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A.,
f \ NA TF Michael F. Easley; Governor
0 R William G. Ross Jr., Secretary
`0? QG North Carolina Department of Environment and Natural Resources
Cr? r Alan W. Klimek, P.E. Director
Division of Water Quality
February 17, 2004
Montgomery County
DWQ Project No. 040203
Replacement of cross pipe on NC 73
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. Timothy Johnson, P.E., Division Engineer
NCDOT Division 8
P.O. Box 1067
Aberdeen, North Carolina 28315
Dear Mr. Johnson:
You have our approval, in accordance with the attached conditions and those listed below, to incur 70
linear feet of permanent impacts to an unnamed tributary to Richland Creek in order to replace a cross
pipe on NC 73 in Montgomery County. The project will be constructed in accordance with your
application dated February 4, 2004 (received February 11, 2004). After reviewing your application, we
have decided that this fill is covered by General Water Quality Certification Nos. 3366 and 3404
corresponding to the U.S. Army Corps of Engineers Nationwide •PermitNumbers 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 you may be required to
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. Erosion and sediment control practices must be in full compliance with all specifications governing
the proper design, installation and operation and maintenance of such Best Management Practices in
order to protect surface water standards:
¦ The erosion and sediment control measures for the project must be designed, installed, operated,
and maintained in accordance with the most recent version of the North Carolina Sediment and
Erosion Control Planning and Design Manual.
¦ The design, installation, operation, and maintenance of the sediment and erosion control measures
must be such that they equal, or exceed, the requirements specified in the most recent version' of
the North Carolina Sediment and Erosion Control. Manual. The devices shall be maintained on
all construction sites, borrow sites, and waste pile (spoil) projects, including contractor-owned or
leased borrow pits associated with the project.
¦ If there are borrow pit sites, the erosion and sediment control measures must be designed,
installed, operated, and maintained in accordance with the most recent version of the North
Carolina Surface Mining Manual.
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), hnp://h2o.enr.state.nc.us/nowetiands/

