20021229 Ver 1_Complete File_20020805

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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
DWQ Project No.: z9 /al 4 9 County: Gr2
Applicant: NCDOT
Project Name: //a c> 13, ? r? hO?'
Date of Issuance of 401 Water Quality Ce ification: 2i'- r3v -?;?
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return this certificate to the
401 /Wetlands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or the
project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
I, Joel B. Setzer, P.E., hereby state that, to the best of my abilities, due care and diligence was used in the
observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and of port' terials.
Signature: Date: 9? d
Agent's Certifi Lion
I, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be
built within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature: Date:
If this project was designed by a Certified Professional
I, , as a duly registered Professional (i.e.,
Engineer, Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to
observe (periodically, weekly, full time) the construction of the project, for the Permitee hereby state that,
to the best of my abilities, due care and diligence was used in the observation of the construction such that
the construction was observed to be built within substantial compliance and intent of the 401 Water
Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting
materials.
Signature Registration No. Date:

North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), hftp://h2o.enr.state.nc.us/ncwetiands/
o? WAT ?Rp61
C/A
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September 20, 2002
Graham County
DWQ Project No. 021229
SR 1120 (Big Snowbird Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. Wesley T. Grindstaff, County Maintenance Engineer
NCDOT
P.O. Box 1551
Andrews, NC 28901
Dear Mr. Grindstaff:
You have our approval, in accordance with the attached conditions and those listed below, to impact 146
linear feet of Lovin Branch, and eight unnamed tributaries to Snowbird Creek in order to improve SR
1120 (Big Snowbird Road) in Graham County. The project should be constructed in accordance with
your application dated July 31, 2002 (received August 5, 2002). After reviewing your application, we
have decided that this fill is covered by General Water Quality Certification No. 3375 corresponding to
the U.S. Army Corps of Engineers Nationwide Permit Number 14. In addition, you should acquire any
other federal, state or local permits before you proceed with your project including (but not limited to)
Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This approval
will expire with the accompanying 404 permit unless otherwise specified in the Water Quality
Certification.
This approval is only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us, in writing, and send us a new
application. If the property is sold, the new owner must be given a copy of this Certification and approval
letter and is thereby responsible for complying with all conditions. If total wetland fills for this project
(now or in the future) exceed one acre or stream impacts exceed 150 linear feet, compensatory mitigation
may be required as described in 15A NCAC 2H.0506 (h) (6) and (7). For this approval to be valid, you
must follow the conditions listed in the attached certification and any additional conditions listed below.
1. NCDOT shall implement Best Management Practices for the Protection of Surface Waters (NCDOT
March 1997).
2. NCDOT shall abide by any conditions or moratoriums as determined by the NC Wildlife Resources
Commission.
3. All work shall be performed during low flow conditions.
4. All mechanized equipment operated near surface waters must be regularly inspected and maintained
to prevent contamination of stream waters from fuels, lubricants, hydraulic fluids, or other toxic
materials. The presence of equipment in the channels must be minimized.
5. Existing vegetated buffers shall not be mowed in order to utilize it for storm water sheet flow.
6. Riparian vegetation (native trees and shrubs) must be reestablished within the construction limits of
the project by the end of the growing season following completion of construction.
7. Use of rip-rap for bank stabilization is to be minimized; rather, native vegetation is to be planted
when practical. If rip-rap is necessary, it must be limited to the stream bank above the high water
mark. Rip rap shall not be placed in the stream bottom.
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetlands/
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
w? M
8. Upon completion of the project, the NCDOT or its authorized agent shall complete and
return the enclosed "Certificate of Completion" form to notify NCDWQ when all work
included in the §401 Certification has been completed. The responsible party shall
complete the attached form and return it to the 401/Wetlands Unit of the NC Division of
Water Quality upon completion of the project.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.
You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written
petition that conforms to Chapter 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its
conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please telephone Ms. Cynthia Van Der Wiele at 919.733.5715 or Mr.
Mike Parker of the Asheville Regional Office at 828.251.6208.
Sincerely,
Attachment
pKi .
Pc : Wilmington District Corps of Engineers
John Hendrix, USACE Asheville Field Office
Mike Parker, NCDWQ Asheville Regional Office
Central Files
File Copy
MEMORANDUM
TO: John Dorney
Non-Discharge Branch
Regional Contact: Michael R. Parker
WO Supervisor: Forrest Wpstall
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name NCDOT - SR 1120
Project Number 02 1229
Recvd From DOT ? ? COPY
Received Date 8/5/02 Recvd By Regi n
Project Type
Certificates
Permit Wetland Wetland Wetland Stream
Type Type Impact Score Index
County GRAHAM
County2
Region Asheville
Stream
Class Acres Feet
Prim. Supp. Basin Req. Req.
Stream Impacts (ft.)
E E
F14 F- P7 -@)N F--2-190-9 FC Tr 40,404. F-F- 146.00
f - Y' ON I--(f`f-F-f ?f`- F_ F_
Mitigation Wetland
MitigationType Type Acres Feet

