20030254 Ver 1_Complete File_20030303

tJF WATER Michael F. Easley, Governor
William G. Ross Jr., Secretary
?O? P4 North Carolina Department of Environment and Natural Resources
r- Alan W. Klimek, P.E., Director
> - Division of Water Quality
p <.
DWQ Project No.: O 30159 County:
7
Alk Applicant: C) L i t
1
Project Name:
4
ie?
rJ1
Date of Issuance of 401 Water Quality Certification:
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification and 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, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be returned to DWQ
by the applicant, the applicant's authorized agent, or the project engineer. It is not necessary tc efinflc ? sl F(OUF'
all of these. F(
Applicant's Certification NOV 2 1 200,E
V 4 - " (l1k , hereby state that, to the best of my abilities ?}'1' ce
was used in the observation of the construction such that the construction was observed to be u1 t w t?pN
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications,
and other supporting materials.
Signature: - Date:
Agent's
I, -n , AA , MAW , 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: f
If this projecZasdsi ed by a Certified Professional
L , 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 Pere- ttee 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

N. C. 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)
[phone] (phone), 919-733-6893 (fax), (http://h2o.enr.state.nc.us/ncwetlands

F wAT ? Michael F. Easley, Governor
o?0
RQG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
V rP.. Alan W. Klimek, P.E. Director
> Division of Water Quality
O
March 24, 2003
Guilford County
DWQ Project No. 030254
SR 2856 (Three Loy Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. J.M. Mills, P.E., Division Engineer
NCDOT Division 7
P.O. Box 14996
Greensboro, NC 27415
Dear Mr. Mills:
You have our approval, in accordance with the attached conditions and those listed below, to permanently
impact 38 linear feet and incur 30 linear feet of temporary impacts to an unnamed tributary to Reedy
Creek in order to upgrade SR 2856 (Three Loy Road) in Guilford County. The project should be
constructed in accordance with your application dated January 7, 2003 (received March 3, 2003). After
reviewing your application, we have decided that this fill is covered by General Water Quality
Certification Nos. 3366 and 3375 corresponding to the U.S. Army Corps of Engineers Nationwide Permit
Numbers 33 and 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 if stream impacts exceed 150 linear feet, compensatory
mitigation may be required as described in 15A NCAC 211.0506 (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. Mowing of existing vegetated buffers is strongly discouraged, so that they may be utilized for storm
water sheet flow.
2. All work shall be performed during low flow (below bankfull) conditions.
3. 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.
4. Riparian vegetation must be reestablished within the construction limits of the project by the end of
the growing season following completion of construction.
5. The pipe required for this project shall be installed in such a manner that the original stream profile is
not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed).
Existing stream dimensions (including the pattern and profile) are to be maintained above and below
locations of the culvert. The culvert shall be designed and installed to allow for fish and other
wildlife movement as well as prevent headcuttin2 of the streams.
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/ncwetlands/

6. 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 below the high water mark,
and vegetation must be used for stabilization above high water. Rip rap shall not be placed in the
stream bottom.
7. The presence of equipment in the channels must be minimized. Under no circumstances must rock,
sand or other materials be dredged from the wetted stream channel under authorization of this permit,
except in the immediate vicinity of the culverts.
8. Upon completion of the project, the NCDOT 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. Beth Barnes at 919.715.8394 or Mr. Steve Mauney
of the Winston-Salem Regional Office at 336.771.4600.
Sincerely,
Attachment
p l m , P.E.
Pc: Wilmington District Corps of Engineers
John Thomas, USACE Raleigh Field Office
NCDWQ Winston-Salem Regional Office
Central Files
File Copy