Mr. Timothy Johnson, P.E.
DWQ 040203
February 17, 2004
¦ Any reclamation measures and implementation must comply with the reclamation in accordance
with the requirements of the Sedimentation Pollution Control Act.
2. No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas -
beyond the footprint of the impacts depicted in the Preconstruction Notice Application. All
construction activities, including the design, installation, operation, and maintenance of sediment
and erosion control Best Management Practices, shall be performed so that no violations of state
water quality standards, statutes, or rules occur.
3. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters
is unavoidable, they shall be removed and the natural grade restored within six months of the date
that the Division of Land Resources has released the project.
4. NCDOT is encouraged to use onsite vegetation and materials for streambank stabilization when
practicable.
5. Riparian. vegetation must be reestablished within the construction limits of the project by the end
of the growing season following completion of construction.
6. Stormwater should be directed to vegetated buffer areas, grass lined ditches or other means
appropriate to the site for the purpose of pre-treating <stormwater runoff, and must not be routed
directly into streams. Mowing of existing vegetated buffers is strongly discouraged, so that they
may be utilized for stormwater sheet flow.
7. Where fish passage is present or where significant aquatic life may be present upstream (and
where practicable), culverts should be oversized and buried to prevent perched culverts. If
oversized piping cannot restore aquatic life; passage by reconnecting the stream ecosystem, riprap
installation should be accomplished in a manner to provide or restore water channels downstream
to help facilitate aquatic life movement.
8. Where: practicable; culverts that are less than 48-inch in`.diameter should be buried to a depth
equal to or greater than 20% of their size to allow for aquatic life passage. Culverts that are 48-
inch in diameter or larger should be buried at least 12 inches below the stream bottom to allow
natural stream bottom material to become established in the culvert following installation and to
provide aquatic life passage during periods of low flow. These measurements must be based on
natural thalweg depths. This may require increasing the size of the culvert to meet flow
conveyance requirements. If any of the existing pipes are perched, they shall be removed and
replaced, and re-installed correctly, unless demonstrated that this is topographically unfeasible.
All waters must flow through without freefalling or damming on either end of the culverts during
low flow conditions, to maintain aquatic life and/or fish passage.
9. _ The dimension, pattern and profile of the stream, above and below the crossing, should not be
modified by widening the stream channel or reducing the stream depth. Disturbed floodplains
and streams should be restored to natural, geomorphic conditions.
10. Riprap should be minimized and installed in a manner so. as not interfere with aquatic life passage
during low flow conditions. Riprap placed for bank stabilization should be limited to the
streambank below the high water mark and vegetation should be used for stabilization above the
high water mark.
11. If concrete is used, work must be accomplished so the wet concrete does not contact the stream
water. This will lessen the chance of altering the stream's water chemistry and causing a fish kill.
12. Heavy equipment must be operated from the banks rather than in the stream channel in order to
minimize sedimentation and reduce the likelihood of introducing other pollutants into the stream.
13. 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.
Mr. Timothy Johnson, P.E.
DWQ 040203
February 17, 2004
14. 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.
15. Removal of vegetation and grading and backfilling at the stream crossing and adjacent:to stream
should be minimized. Native trees and shrubs should be planted along the streambank to
reestablish the riparian zone and provide long-term erosion control and cover for fish and wildlife
in the vicinity of the road crossing and along the streams within the dedicated rights of way.
Backfill materials should be obtained from upland sites.
16. All work shall be performed during low flow conditions.
17. 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 NCDOT
is strongly advised to send in photographs upstream and downstream of each structure to
document correct installation.
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 unlessyou 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.
Michael Parker of the Mooresville Regional Office at 704.663.1699.
S• ly,
Alan W. Klimek, P.E.
Attachment
Pc: Wilmington District Corps of Engineers
Richard Spencer, USACE Wilmington Field Office
NCDWQ Mooresville Regional Office
Central Files
File Copy
401 ISSUED ? FILE COPY
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DIVISION OF HIGHWAYS LYNDO TIPPETT
GOVERNOR SECRETARY
February 04, 2004
Richard K. Spencer cc: Mr. Rob Ridings
Regulatory Division NCDWQ
U.S. Army Corps of Engineers 401 Wetlands Unit
P.O. Box 1890 1630 Mail Service Center
Wilmington, NC 28402-1890 040203 Raleigh, NC 27699-1630
Subject: Nationwide Permit:#14 & #33 WETLANDS/ 401 GROUP
SR: Hwy. NC 73 County: Montgomery County
Project: 8B.201911 (DWQ Permit Fee $200)
FEB 1 z 2004
Mr. Spencer:
The North Carolina Department of Transportation Highway Division 8 is requesting Nationwi?l1?T?rECTIQN
14 and 33 for project 8B.201911 on NC Hwy 73 in Montgomery County. The proposed project will extend
existing deficient crossing pipe in order to widen the shoulder and improve safety at the intersection of NC 73 and
SR-1112. The extension will be as follows:
Site 1) An additional 20ft of 66" x 51" CMP will be joined to the existing culvert. 50ft of channel
realignment will also be needed to improve the hydraulic flow into the pipe.
This pipe is located under the intersection of NC 73 and SR-1112 in Montgomery County. The pipe extension is
needed to allow us to increase the road shoulder width at this location. The existing narrow shoulder and resulting
tight turn radius has caused repeated damaged to the guardrails by large trucks turning at this intersection.
The total percentage of impervious surface within the project area will remain at less than 30%. All erosion
control devices will be appropriate to the location and in compliance with the current version of the NCDOT Best
Management Practices manual. There are no wetlands, HQW or OWR located within the project areas.
The pipe extension is located on Richland Creek, a class WS-IV b stream in the Yadkin River basin. The total
permanent stream impacts for this project will consist of 70 ft. including the realignment and dewatering.
Construction will be done under dry conditions whenever possible.
There were no threatened or endangered species observed within the project area.
If you require any additional information, please contact me. N, YMFN T
Sincerely, R Crj V ED
Art C. King
Division Environmental Officer, Highway Division 8
cc: Tim Johnson, PE
T.F. Welch, PE
P.O. BOX 1067, ABERDEEN NORTH CAROLINA 28315
PHONE [phone] FAX [phone]
e.,s STATE' u
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P.O. BOX 25201, RALEIGH, N.C. 27611-5201 LYNDO TIPPETT
GOVERNOR SECRETARY
September 29, 2004
North Carolina Division of Water Quality
401 /Wetlands Unit OCT 0 5 2004 U
1621Mail Service Center
Raleigh, NC 27699-1621 WETLAN °ENR - WATER QUALITY
DS AND STORA#WATER BRANCH
Reference: DWQ Project No. 040203
NCDOT/NC 73 Montgomery County
Dear Sir or Madam:
Attached is certification of completion for the work performed under the above
referenced permit. The certification is signed by our field agent. If additional
information is required please advise.
Sincerely,
?s?ti,,4.,ny
Timothy hnson P.E.
Division Engineer
Attachment
cc: Tim Welch, PE
Barry Harrington
Art King
File
DIVISION 8, P. O. BOX 1067, ABERDEEN, NC 28315
Telephone: [phone] Fax: [phone]
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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.: Oa 03 County: fy) 10 n1g0f1V
Applicant: iii- po- . -T;.r. 1]- oknson , ?E OtvlSIOZ( 8
Project Name: WC '13
Date of Issuance of 401 Water Quality Certification: Fsb r v o,r.,
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
1, 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:
Agent's Certification
I, --J? F Wr: L CN , 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 lans and specifications, and other supporting materials.
Signature: M? Date: 9- Z3 _ 01-
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_materi:als.
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/ncwetlands/
fZDnN
x
Office Use Only: Form Version October 2001
04020
USACE Action ID No. DWQ No.
If any particular item is not app 'cab e to ,,_Ws proje please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
I. Processing E WETLANDS / 401 GROUP
I
1. Check all of the approval(s) requested or this COPY project: FEB 1 1 2004
® Section 404 Permit
? Section 10 Permit WATER QUALITY SECTION
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: 14 & 33
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: ?
H. Applicant Information
1. Owner/Applicant Information
Name: North Carolina Department of Transportation
Mailing Address: Timothy Johnson, P.E. Division Engineer
North Carolina Department of Transportation. Division 8
P.O. Box 1067
Aberdeen, North Carolina 28315
Telephone Number: [phone] Fax Number: 910 944-5623
E-mail Address: TJohnson&dot.state nc us
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: T. F. Welch PE
Company Affiliation: NC Department of Transportation
Mailing Address: PO Box 289
Siler Citv NC 27344
Telephone Number:_ 919) 742-5649 Fax Number: (919 663-0214
E-mail Address: -twelchnadot.state.nc us
L ? ? / yi

