTALLED.
E. SEEDING AND OTHER PERMANENT
EROSION CONTROL MEASURES ARE
TO BE IMPLEMENTED AS SOON AS
PRACTICAL.
4. ADDITIONAL EROSION-CONTROL DEVICES WILL BE
INSTALLED AS NEEDED IN THE FIELD OR AS
DIRECTED BY THE ENGINEER.

SR: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
SCALE: I"=100' APPROVED BY DRAWN BY: AEG

DATE: 10-23-98 M.C. SH.AFFNER, DISTRICT ENGINEER
REVISED:
EROSION CONTROL I RIGHT-OF-WAY PLANS
MAP LENGTH: 0.80 MILE(S) T 1 OF 4
-Sent` +d C ca- r\ 'y lo-a3 - `l `,
VICINITY MAP
23T4"R7 PROTFC-7
y - 20 t ov
- L - /0 t
N
1a
PrU'f Al, .?02 A/.
3 H S - d3'i 1
-?? 90

r
)9-G74.t

S.R: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL I RIGHT-OF-WAY PLANS
SCALE: 1"= 100' DRAWN BY: AEG PAGE: a OF
9
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?w
S.R: 1317 COUNTY: STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL / RIGHT-OF-WAY PLANS
SCALE: F= 100' DRAWN BY: AEG PAGE:3 OF 4
cA U C4,? fr;I

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COUNTY: STOK S
S.R: (217
NAME: TOM SMITH ROAD
EROSION CONTROL I RIGHT-OF-WAY PLANS
SCALE: 1"= 100' DRAWN BY: AEG T PAGE: I OF
,--,sue
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- ME-
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\\ •? -=?`??. ?;\\ -?/• ?\\? ? i ? ?f r? i ?r?. / ?? 1 ? \\ 1. ?: r1 ?? -` \ ???/fir-?,\?i?^ I I I \? '? '.':; ,,'??
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IN 11
PROPOSED DRAINAGE CROSS LINE TREATMENT
ALONG:TOM SMITH ROAD SR:1217, STOKES COUNTY
LOCATED: FROM GAP NC, TAKE NC 66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE
LEFT.

STATION EXISTING
DESCRIPTION
LGTH/DIAM/TYPE REPLACEMENT
DESCRIPTION
LGTH/DIAM/TYPE
SECTION TYPE
LEFT/RIGHT

COVER
SKEW
(APPROX)
24+00 20'-15"RCP 40'-18"RCP FILL/FILL MIN 1' 90°
48+75 NONE 40'-18"RCP FILL/FILL MIN 1' 90°

CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH 0'-8'
20'
PLAN VIEW
EP CL EP
FILL I
I FILL
I SKEW = 90°
STATION = 24+00
I
vl? 0 I
FL W -? 1§8o
0
EXISTING: 20'-15"RCP
I
PROPOSED: 40'-18"RCP
COVER: MIN I' I
I
I
DRAWN BY: LAJ COUNTY: STOKES
I
i
I
APPROVED BY: M.C. SHAFFNER NAME: TOM SMITH ROAD
DISTRICT ENGINEER
DRAINAGE PERMIT STA. 24+00

SR 1217

DRAWING 1 OF 2
CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH
20'
PLAN VIEW
EP CL EP
FILL I
I FILL_
I
I SKEW = 90°
STATION = 48+75
I
00
O I
FL W -? 1§8o
DO I
EXISTING: NONE I
PROPOSED: 40'-18"RCP
I
COVER: MIN 1'
I
DRAWN BY: LAJ COUNTY: STOKES
I
I
I
I
APPROVED BY: M.C. SHAFFNER CIL
DISTRICT ENGINEER
DRAINAGE PERMIT STA. 48+75