MICHAEL F. EASLEY
GOVERNOR
N dM ????
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
1584 YANCEYVILLE STREET, GREENSBORO, NC 27415
January 7, 2003
MEMORANDUM TO:
FROM:
SUBJECT:
Ms. Cynthia Van der Wiele
Wetlands/401 Unit
Lane Hall
District Engin Aer, strict 2, Division 7
030254
LYNDO TIPPETT
SECRETARY
wE7ZNOS1401 GROUP
MAR 0 3 2003
wArERQUALI
TVSFCrl
Payment Information - Water Quality Certificate forGuilford County,
Three Loy Road (SR 2856)
In accordance with General Statute 143-215.3D(e) the following information if being provided to
facilitate payment of fees associated with the appropriate Water Quality Certificate:
• Certificate being requested: #3375 (NWP14)
• Work Order Number : 6.492131T
• Amount of fee: $200
FILE COPY
401 ISSUED
f4j,-??F
Fp
PHONE [phone] FAX [phone]
AR
6..91A1
STATE OF NORTH CAROLINA
DEPART MNT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415
GOVERNOR
Ms. Cynthia Van der Wiele
Wetlands/401 Unit
NC DENR Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699
(Seven Copies)
Mr. John Thomas
U.S. Army Corps of Engineers
Regulatory Field Office
6508 Falls of the Neuse Road, Suite 105
Raleigh, North Carolina 2761
(Two Copies)
LYNDO TIPPETT
SECRETARY
03 02 55 4
SUBJECT: Guilford County, Upgrade of Three Loy Road (SR 2856) from an unpaved secondary
road to a paved secondary road. State Project Number: 6.492131T
To Whom It May Concern:
The North Carolina Department of Transportation (NCDOT) proposes to upgrade Three Loy Road
(SR 2856) from an unpaved to a paved secondary road to reduce future maintenance needs and
increase traffic safety. This activity will result in impacts to a stream due to the replacement and
extension of a crossline pipe to facilitate travel lane and shoulder widening. The NCDOT
anticipates that the pipe replacement activity will be authorized under Nationwide Permit (NWP)
14. This application is intended as request for written authorization from the NC Division of Water
Quality to replace the pipe under General Water Quality Certificate # 3375 (NWP 14). This
application is also intended to provide a courtesy copy to the US Army Corps of Engineers. The
following information is being provided to satisfy Condition 1 of General Water Quality Certificate
# 3375.
January 7, 2003
PHONE [phone] FAX [phone]
PROJECT INFORMATION
Road Name SR Number Project Length
(miles) Classification
Three Lo Road 2856 0.30 Rural