Is Wetland Rating Sheet Attached? O Y ON Did you request more Info? O Y ON
Have Project Changes/Conditions Been Discussed With Applicant? O Y O N
Is Mitigation required? O Y pO N Recommendation: O lssue #Issue/fond O Deny
Provided by Region: Latitude (ddmmss) 351725 Longitude (ddmmss) 835323
cc: Regional Office
Central Office Page Number 1
Triage Check List
Date: O2- Project Name: (-,__1N)7SX 11.
DWQ#: &V 1 9.
V Ia copy
To: _LJ?ARO Mike Parker
? FRO Ken Averitte
? MRO Mike Parker
? RRO Steve Mitchell
From: rr
County: 'e flwsr
? WaRO Deborah Sawyer
? WiRO Joanne Steenhuis
? WSRO Jennifer Frye
Telephone : (919) 7??3
The file attached is being forwarded to your for your evaluation.
Please call if you need assistance.
'ET-Stream length impacted
? Stream determination
? Wetland determination and distance to blue-line surface waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules (Neuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
? Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings?
? Cumulative impact concern
Comments: -

7
t

MICHAEL F. EASLEY
GOVERNOR
July 31, 2002

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
U.S. Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, NC 28801-2714
Attention: Mr. John Hendrix
NCDOT Coordinator
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N'r: 77-Amp s g,t,Tu F-i
LYNDO TIPPETT
SECRETARY
Subject: Proposed widening and paving of SR 1120, Big Snowbird Road near
Robbinsville, NC, Graham County.
State Project No. 6.932027T (DWQ Minor Permit Fee $200)
Dear Mr. Hendrix:
The North Carolina Department of Transportation (NCDOT) is proposing to widen and
pave SR 1120, Big Snowbird Road, in Graham County. This proposal entails widening
the existing gravel roadway to meet NCDOT secondary road standards and the paving of
two nine feet travel lanes with BST asphalt. Due to this proposed widening, nine existing
stream crossings will be impacted by the installation/replacement/extension of corrugated
metal pipes and one section of ditchline carrying water will require relocation. NCDOT
is requesting permission to impact these 9'existing crossings as well as relocate 50 feet of
wet ditch during the construction process.
The proposed widening and paving of SR 1120 has been identified as a necessary
maintenance and safety improvement. Funds have been allocated for this project, and
NCDOT would like to perform these activities sometime during the 2002 construction
season.
I am attaching details of the various sites where will propose to be in conflict with the
streams. I am also attaching a vicinity map as well as a USGS map with these sites
shown and their coordinates listed. We propose to install all the new culverts slightly
below the existing streambed elevations where bedrock is not encountered to minimize
impacts to wildlife habitats and allow the existing stream gradients to remain as
unchanged as is physically possible. No threatened or endangered species are known to
be present in or near the project area; therefore, no significant impacts are anticipated
Andrews District Office } "A"11
1 i ?' '- '
P. O. Box 1551, Andrews, N. C. 28901 ? ; j C I '!,' }