SR 1217
NAME: TOM SMITH ROAD
DRAWING 2 OF 2

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 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: NC DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: 2125 CLOVERDALE AVENUE
SUBDIVISION NAME
CITY: WINSTON-SALEM STATE: NC
ZIP CODE: 27103
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME):
(WORK) :
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICAL, ADDRESS,
PHONE: M.C SHAFFNER
2125 CLOVERDALE AVENUE
WINSTON-SALEM NC 27103 [phone]
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: STOKES
NEAREST TOWN OR CITY: GAP
SPECIFIC LOCATION (INCLUDING ROAD NUMBERS, LANDMARKS, ETC.):
FROM GAP NC, TAKE NC66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE LEFT
6. IMPACTED OR NEAREST STREAM/RIVER: DAN RIVER
RIVER BASIN: ROANOKE RIVER BASIN
1
sN
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER (SA),
HIGH QYALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES ® NO ? IF YES, EXPLAIN: OUR PROJECT IS
WITHIN A WATER SUPPLY WATERSHED PROTECTED AREA.
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? N/A
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES ? NO ® 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 ® IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: N/A
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
N/A
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
N/A
FILLING: 0 EXCAVATION: 0
FLOODING: 0 OTHER: 0
DRAINAGE: 0 TOTAL ACRES TO BE IMPACTED: 0
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
t?) STREAM
CHANNEL IMPgCTS
OPEN WILL RESULT CHANNEL RELOCATION FROM' . (GREG
a CHANNEL EXCgV ? PLACEMENT OPIPE K IN ALL CHANNEL APPLY)
EXCAVATION ? CONSTRUCTION OF DA
11. OTHER [] EXPLAIN. ?
IF CONTR UCTION OF A AIN. M/FLOODING?
POND IS PROPOSED, WHAT IS
WHAT IS THE SIZE OF THE WATERSHED
12 EXPECTED THE L
DESCRIPTION OF POND
SURFACE AREA?
INCL
HANK PROPOSED WORK
ONLY ; EQUIPMENT TO BE US UDING DISCUSSION OF DRA
GRADE> BASE ED (ATTACI-I PLANS: TYPE OF
PAVE TOM SMITH ROAD ANS: 8 1/2" X 11" WINGS
(SR 1217) IN STOKES C CONY.
13. PURPOSE OF
PROPOSED WORK: TO IMPROVE ROAD CONDITIOINS
14. STATE REASONS WHY IT IS BELIEVED
IN WETLANDS THAT ANY HAT THIS ACTIVITY
IMPACTS): CTS): THIS MEASURES MUST B
ROAD WEST TAKEN TO MINIMIZE
TH E CARRIED OUT
YEAR 1999 00 - ABA LZED IN THE Up
FORCE BECAUSE
ST S. MI WETLAND
S WILL MINIM ZE F FETY FACT ORSCO NG MONTHS
IMPAC"rc ? - __ • THE r?A n---
S• YOU ARE
REQUIRED
AND/OR NATIONAL MARINE O CONTACT THE U.
S• FISH AND WILDLIFE
SHEET] REGARDING FISHERIES SERVICE SERVICE
LISTING THE PRESENCE (NULL) (SEE (USFWL)
RED OR T OF qNy FEDERAL-LY AGENCY ADDRESSES
ONTA AREA TI HREATENED SPECIES OR LISTED OR
PROPOSED FOR
P AT MAY B TED BY T AL HE p CRITIC
CONTACTED: E AEC HABITAT IN THE
AGENCIES. 02-04-99 ROPOSED
PROJECT DATE
16. YOU ARE REQUIRED (A RESPO
QUIRED TO CO NSES FROM THESE
CONTACT AGENCY ADDRESSES S HISTORIC P
PROPERTIES IN T HEET RESERVATION
HE PERMIT 1' REGARDING
THE PRESENCE OFFICER
PROJECT. DATE CO AREA WHICH MAY OF
'ACTED; BE AFFECTED HISTORIC
02-0-x-91 BY THE PROPOSED
17. DOES THE
PROJECT INVOLVE
AN EXPENDITURE
PUBLIC (STATE) LANDS
OF PUBLIC FUNDS O
YES El NO ® (IF NO, GO TO 18 R THE USE OF
3
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 STAE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREED, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
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 DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND US OF SURROUNDING PROPERTY? N/A
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
g. SIGNED AND DATED AGENT AUTHORIZATION-LETTER, IF APPLICABLE.
4
NOTE: WETLANDS OR WATERS OF THE U. S. MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTON 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.
c
OWNER'S/AGENT SIGNATURE
AI Z - `/- f
DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION LETTER FROM THE OWNER IS PROVIDED (I 8g.))
5
VICINITY MAP
ROCK INLET PROTECTION:
896.01 TYPE A ..................................................... A t OR A )
896.02 TYPE B ...................................................... B ? OR B i,
896.03 TYPE C ...................................................... C L E21 J3 OR C?
897.01 ROCK PIPE INLET PROTECTION......... k
N/A PIPE OUTLET ENERGY DISSIPATOR.. e e
seae
N/A DRAINAGE TURNOUT ...........................
N/A RIP-RAP LINED DITCH ..........................
N/A STREAM ............................................
STOKES COUNTY
SECONDARY ROAD
CONSTRUCTION PLAN
SR: 1217 NAME: TOM SMITH ROAD
TOWNSHIP: MAKER GAP
PROPOSED FISCAL YR:1999-2000
PRIORITY NO: 36-R
EROSION CONTROL
DETAILS AND
SPECIFICATIONS
STD* DESCRIPTION SYMBOL
N/A HIGH POINT / WATER FLOW DIREC-ION .................... -40- X mmo-
245.01 SILT BASIN TYPE A ...............................
245.02 SILT BASIN TYPE B ............................................................ TIT/7
245.03 TEMPORARY SILT DITCH ................................................. _TSD -
245.05 TEMPORARY DIVERSION DITCH ..........................
100.01B STORM DRAINAGE PIPE ....................................................
890.05 TEMP. SLOPE DRAIN W/ EARTH BERM :.........................
892.01 TEMPORARY ROCK SEDIMENT DAM TYPE A ..............
892.02 TEMPORARY ROCK SEDIMENT DAM TYPE B ..............
892.04 TEMPORARY ROCK SILT CHECK TYPE A .....................
893.01 TEMPORARY SILT FENCE ................................