River Basin: DWQ
ID Water Quality
Designation
% Impervious Surface
Cape Fear 16-1149) C 5%
Buffer Rules° Buffer Rule Conditions (where applicable)
No Not Applicable
Protected Species
Presentb Mapped Historic
Properties' CAMA
AEC Essential Fishery
Habitat
No No No No
° Separate documentation attached as needed: ° See the attached Endangered Species Review Sheet for further
information: 'When Applicable - See the attached Historic Review Letter for further information
PIPE REPLACEMENT INFORMATION
Site 1(11+08) Stream Type Intermittent
(Station)
Existing 18" RCP - 32' Long Proposed 24" RCP or CMP 60'
Pie Pie Lon
Construction Pump around with on-site detour Dewatering ABC aggregate
Method Device*
Burial Depth 20% E/C Plan 11/12/02
Date
Construction As soon as practicable Duration 2 weeks
Date
Impacts (ft. 28' -enclosure; 10'-rip-rap dissipaters; 30'-temporary
Special
Conditions
Restoration Within 15 working days of the of the pipe replacement the natural stream
Plan contours will be restored and seeded. Temporary silt screens placed in will
be cleaned and removed following vegetation establishment.
RCP = reinforced concrete pipe; CMP = Corrugated metal pipe; CMPA = Corrugated metal pipe arch; E/C = Erosion
control. *A less intrusive dewatering device may be used in lieu of the one proposed.
-2-
MINIMIZATION INFORMATION
Impacts will be minimized by strict enforcement of Best Management Practices for the protection of
surface waters and wetlands, restrictions against the staging of equipment in or adjacent to waters of
the US, and coordination (including a pre-construction meeting) with the Division Environmental
Officer.
MITIGATION INFORMATION
Stream mitigation is not anticipated, as the impacts to any individual stream do not exceed 150 feet
Wetland mitigation is not anticipated, as wetland impacts do not exceed 0.10 acres and do not occur
in a unique natural wetland.
APPLICATION INFORMATION
Enclosed please find the Pre-construction Notification Form and supporting documentation for the
above referenced project. If you have any questions or need any additional information, please
contact Lane Hall at [phone]. Your time and effort are appreciated.
Sincerely,
Mills, P.E.
Engineer, Division 7
Mr. S. Lane Hall, District 2 EngineerJZ?L4
Mr. Paul Ingram, P.E., County Maintenance Engineer, Guilford
Mr. Donald Pearson, Area Roadside Field Operations Engineer
Mr. Kevin Hazelwood, Grade Crew Foreman
- 3 -
Office Use Only: Form Version May 2002
030 s-4
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project:
? Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 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 (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information
Name: Mr. J.M. Mills, RE, Division Engineer - Division 7
Mailing Address: P.O. Box 14996
Greensboro NC
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
2. Agent/Consultant 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: Not Applicable
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
Page 1 of 8
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: Three Loy Road
2. T.I.P. Project Number or State Project Number (NCDOT Only): 6.492131T (Non-TIP)
3. Property Identification Number (Tax PIN): Not Applicable
4. Location
County: Guilford Nearest Town: Osceola
Subdivision name (include phase/lot number): Not Applicable
Directions to site (include road numbers, landmarks, etc.):
The project is south of Osceola. Traveling North on NC 61 towards Osceloa take a left on.
High Rock Road and travel west until you get to Rivertrack Road. Take a Right on
Rivertrack and Three Loy Road will be about a mile on the left.
5. Site coordinates, if available (UTM or Lat/Long): See the attached USGS mo.
(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. Property size (acres): Not Applicable
7. Nearest body of water (stream/river/sound/ocean lake): UT to Reedy Creek
8. River Basin: Cape Fear
(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/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Primarily Agricultural
Page 2 of 8
10. Describe the overall project in detail, including the type of equipment to be used:
The project will involve paving an unpaved secondary road and bringing the travel lane
shoulders, ditchlines, and drainage structures up to current standards. Travel lane widening
will be required to bring the road up to current standards. Standard shoulder widths will be
6'-8' with deviations shown on the attached site plan. Ditch widths will vary based onsite
conditions. Proposed right-of-way width is illustrated on the attached site plan. Equipment
used will be standard road construction equipment (trackhoe, grader, backhoe, and
bulldozer).
11. Explain the purpose of the proposed work: To upgrade an unpaved secondary road to a
paved secondary road. Paving and widening are being conducted to reduce future
maintenance costs, bring the road up to current construction standards, and increase traffic
safety.
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.
Not Applicable
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.
Not Applicable
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 8
1. Provide a written description of the proposed impacts: Permanent stream impacts will
result from channel enclosure and placement of rip-rap energy dissipaters. Temporary stream
impacts will result from placement of cofferdams (perennial streams) and siltscreens. Silt
screens placed in intermittent channels will be cleaned and removed following vegetation
establishment.
2. Individually list wetland impacts below:
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***
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
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 http://www.rema.gov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: Not Applicable
Total area of wetland impact proposed: Not Applicable
3. Individually list all intermittent and perennial stream impacts below:
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?
(please secif )

1(11+08)
Pipe replacement 28'(en)
30'(tmp)
10'(r )
UT to Reedy Creek
2.0'
Intermittent

* 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.usgs.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www,tot)ozone.com,
www.mapguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 28'- enclosure (en),
30'- temporary (tmp), 10'- rip rap (rp)
Page 4 of 8
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
(indicate on ma)
Type of Impact* Area of
Impact
(acres) Name
Wat)
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
5. Pond Creation
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 illustrated 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.): Not Applicable
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): Not Applicable
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.
Pine replacement activities are necessarv to increase travel lane and shoulder width to current
construction standards. Impacts will be minimized by strict enforcement of Best Management
Practices for the protection of wetland and surface waters, restrictions against the staging of
equipment in or adjacent to waters of the US, and coordination (including a pre-construction
meeting) with the Division Environmental Officer.
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
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Page 5 of 8