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from project construction. NCDOT has surveyed one section of the roadway for the
Indiana Bat and found no evidence of any existence in the area. Mr. Mark. Davis is in the
ress of scheduling another bat survey for the upper reaches of this road.
The best management practices will be used to minimize and control sedimentation and
erosion on this project. The construction foreman will review all erosion control
measures daily to ensure sedimentation and erosion are being effectively controlled. If
the planned devices are not functioning as intended, they will be immediately replaced
with better devices. The rocksilt screens and other erosion control devices will be in
place prior to pipe culvert construction and will remain in place until the project is
stabilized.
Impacts to Waters of the United States
In order to widen and pave SR 1120 in Graham County, it will be necessary to impact
waters of the United States in the Little Tennessee River Basin. Specifically, NCDOT is
requesting to modify nine corrugated metal pipes; one in Lovin Branch (Class C - Trout),
and eight in UT's to Snowbird Creek (Class C - Trout). Listed below is a summary of
proposed impacts.
Station Existing Proposed Net Impacts
Cond. Cond. '
6+40 25' x 15" New 35' x 24" 10' x 24" CMP
CMP CMP
24+60 None New 40' x 24" 40' x 24" CMP
CMP
24+60 50' Wet Ditch Move ditch 12' No net stream loss proposed
Left
25+15 20' x 18" New 35'x 36" 15' x 36" CMP
CMP CMP
51+56 40' x 24" Extend by 10' 10' x 24" CMP
CMP
57+76 30' x 18" New 40' x 24" 10' x 24" CMP
CMP CMP
76+00 None New 35' x 18" 35' x 18" CMP. Eliminate 320'
CMP of intermittent wet ditch; will not
require mitigation.
6+60 35' x 18" New 45' x 24" 10'x 36" CMP
CMP CMP
8+05 20' x 18" New 30' x 24" 10'x 24" CMP
CMP CMP
10+50 24' x 24" New 30'x 36" 6'x 36" CMP
CMP CMP
04•
Permits Requested
NCDOT is hereby requesting authorization under NWP 14 and Section 404 of the Clean
Water Act to proceed with the construction project outlined above. By copy of this letter,
I am asking Mr. Owen Anderson, North Carolina Wildlife Resources Commission
(NCWRC) Western Mountain Region Coordinator, to comment directly to you
concerning the 404 Nationwide Permit Request.
Also, by copy of this letter, I am requesting authorization to proceed under Section 401 of
the Clean Water Act from the Division of Environmental Management (Please charge all
necessary fees from this project to the Project No. indicated in the subject line).
Due to this road being in close proximity to Big Snowbird Creek (Class C - Trout), I will
request a variance in the Trout Water Buffer Zone. For this reason, I am requesting that
Mr. Owen Anderson and Mr. Ed Ingle to comment directly to me concerning the Trout
Water Buffer Zone encroachment.
Your early review and consideration of this project will be greatly appreciated. If you
require additional information, please contact me at 828.321.4105.
Sincerely,
Wesley T. Grindstaff
County Maintenance Engineer
copy: Mr. Richard Phillips, P.E., Regional Engineer DEHNR
Mr. R.G. Watson, P.E., Division Engineer
Mr. John Dorney, DWQ, DENR
Mr. Owen Anderson, Western Mountain Coordinator, NCWRC
Mr. B.C. Burch, P.E., District Engineer
Mr. W.D. Laughter, Transportation Supervisor III
Mr. Mark Davis, Division Environmental Officer
Mr. Ed Ingle, Area Roadside Environmental Engineer
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Name: SANTEETLAH CREEK Location: 035° 17'24.7" N 083° 53'22.9" W
Date: 7/31/102 Caption: SR 1120 - Big Snowbird Road
Scale: 1 inch equals 2000 feet Graham County
Big Snowbird Creek - Class C Trout

SITE #1
SR-1120
BIG SNOWBIRD
GRAHAM COUNTY

CHECK DAMS
SPACED AS
REQUIRED

• SILT BASIN
TYPE B
3'x 2'x 8'

1' BRANCH
•
ROCK PIPE INLET
PROTECTION

SILT BASIN
TYPE B
3'x 2'x 8'

CHECK DAMS
SPACED AS D
REQUIRED STA. 6+40

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35° 17' 44" N
83° 53' 11" W

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NORTH

ILT FENCE
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ROCK SILT
CMP SCREEN

ILT FENCE

ROCK BERM

OTE: THIS PIPE
WILL BE
PERCIIED.

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SITE #2
SR-1120
BIG SNOWBIRD
GRAIIAM COUNTY

MAINTAIN 50'
WET DITCH \
1' to'2' v
IN WIDTH
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ROCK PIPE INLET ?j
PROTECTION

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SPACED AS
REQUIRED
v STA. 24+60

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35° 17' 36" N
83° 53' 23" W

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GRADIENT, PIPE
WILL BE PERCHED.
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SITE #3 STA. 25+15
SR-1120
BIG SNOWBIRD
GRAHAM COUNTY
NEW OLD
CL CL
CHECK DAMS
SPACED AS
REQUIRED ?
? 8' ? SILT FENCE
SILT BASIN I 1 &
TYPE B ® 1 I ROCK BERM
12'x 3'x 2'
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ROCK PIPE INLET I SCREEN
PROTECTION
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RECREATE WET
DITCH FROM 8' I SILT FENCE
STA. 24+60 1 &
TO STA. 25+10 ROCK BERM
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GPS
35°17' 36" N
83°53' 23" W
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SITE #4
SR-1120
BIG SNOWBIRD
GRAHAM COUNTY
NOTE: CUT SHOULDER
WIDTH TO 3'
TO AVOID STREAM ?PLACE COIR FIBER •`v
MATTING ALONG
CHANNEL SLOPES. ' v
.V
ROCK PIPE INLET
PROTECTION
CHECK DAMS
SPACED AS
REQUIRED
- .<
NOTE: WET DITCH FROM
STA. 51+56 TO
STA. 54+50 WILL
NOT BE IMPACTED
BY ROAD CONST.
STA. 51+56
NEW OLD
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35'171 29" N
83°53' 31" W

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SCREEN
SILT FENCE
ROCK BERM

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SITE #5
SR-1120
BIG SNOWBIRD
GRAHAM COUNTY