894.01
ROCK SILT SCREEN ............................................................ ,. r

895.10 TEMPORARY ROCK SILTCHECK TY?E B ......................
GENE- RTES: In,1
STO ES CO.
1. ROADWAY ALIGNMENT AND PROR$RTYZbNlOa
ARE BASED ON COUNTY TAX ! rAL ?
2. TYPE "B" SILT BASINS WILL BE
6'x 3'x 3' UNLESS OTHERWISE NOTED ON PLANS.
3. THE NSTALLATION ORDER OF EROSION CONTROL
MEASURES SHOULD BE AS FOLLOWS:
A. TEMPORARY SILT BASINS SHALL BE
INSTALLED PRIOR TO CLEARING AND
GRUBBING.
B. SILT FENCES AND TEMPORARY SILT
DITCHES SHALL BE INSTALLED AFTER
CLEARING AND BEFORE GRADING.
C. TEMPORARY STONE DITCH CHECKS
SHALL BE INSTALLED AS SOON AS
THE DITCHLNE IS ESTABLISHED.
D. PIPE OUTLET AND INLET PROTECTION
WILL BE DONE AS SOON AS THE PIPE
IS INSTALLED.
E. SEEDING AND OTHER PERMANENT
EROSION CONTROL MEASURES ARE
TO BE IMPLEMENTED AS SOON AS
PRACTICAL.
4. ADDITIONAL EROSION-CONTROL DEVICES WILL BE
INSTALLED AS NEEDED N THE FIELD OR AS
DIRECTED BY THE ENGINEER.

