20050655 Ver 1_Complete File_20050422

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April 22, 2005
Gates County
DWQ Project No. 050655
APPROVAL of 401 Water Quality Certification
Mr. Anthony Roper, P.E. Division Engineer
NCDOT, Division 1
113 Airport Drive
Suite 100
Edenton, NC 27932
Dear Mr. Nance:
You have our approval, in accordance with the conditions listed below, for the following impacts for the purpose of
road widening and pipe replacements on SR 1418 (Spivey Road) in Gates County.
Impact Locations Stream Impacts - Permanent Fill
(Linear Feet)
Site 1 10
Site 2 4
Site 3 4
Site 4 4
Site 5 2
Site 6 14
Site 7 8
Site 8 10
The project shall be constructed in accordance with your application dated received April 19, 2005. After reviewing
your application, we have decided that the stream impacts described are covered by General Water Quality
Certification Numbers 3404. This certification corresponds to the Nationwide Permit 14 issued by the Corps of
Engineers. 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 valid solely for the purpose and design described in your application (unless modified below).
Should your project change, you must notify the DWQ and submit 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 the conditions. If total wetland fills for this project (now or in the future) exceed one acre, or of total
impacts to streams (now or in the future) exceed 150 linear feet, compensatory mitigation may be required as
described in 15A NCAC 2H.0506 (h) (6) and (7). For this approval to remain valid, you must adhere to the
conditions listed in the attached certification.
1.) Upon completion of the project, the NCDOT shall complete and return the enclosed "Certification of
Completion Form" to notify DWQ 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 Division of
Water Quality upon completion of the project.
N??"Caro rna
at!lCa?ly
Transportation Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: httg://h2o.enr.state.nc.us/ncwetlands
A. C--1 n......-.-./AH1.......-- -2- L.....1....... -/ o,.....,.I. Al ro/ n- n....-....., o.......
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
2.) During the construction of the project, no staging of equipment of any kind is permitted in waters of the U.S., or
riparian buffers.
3.) Riparian vegetation must be reestablished within the construction limits of the project by the end of the growing
season following completion of construction.
4.) 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 depth of the stream. Disturbed floodplains and streams should be
restored to natural geomorphic conditions.
5.) Any riprap used must not interfere with thalweg performance and aquatic life passage during low flow
conditions.
6.) 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.
7.) Discharging hydroseed mixtures and washing out hydroseeders and other equipment in or adjacent to surface
waters is prohibited.
8.) The outside buffer, wetland or water boundary located within the construction corridor approved by this
authorization shall be clearly marked by highly visible fencing prior to any land disturbing activities. Impacts
to areas within the fencing are prohibited unless otherwise authorized by this certification.
9.) There shall be no excavation from or waste disposal into jurisdictional wetlands or waters associated with this
permit without appropriate modification of this permit. Should waste or borrow sites be located in wetlands or
stream, compensatory mitigation will be required since it is a direct impact from road construction activities.
10.) 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.
11.) Placement of culverts and other structures in waters, streams, and wetlands must be placed below the elevation
of the streambed by one foot for all culverts with a diameter greater than 48 inches, and 20 percent of the
culvert diameter for culverts having a diameter less than 48 inches, to allow low flow passage of water and
aquatic life. Design and placement of culverts and other structures including temporary erosion control
measures shall not be conducted in a manner that may result in dis-equilibrium of wetlands or stream beds or
banks, adjacent to or upstream and down stream of the above structures. The applicant is required to provide
evidence that the equilibrium shall be maintained if requested in writing by DWQ.
12.) If the above condition (#11) is unable to be met, due to bedrock or other limiting features, encountered during
construction, please discontinue activities and contact the NCDWQ for directions on how to proceed.
13.) No live or fresh concrete shall come into contact with waters of the state until the concrete has hardened.
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.) All work shall be performed during low or normal flow conditions.
16.) All fill slopes located in jurisdictional wetlands shall be placed at slopes no flatter than 3:1.
17.) A copy of this Water Quality Certification shall be posted on the construction site at all times. In addition, the
Water Quality Certification and all subsequent modifications, if any, shall be maintained with the Division
Engineer and the on-site project manager.
0'.
18.) All riparian buffers impacted by the placement of temporary fill or clearing activities shall be restored to the
preconstruction contours and revegetated with native woody species upon completion of the project
construction. A post-construction as-built with the restoration activities included shall be submitted to the
DWQ no later than 60 days after the project is closed out by the Department of Transportation.
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, P.O. Box 27447,
Raleigh, N.C. 276 1 1-7447. 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 contact Christina Breen at [phone].
gWW ly,
. Klimek, P.E.