HECK DAMS SPACED
AS REQUIRED

ILT BASIN
- TYPE B
8'x 3'x 2'

ROCK PIPE :INLET

PROTECTI

V BRANCH

SILT BASIN
TYPE B
81x 31x 2' ®

CHECK DAMS
SPACED AS ®
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35°17' 30" N
83°53' 38" W

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SITE #7
SR-1120
BIG SNOWBIRD
GRAHAM COUNTY
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SR-1120
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GRAHAM COUNTY 4110
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Office Use Only: Form Version October 2001
USACE Action ID No. DWQ No0 2 1 2 2 9
If any particular itern is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
1. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: NW 14
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ?
II. Applicant Information
1. Owner/Applicant Information
Name: North Carolina Department of Transportation
Mailing Address: P.O. Box 1551
Andrews NC 28901
Telephone Number: 828.321.4105 Fax Number: 828.321.3228
E-mail Address:
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be
attached if the Agent has signatory authority for the owner/applicant.)
Name: Wesley T. Grindstaff
Company Affiliation: NCDOT
Mailing Address: P.O. Box 1551
Andrews NC 28901
Telephone Number: 828.321.4105 Fax Number: 828.321.3228
E-mail Address: [e-mail]
Page I of 9
AA
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Widening and Paving of SR 1120, Big Snowbird Road
2. T.I.P. Project Number or State Project Number (NCDOT Only): 6.932027T
3. Property Identification Number (Tax PIN):
4. Location
County: Cherokee Nearest Town: Robbinsville
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.):
From Robbinsville take NC 143 west for approx. 6.5 miles to SR 1115. Turn left on SR
1115 and continue for approx. 3.5 miles to SR 1120.
5. Site coordinates, if available (UTM or Lat/Long): Listed on attached site drawings
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Describe the existing land use or condition of the site at the time of this application:
Existing graveled roadway
7. Property size (acres):
8. Nearest body of water (stream/river/sound/ocean/lake):Big Snowbird Creek(Class C-Trout)
9. River Basin: Little Tennessee
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
Page 2 of 9
10. Describe the purpose of the proposed work: Widen and pave existing gravel roadway
11. List the type of equipment to be used to construct the project: Backhoe, track excavator,
loader, dozer, dump trucks
12. Describe the land use in the vicinity of this project: Forest resoruces, residential, recreation
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
N/A
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application:
N/A
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 3 of 9
1. Wetland Impacts None
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, till,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at httu://www.fema.Pov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: 0
Total area of wetland impact proposed: 0
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
indicate on ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
lease specify)
Site 1 Replace Culvert 10 UT of Snowbird Creek 1' Perennial
Site 2 Add Culvert 40 UT of Snowbird Creek 1' Perennial
Site 3 Replace Culvert 15 Lovin Branch 4' Perennial
Site 4 Extend Culvert 10 UT of Snowbird Creek 2' Perennial
Site 5 Replace Culvert 10 UT of Snowbird Creek 1' Perennial
Site 6 Add Culvert 35 UT of Snowbird Creek 0.5 Intermittent
Site 7 Replace Culvert 10 UT of Snowbird Creek 1' Perennial
Site 8 Replace Culvert 10 UT of Snowbird Creek 4' Perennial
Site 9 Replace Culvert 6 UT of Snowbird Creek 4' Perennial
* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.us¢s.oov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 146'
Page 4 of 9
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S. - None
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation - None
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrate&on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
The minimum length of culvert that could facilitate a two lane facility was used on all stream
crossings. Where possible, the roadway was shifted to one side or another to avoid impacts to
live streams and wet ditches. A reduced typical section is planned for the section of roadway
from Survey Station 8+00 thru 11+00 to avoid impacts.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
Page 5 of 9
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlandg/strmgide.html.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP.must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at http•//h2o.cnr.state.nc.us/wrp/index.htm. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet): N/A
Amount of buffer mitigation requested (square feet): N/A
Page 6 of 9
Amount of Riparian wetland mitigation requested (acres): N/A
Amount of Non-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers. Required
Zone* (square feet) Multiplier N itti ation
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 7 of 9
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
No Riparian Buffer exists. A trout stream buffer variance will be applied for where road
construction requires.
XI. Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
The existing compacted gravel roadway acts as an impervious surface. The existing roadway
will be widened and paved approximately 3' throughout. This will increase the impervious area
from 2.73 acres to 3.27 acres. Stormwater will be transported and filtered through a vegetation
lined ditch and will also pass through rock check dams and silt basins before being diverted from
roadbed through metal pipes.
XII. Sewage Disposal (DWQ Only)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
N/A
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Indiana Bat survey will be conducted.
Page 8 of 9

07-24-oL
Applicant/Ag6'nt's Signature' v Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9