SR: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
SCALE: I" =100' APPROVED BY DRAWN BY: AEG

DATE: I0-23-98 M.C. SH AFFNER, DISTRICT ENGINEER
REVISED:
EROSION CONTROL / RIGHT-OF-WAY PLANS
MAP LENGTH: 0.80 MILE(S) T 1 OF 4
-s fi fo ??u?fiY 10-1 -
I ° e?71?-R7 PROTECT
y - 20 -r Ora

N
ZQ
Pry, ft/ Cher`1' N, d' oe- N.
3H8-3391
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d
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Q, vn / EcI,.A,? n 0. -M
3?3 -
' 7- 3, d 4
0
S.R: 12I7 COUNTY: STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL / RIGHT-OF-WAY PLANS
SCALE: 1"=100' DRAWN BY: AEG PAGE:3 OF y
vl
9D
Docl-6Ga
7-
0

I.
I
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4605
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VI/ 3<g- ai?'LI
S.R: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
EROSION CONTROL / RIGHT-OF-WAY PLANS
SCALE: P' 100' DRAWN BY: AEG PAGE: OF 7
;7 A
L?V I ? ??`
it j
it
k-A
Fish
tI' 1Hatche
ilk
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low
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--? . , -?-' 1, r: ?., 7 :??-? •°-` ? ?' ? !'%' \?,
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00
\ ,1 ,
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2! -00",
Yr
11 q
117
n -? 119b \ J J ?-/ J ? /
tal
1195 v? `, q?\? 1r ` \ , :1 \?. .!( \ 1 \' i
? ?- ?( ?? • \. , ``??\? \ 'n ? `?,v-l - ? ? if
Av*
rth
abbe" /\?\\?ooc 7.,)
!_ 0 1 \ , ?r=8 Inc ce S.t'aa? i r ? ,Q /
Qyr?
,icy,

G

/

O
I \
W",

Z 102 J\„??o/ " y
lu( 1.1
° ?• mgt ?\ ???? \

n ?
"V V
Q
r
PROPOSED DRAINAGE CROSS LINE TREATMENT
ALONG:TOM SMITH ROAD SR:1217, STOKES COUNTY
LOCATED: FROM GAP NC, TAKE NC 66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE
LEFT.

STATION EXISTING
DESCRIPTION
LGTH/DIAM/TYPE REPLACEMENT
DESCRIPTION
LGTH/DIAM/TYPE
SECTION TYPE
LEFT/RIGHT

COVER
SKEW
(APPROX)
24+00 20'-15"RCP 40'-18"RCP FILL/FILL MIN 1' 90°
48+75 NONE 40'-18"RCP FILL/FILL MIN 1' 90°

CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH 01-8'
20'
PLAN VIEW
EP CL EP
FILL I
I FILL
I
I SKEW = 90°
STATION = 24+00
Lf 0 I
FL W -? 0§80
I
0 I
EXISTING: 20'-15"RCP
I
PROPOSED: 40'-18"RCP
I
COVER: MIN I'
DRAWN BY: LAJ COUNTY: STOKES
I
I
I
APPROVED BY: M.C. SHAFFNER NAME: TOM SMITH ROAD
DISTRICT ENGINEER CIL DRAWING 1 OF 2
DRAINAGE PERMIT STA. 24+00

SR 1217

CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH 0'-8'
20'
PLAN VIEW
EP CL EP
FILL
I FILL
( SKEW = 90°
STATION = 48+75
00 I
0
FL W 0§8o
o° I
0 I
EXISTING: NONE
1
PROPOSED: 40'-18"RCP
i
COVER: MIN 1'
I
DRAWN BY: LAJ COUNTY: STOKES
I
I
I
I
APPROVED BY: M.C. SHAFFNER NAME: TOM SMITH ROAD
DISTRICT ENGINEER CIL DRAWING 2 OF 2
P,
DRAINAGE PERMIT STA. 48+75

SR 1217

f- 0
DEM ID: CORPS ACTION ID:
a
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 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: NC DEPARTMENT OF TRANSPORTATION
2. MAILING ADDRESS: 2125 CLOVERDALE AVENUE
SUBDIVISION NAME
CITY: WINSTON-SALEM STATE: NC ZIP CODE: 27103
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME):
(WORK) :
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICAL, ADDRESS,
PHONE: M.C SHAFFNER
2125 CLOVERDALE AVENUE
WINSTON-SALEM NC 27103 [phone]
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: STOKES
NEAREST TOWN OR CITY: GAP
SPECIFIC LOCATION (INCLUDING ROAD NUMBERS, LANDMARKS, ETC.):
FROM GAP NC, TAKE NC66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE LEFT.
6. IMPACTED OR NEAREST STREAM/RIVER: DAN RIVER
RIVER BASIN: ROANOKE RIVER BASIN
1