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/ncwetlands/strmgide.html.
1. 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.
A finding of insignificant impact is anticipated; therefore, a mitigation plan is not provided.
Cumulative impacts are less than 150 feet. The maximum amount of impact to a single
stream is 38' linear feet. No Outstanding Resource Waters, federally protected species or
their habitats, or essential fishery habitats occur in the project area. The project is not located
in a High Quality Water.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.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): Not Applicable
Amount of buffer mitigation requested (square feet): Not Applicable
Amount of Riparian wetland mitigation requested (acres): Not Applicable
Amount of Non-riparian wetland mitigation requested (acres): Not Applicable
Amount of Coastal wetland mitigation requested (acres): Not Applicable
Page 6 of 8

IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) 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 (required by DWQ)
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
(Neuse), 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.
Zone* Impact
(square feet) Multiplier Required
Mitigation
1 N/A 3
2 N/A 1.5
Total N/A
" 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 8

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.
Not Applicable
XI. Stormwater (required by DWQ)
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 travel lane is 15-feet. The proposed travel lane is 18-feet. The proposed right-of-
way is 60-feet. The percent new impervious surface (relative to the right-of-way) is 5 %.
Because the percent new impervious surface is less than 30% stormwater controls are not being
provided.
XII. Sewage Disposal (required by DWQ)
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.
Not Applicable
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 211.0500) 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).
2 - 2/- O
pplicant/Agent's Signature Date
signature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 8
NATURAL RESOURCE EVALUATION SHEET
State Pro'ect # SR Number Road Name Coun Investigator(s)
6.49213 IT 2856 Three Loy Road Guilford Len Smith
Date: River Basin: Water Quality Designation Buffer Rules (Type)
03/07/02 Cape Fear C NSW No
Primary Land Use Percent Residential Percent Agricultural Percent Unmaintained
Apiculture 20 40 40
Federally Threatened or Endangered
Anticipated Permits or Consultations High Quality or Rare Wetlands Species
NWP 14 No No
Communi T e
Pine forest Dominant Trees
Virginia pine Dominant Shrubs
American holly, southern
red oak, sweet gum, Dominant Herb(s)
Japanese honeysuckle, ground
_pine, Christmas fem

waters oI the uo
.7 ?rCZ?uia
Perennial or
Ave. Wdth
Ave. Dpth
Ave. Wdth
Ave. Dpth
DNrQ ID.
ST Stream Name Intermittent OHWM OHWM TOB TOB
I 1+08 UT to Reed Creek Intermittent 2.0' <0.5' 2.5' 3.5' 16-11-(9)

5 t = station, VrtWwt = ivleasurcnlcuLa [lid C; uvu. v.u.-J ...g.. ........ ........_.,
made from the Top of the Bank
?? c?

ST aauua
Within 100-year
Floodpiain
Distance to
Nearest Stream
linear feet

Cowardin Classification

Dominant Plants
N/A

v ? cu ?? aaci
Name of Waterbody
Type of
Name of Watcrbody
Type of Waterbody
ST (if applicable) Waterbod M .M. if applicable)
N/A

General Notes/Comments: The stream at Station 11+08 starts at the road.
August 7, 2002
Division Environmental Officer Date
ENDANGERED SPECIES REVIEW FOR DIVISION 7
DISTRICT 2
State Project # SR Plumber Road Name county
6.49213 IT 2856 Three Lo Road Guilford
Guilford County
River Basin: Cade Fear
Bald Eagle (Haliaeetus leucocephalus). Lake Higgins Area.
Is the activity within the primary or secondary zone Yes ? No