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 NC 73 Montgoome County
2. T.I.P. Project Number or State Project Number (NCDOT Only): 813.201911
3. Property Identification Number (Tax PIN): N/A
4. Location
County : Montgomery Nearest Town: Pee Dee
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From Pee Dee follow NC 73 NW
approx. 1 mile. Culvert is located at the intersection of NC 73 & SR 1112
5. Site coordinates, if available (UTM or LaVT ong): N 35* 16.06' W 80* 2.56'
(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:
Rural
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): Richland creek Class WS-IV bl
9. River Basin: Yadkin-Pee Dee
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h?o.enr.state.nc.us/admin/maps/.)
_6

10. Describe the purpose of the proposed work: Extend existing 3'x 4' Concrete Culvert with
20' of 66" x 51" CUT.
11. List the type of equipment to be used to construct the project: Excavator
12. Describe the land use in the vicinity of this project: Rural/Residential
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 stream (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.
-7-
V==
1. Wetland Impacts
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Fooodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***
None

- Lisa each impact separatery and identity 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 1ittp;/hvl\1C tema.ac?v.
*** 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:
Total area of wetland impact proposed:
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?
leasespecify)
Perm. pipe 20 ft UT to Richland Creek 2.5 ft Intermittent
realignment 50 ft

* 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
«NiNiv.uses.co?. Several internet sites also allow direct download and printing of USGS maps (e.g., ?NiAi vtopozone.com,
xxw\%.mapquest.com, eta).
Cumulative impacts (linear distance in feet) to all streams on site: 70'
-8-
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
Open Water Impact
Site Number

indicate on ma
Type of Impact* Area of
Impact

acres
Name ofWaterbody
(if applicable) Type of Waterbody

(lake, pond, estuary, sound,
-bay, ocean, etc.
None

last each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. 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.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
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.
N/A
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.
-9-
r"
USACE In accordancewith 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/strmctide. 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.
NIA
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 hq://h2o.enr.state.ne.us/Amr inde .hnn. 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):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
ro
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.
Zone" Impact
(square feet Multiplier Required
Mitigation
1 3
2 1.5
Total
[one 1 extends out 30 teet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
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.
N/A
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.
Neither the current impervious cover (asphalt paveffient) nor the new proms impervious cover
(asphalt pavement) will exceed 30% of the total site area. Erosion control devices appropriate to
the site will be utilized on this project which may include silt fences, check dams and storm
water retaining basins.
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 1®Q Wetland Rules (1 SA 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).
-J Pwg- 2-,5 -44
Applicant/Aga's Ygnature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
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