7a• IS PROJECT LOCATED NEAR W
HIGH QyALITY ATER CLASSIFIE
SUPPLY WATERS (HQW), OUTS AS TROUT, TIDAL
(WS-I OR WS-II)? TIDING D AL SALTWATER
WITHIN A W YES ® NO RESOURCE WATERS (SA),
WITATER SUPPLY ?, ? IF YES, E "PLAIN- WATER
7b. ROTECTED AREA ROJECT IS
ATERSHED PROTECTED OUR P
IS THE PROJECT LOCATED
ATED WIT
IjIN MANAGEMENT AREA OF ENVIROjijN NMENORTIi CAROLINA DIVISION
NTAL CONCERN OF COASTAL
7c. IF THE PROJECT IS (AEC)? yES ? NO
COASTAL C LOCATED WITHIN
A COASTAL
COUNTIES), WHAT IS THE LAND USE PL AN UNTY (SEE PAGE 7 FOR LI
(L UP) DESIGN ST OF
Sa. HAVE ATION? N/A
ANY SECTION 404 PE
PROPERTY? YES RMITS BEEN PRE
? NO VIpUSLY
pERMITgND IF YES, PRONTO QUESTED FOR
ANY ADDITION E ACTION I.D USE ON THIS
CERTIFICATION): FORMATION NUMBER OFP
(INCLUDE pH0T PREVIOUS
OCOpy OF 401
8b. ARE ADDITIONAL PERMIT REQUESTS
FUTURE? YES ? NO EXPECTED FpR THIS P
® IF YES, DESCRIBE ANTICIPgT ROPERTY IN THE
ED WORK:
9a ESTIMATED TO
9b. ESTIMATED TOTAL NUMBER OF AC
N/q 'IV TRACT OF
UMBER OF ACRES F WETLANDLf1ND: N/A
10a. 'NUMBER S LOCATED
FILL N/OF ACS OF WETLANDS IMP ON PROJECT SITE:
IG: 0 ACTED B y T
FLOODING O HE PROPOSED
DRAINAGE: 0 EXCAV PROJECT B y:
ATION: 0
OTHER: 0 _
l 0b. (l) STREAM CH TOTAL ACRES TO BE IMPACTED.
PRONTO ANNEL TO BE IMPACTED B Y T 0
E DISTAnrCE BOTH BEFORE HE PROPOSED PROJECT (IFRELOC
LENGTH ED
WIDTH BEFORE AND AFTER RELOCATION: AT
(based on normal h.o FT. AFTER:
WIDTHAFTER: high water contours):
AVERAGE DEPTH BEFORE: FT.
FT. FT.
FT. AFTER:
FT.
2
. (2) STREAM CHANNEL IMPACTS WILL
OPEN CHANN RESULT FRO
J CHANNEL EL RELOCATION ? PLACEMENT HECK ALL THAT APPl,y)
11 EXC:NATION? CONSTRUCTIO F PIPE IN CH
OTHER
`` NNEL ?
IF CONTR UC 13 EXPLAIN: N OF A D
TION OF
A POND IS PROPOSED, WHAT IS AM/FLOODING? 12 THE SIZE IS THE
EXPECTED P OF THE WATERSHED
. DESCRIPTION Opp OND
ROPOSED SURFACE AREA?
MECHANICAL - WORK INCLUDI
EQUIPMENT NG DISCUSSIO
ONLY): GRADE, B TO BE USED (ATTACH PLANS: N OF TYPE OF
ASE PAVE ANS. 8 1/2"
TOM SMITpl RO X 11 DRAWINGS
AD (SR 1217) IN STOKES COUNTY.
13• PURPOSE OF W
14. :PROPOSED
ORK: TO IMPROVE ROAD CONDITIOINS
TA
REASONS WHY IT IS BELIEVED THAT WETLANDS (INCLUD HAT THIS ACTIVITY MUST THIS E ANY MEASURES T BE CARRIED OUT
T KEN TO
FISC ROAD WILL BE ST A MINI
THEN PEAR 1999-2000 B ?LIZED IN MIZE WETLAND
CDOT FO EC:USE OF S THE US
ST_ S - RCES WILL MINIMIZE I?pTY FACTORS- Tu ING MONTHS
15. YOU ARE
AND/OR NAT pEQU
AND TO CONTACT THE U. S. I
SHEET AL MARINE FISHERIES NND WILDLIFE SERVICE
REGARDING THE P (USFWS)
LISTING ENDANGE p
RED ESENCE OF SERVICE S) (SEE AGENCY ADDRESSES
RED OR TH SANY ERVFICE RALLY LISTED OR FOR
gCENED SPECIES OR CRITICAL R
CONTACTED: THAT MAY BE PROPOSED
AGENC 02-04-99 TED B Y THE PROP HABITAT IN THE
AGENCIES.) .) ED PROJECT.
16. DATE
YOU ARE REQUIRED TO CONTACT (ATTACH RESPONSES FROM THE
(S,-'PO) (SEE AGENCY THE STATE HISTORIC SE
PROPERTIES ADDRESSES SHEET) RIC PRESERVATION
IN THE PERMIT AREA WHICH THE PRESENCE OFFICER
PROJECT. DATE HIGH MAY RESENCE OF
CONTACTED: BE AFF CTED By HISTORIC
02-04.99 H
17. E PROPOSED
DOES THE PROJECT INVOLVE AN EXPENDITURE
PUBLIC (STATE)
YES C7 NO LAND? OF PUBLIC FUNDS OR
® (IF NO, GO TO 18) THE USE OF