JalllGJ J l1
Habitat 1 111YJJb1
Survey Date
Investigator(s)
Man-hours
Comments/Fiadings
N/A
Potential Species (Listed in Nearby Counties)
1\A., , 6. .-4 4i- £rnm IntP Auauct to nCtnher
J\.I1WG111II
Habitat L JJw ILV..... ?..,
Survey Date ....-......+.. ........-.. ..___._. __? __
Investigator(s) _-_
Man-hours
Comments/Findings
No 03/07/02 Len Smith 0.5
General Notes/Comments:
Division Environmental Officer
August 7, 2002
Date
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division Seven County Guilford Project ID: 6.492131T
River Basin Cape Fear Bridge No: -71
Route 2856 Stream UT to Reed Creek
Water Quality Criteria
Yes No
Stream Crossing Blueline on USGS ? Z
ORW ? Z
WSI ? Z
WS II, III, or IV Crossing Within 0.5 mi. of W.S. Critical Area ?
Roadway Criteria
Route Designation Yes No
Arterial Urban ?
Arterial Rural ? Z
Additional Site Information:
Yes No
Is a Hazardous Spill Basin Required? ?
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
LPG IND
E? IP Found P 7*;';c
Z.
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1/7/03
Site Station 11+05
Construction Sequence and Erosion Control Plan for Replacement of
Pipe with Pipe using an On-site Detour - Guilford County, SR 2856
Three Loy Road
Work to begin as soon as practicable following authorization.
Construction is anticipated to take 2 weeks.
1. Install a rock silt dam downstream of the work area to prevent incidental sediment
loss.
2. Install ABC aggregateor a less intrusive dewatering device to allow dewatering of the
work area.
3. Install pumps to divert flow around the work area.
4. Place a temporary extension at one end of the existing pipe to allow a travel lane
shift.
5. Place a temporary detour over the temporary extension.
6. Opposite the detour, remove existing RC pipe to at least the centerline of the
roadway.
7. Excavate to sufficient depth to allow 20% burial of the pipe, place base stone, and
sections of 30' long 24" CM pipe.
8. Backfill the new section of pipe and place rip rap only as needed.
9. Place the temporary detour over the new sections of pipe.
10. Remove remaining sections of pipe.
11. Excavate to sufficient depth to allow 20% burial of the pipe, place base stone, and
sections of 30' long 24" CM pipe.
12. Backfill the new section of pipe and place rip rap only as needed.
13. Remove the dewatering device and restore the natural stream contours.
14. Place final roadway in desired location.
15. Notify landscape department for final seeding.
16. Silt fences to be placed as site conditions require.
17. A 10' X 15' dirt bag will be used to remove excess water in the hole where the new
pipe is being replaced.
18. Site conditions and weather may alter these plans.
19. A method less intrusive than a pump around system may not be utilized if site
conditions allow.