3
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 STAE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGE7T, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREED, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
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 DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND US OF SURROUNDING PROPERTY? N/A
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
4
NOTE: WETLANDS OR WATERS OF THE U. S. MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTON 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.
OWNER'S/AGENT SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY IF AUTHORIZATION LETTER FROM THE OWNER IS PROVIDED (I 8g.))
ROCK INLET PROTECTION:
896.01 TYPE A ....................................... . A OR A ?l
896.02 TYPE B ...................................................... B LE OR B i1
896.03 TYPE C .......................... ......... C 0 OR C?
897.01 ROCK PIPE INLET PROTECTION......... k
NIA PIPE OUTLET ENERGY DISSIPATOR.. ' .
NIA DRAINAGE TURNOUT.
..........................
NIA RIP-RAP LINED DITCH ........................
NIA STREA M ...................
STOKES COUNTY
SECONDARY ROAD
CONSTRUCTION PLAN
SR: 1217 NAME: TOM SMITH ROAD
TOWNSHIP: (QUAKER GAP
PROPOSED FISCAL YR:1999-2000
PRIORITY'` NO: 36-R
EROSION CONTROL
DETAILS AND
SPECIFICATIONS
STD# DESCRIPTION SYMBOL
NIA HIGH POINT / WATER FLOW DIREC7710N .................... --*- X ??
245.01 SILT BASIN TYPE A ..............................
.............................
245.02 SILT BASIN TYPE B ............................
245.03 TEMPORARY SILT DITCH ................................................. _TSD-
245.05 TEMPORARY DIVERSION DITCH .................................... -TD --
100.OIB STORM DRAINAGE PIPE .................................................... lola?
890.05 TEMP. SLOPE DRAIN Wl EARTH BERM :......................... T --4-
892.01 TEMPORARY ROCK SEDIMENT DAM TYPE A .............. 9MM
892.02 TEMPORARY ROCK SEDIMENT DANI TYPE B ..............
892.04 TEMPORARY ROCK SILT CHECK TYPE A .....................
893.01 TEMPORARY SILT FENCE .................................................?
894.01 ROCK SILT SCREEN ..............................................
895.10 TEMPORARY ROCK SILTCHECK TYPE B ...................... ,
GENERALNOTES: ` I r STGKES CO.
3. THE INSTALLATION ORDER OF EROSION CONTROL
MEASURES SHOULD BE AS FOLLOWS:
A. TEMPORARY SILT BASINS SHALL BE
INSTALLED PRIOR TO CLEARING AND
GRUBBING.
B. SILT FENCES AND TEMPORARY SILT
DITCHES SHALL BE INSTALLED AFTER
CLEARING AND BEFORE GRADING.
C. TEMPORARY STONE DITCH CHECKS
SHALL BE INSTALLED AS SOON AS
THE DITCHLINE IS ESTABLISHED.
D. PIPE OUTLET AND INLET PROTECTION
WILL BE DONE AS SOON AS THE PIPE
IS INSTALLED.
E. SEEDING.AIvD OTHER PERMANENT'
EROSION CONTROL MEASURES ARE
TO BE IMPLEMENTED AS SOON AS
PRACTICAL.
4. ADDITIONAL EROSION-CONTROL DEVICES WILL BE
INSTALLED AS NEEDED IN THE FIELD OR AS
DIRECTED BY THE ENGINEER.
I. ROADWAY ALIGNMENT AND PRORERTY2 Ca
BASED ON COUNTY TAX ? A I ? D
2. TYPE "B" SILT BASINS WILL BE
ARE 6'x Y x 3' UNLESS OTHERWISE NOTED ON PLANS.