r', t

'
\r I U

- .11
-1) 1
jht (C) 1997,
` lY
l r

-? t s

'
e° CSC P m

4 -owl
Ir

View Immediately Downstream
View Immediately upstream

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASixy
GOVEX,40R
Sincerely,
Richard Silvennan
Attachement
Jeremy Delapp
Assistant District Engineer
Division 7, District 2
1584 Yanceyville St.
PO Box 14996
Greensboro, 27415-4996
Dear Jeremy,
The NCDOT Historic Architecturo Section has received your county commission-approved 2002-2003
Secondary Roads Rural Paving Program. We have map-checked all submitted roads at the NC Historic
Preservation Office (14PO) for the following currently designated historic property types: National
Register (NR), Study List (SL), and Determined Eligible (DOE) properties. Based on the map-check
reviews, we are writing (t) to inform you of the current historic compliance status for your SR Rural
Paving Program; (2) to notify you of the SR projects that definitely will require our fieldwork; (3) to
provide you with information that can be included (or attached) in your cover letter for a Pre-Construction
Notification.
If coordination is required, the NCDOT staff architectural historian will notify the Division/District
Maintenance Engineers to start a mitigation effort involving onvirorunental commitment agreeable to all
parties. Documentation will be coordinated by the staff' architectural historian with the Division
Environmental Officer.
January 15, 2003
LYNDO TIPPETT
SECRETARY
When additional SR projects are added to a program, individual updates will be sent to the
Division/District Maintenance Engineers and the DRO. All status updates can be tracked on the Division
Support vvebsite. If there are errors or omissions in this letter or on the website, please a-mall your NCDOT
staff architectural historian or call the Division Coordinator, Richard Silverman, 919.733-7844 x398.
?MUNG ADDRESS:
NC DGPA WENT OF TRANSPORTATION
PROJICT DEVELOPMEN1 AND ENVIRONMENTAL ANALYSIS
1546 NAIL 36RMCG CeNTER
RALEIGH NC 27690-1s4a
TPL@PHONE; 019-733-3141
r-AX: 919.733.0704
V&9SITE: 1MMNW.DOH, DOT. STATE, NC. US
LOCATION:
TRANSPORTATION BUILDING
1 sourM WILMINGTON 5TR6¢T
RALEIGH NC

HISTORIC ARCHITECTURE STATUS REVIEW SMERT
NCDOT Secondary Roads Rural Paving Projects
The county-commission approved 2002-2003 SR Rural Paving Program for Division 7, District 2 has been
map-checked at the NC Historic Preservation Office by NCDOT Architectural Historians. The results of
this map-check should be included in your Pro-Construction Notification application (by attachment of this
document with the applicable SR# circled or by inclusion In your own letter).
Historic Properties Present (NR, SL, or DOE)
Status; THL DIVISION WILL NOT PROCEED until compliance work is completed by NCDOT
Historic Architecture gid Concurrence has been obtained from the NC Historic Preservation Office
Futher Inrormation & Scheduling; Contact your assigned Architectural Historian or go to
htm://www,dot,state,ne.us/nlanningloe/histurchi/dIvstipport/
Based on a review of USGS county survey quad maps at the HPO, the following roads have properties
that are currently designated as historic, Please do not proceed with consirtiction until compliance
work is completed by the Historic Architecture Section, We will be in contact with the
Division/District Maintenance Engineers and the Division Environmental Officer to coordinate this
effort. Please note: not all N& SL, or DOE properties will necessarily require mitigation. We will
work with the Division and District Maintenance Engineers if environmental commitments are
required. At any sitne, ifyou are not in agreement with the proposed mitigation efforts, please contact
Richard Silverman, Division Coordinator at 919-733.7844 x298,
Guilford: SR 3062 (National Register); SR 3081 (Determined Eligible Property)
HISTOMC ARCHITECTUkE STATUS REVIEW SHERT (Continued)
NCDOT Seoondary Roads Rural Paving Projects
No Designated Historic Properties Present (NO NR/SL/DOE)
Status for projects with No Federal Permit: PROCEED
Status for projects with a Federal Permit anticipated: PROCEED WITH CONDITIONS
(see below)
Futher lnformntion & Scheduling: Contact your assigned Architectural Historian or go to
http://w«ny,dot.state.nc.us/plann int2/pe/histarch i/dlvsupport/
Based on a review of USGS county survey quad maps at the PIPO, the following roads do not have
properties that are currently designated historic. The Division may proceed with construction with the
following conditions: If the Division applies for a Federal Permit, the NC Historic Preservation Office
(HPO) may request additional Celdwork, (usually to identify Potentially Eligible Properties).
Typically this request is made for counties where historic resource surveys have not been completed or
are out-or-date. If additional historic properties are ideatifled, further coordination, including
environmental eornmitments, may be roRLdred as part of the project, For SR Projects when no Federal
Permit is to be applied for, no further, compliance work is anticipated by NCDOT. 71iose projects may
proceed unconditionally,
Guilford: SR 2856, 3356, 1856, 2858, 3327, 2806, 2021, 2737, 1134, 3404, 3438, 3447, 3455