SR: 1217 COUNTY: STOKES
NAME: TOM SMITH ROAD
SCALE: 1" =100' APPROVED BY DRAWN BY: AEG
DATE: 10-23-98 M.C. SHAFFNER, DISTRICT ENGINEER
REVISED:
EROSION CONTROL / RIGHT-OF-WAY PLANS
L MAP LENGTH: 0.80 MILE(S) I OF 4
-s?fi+n T?0L?ntY io -a? - cl cd,
VICINITY MAP
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SCALE: I"= IOO' DRAWN BY: AEG PAGE:3 OF l
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PROPOSED DRAINAGE CROSS LINE TREATMENT
ALONG:TOM SMITH ROAD SR:1217, STOKES COUNTY
LOCATED: FROM GAP NC, TAKE NC 66 NORTH FOR APPROX 7 MILES, SR 1217 ON THE
LEFT.

STATION EXISTING
DESCRIPTION
LGTH/DIAM/TYPE REPLACEMENT
DESCRIPTION
LGTH/DIAM/TYPE
SECTION TYPE
LEFT/RIGHT

COVER
SKEW
(APPROX)
24+00 20'-15"RCP 40'-18"RCP FILL/FILL MIN 1' 90°
48+75 NONE 40'-18"RCP FILL/FILL MIN 1' 90,

CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH
20'
PLAN VIEW
EP CL EP
FILL I
I FILL_
I SKEW = 90°
STATION = 24+00
DO
FL W
0§80
O
O
EXISTING: 20'-15"RCP
PROPOSED: 40'-18"RCP
I
COVER: MIN I'
DRAWN BY: LAJ COUNTY: STOKES
I
I
I
APPROVED BY: M.C. SHAFFNER CIL
DISTRICT ENGINEER
DRAINAGE PERMIT STA. 24+00

SR 1217
NAME: TOM SMITH ROAD
DRAWING 1 OF 2
CROSS SECTION
C?
RIGHT-OF-WAY
SHLDR SHLDR
PAVEMENT WIDTH 0'-8'
20'
PLAN VIEW
EP CL EP
FILL
I FILL_
I
I SKEW = 90°
STATION = 48+75 I
Lr,lo O I
FL W -? J§8o
0 I EXISTING: NONE I
PROPOSED: 40'- 18"RCP
I
COVER: MIN V
I
DRAWN BY: LAJ COUNTY: STOKES
I
I
I
APPROVED BY: M.C. SHAFFNER
DISTRICT ENGINEER
DRAINAGE PERMIT STA. 48+75

SR 1217
-
NAME: TOM SMITH ROAD
DRAWING 2 OF 2