JEH/cmb
Attachment
cc: Mr. Bill Biddlecome, US Army Corps of Engineers, Washington Field Office
Mr. Clay Willis, Division 1 Environmental Officer, 113 Airport Drive, Edenton, NC 27932
NC DWQ Washington Regional Office
Central Files
File Copy
c:\Correspondence\2005 SR Projects\DWQ050655\042205wgc.doc
t
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR ti+ SECRETARY
Division of Water Quality
401/Wetlands Unit
1650 Mail Service Center
Raleigh, N.C. 27699-1650
Attention: Nicole Thomson
April 14, 2005
oSO655
Qr?c?[ROW m-4
APR 1 9 2005
DENR • WATER QUALITY
WETLANDS AND STORMWATER BRANCH
Subject: notification for a NW 14 for road widening and pipe replacements on SR 1418 (Spivey
Road) in Gates County.
The North Carolina Department of Transportation is sending a e1111111111ft NW 14 permit notification
for asphalt widening on SR 1418 (Spivey Road) in Gates County from 16' to 20'. There are also some pipe
replacements associated with the asphalt widening. These pipes are located along eight locations. Site 1 is
located 0.26 miles from SR 1414 (Hobbsville Road). Site 2 is located 0.35 miles from SR 1414. Site 3 is
located 1.04 miles from SR 1414. Site 4 is located 1.50 miles from SR 1414. Site 5 is located 1.76 miles
from SR 1414. Site 6 is located 0.05 miles from SR 1417 (Spivey Road). Site 7 is located 0.46 miles from
SR 1417. Site 8 is located 0.57 miles from SR 1417. These pipes will be removed using NCDOT best
management practices for pipe replacement. The PCN, vicinity map, and permit drawings are included
with this letter. If you need any additional information or have any questions concerning this project please
call me at 252-482-7977.
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Sincerely,
Anthony Roper, PE
Division One Engineer f
Clay Willis
Division One Env' onmental Officer
Cc Bill Biddlecome, USACOE
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Office Use Only: nn Form Version May 2002
USACE Action ID No. : DWQ N(a n r
(If any particular item is not applicable to this proj6ct, please enter "Not Applicable" or "N/A".)
I. Processing " a
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: NW 14
3. If this notification is solely a gourtesy copy because written approval for the 401 Certification
is not required, check here;?a
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: Clay Willis, NC DOT Division 1 Environmental Officer
Mailing Address: 113 Airport Drive
Suite 100
Edenton NC 27932
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: tcwillis(Ddot.state.nc.us
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: N/A
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page 5 of 13
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: SR 1418 Pipe Replacements ; Gates County
2. T.I.P. Project Number or State Project Number (NCDOT Only): 1C.037030
3. Property Identification Number (Tax PIN):
4. Location
County: Gates County Nearest Town: Sunbury
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): From Sunbury, Take NC 32
south for approximately 7.7 miles. Turn left onto SR 1414 (Hobbsville Road and go
approximately 1.1 miles. Turn right onto SR 1418 (Spivey Road). Site 1 is approximately
0.26 miles from SR 1414. Site 2 is approximately 0.35 miles from SR 1414. Site 3 is
approximately 1.04 miles from SR 1414. Site 4 is approximately 1.50 miles from SR 1414.
Site 5 is approximately 1.76 miles from SR 1414. Keep straight through the intersection of
SR 1418 and SR 1417 (Selwin Road). Site 6 is approximately 0.05 miles from SR 1417.
Site 7 is located approximately 0.46 miles from SR 1417. Site 8 is located approximately
0.57 miles from SR 1417.
5. Site coordinates, if available (UTM or Lat/Long): Site 1 36.338013N, 76.615366W,
Site 2 36.337069N 76.613991W, Site 3 36.320875N 76.604288W, Site 4 36.331525N
76.596255W, Site 5 36.333419N 76.596255W, Site 6 36.334833N 76.585680W,
Site 7 36.338683N 76.580352W, Site 8 36.338525N 76.578777W.
(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): 23.64 acres
7. Nearest body of water (stream/river/sound/ocean/lake): Warwick Creek (Welsh Pond)
Page 6 of 13
8. River Basin: Chowan River Basin
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at httn:/ih2o.einr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site an&g6neral land use in the vicinity of the project
at the time of this application: woodlands rural residential, agriculture
10. Describe the overall project in detail, including the type of equipment to be used: Widen
asphalt of SR 1418 from 16' to 20'. No widening of ditches are expected. Replace the
existing pipes with proposed pines on its current alignment. The existing pipe will be
removed entirely. The existing and proposed Pines are: Site 1 existing pipes two P, 40' x 48"
CMP and replace with two P,, 50' x 48" CMP. Site 2 existing pipe one na, 36' x 18" CMP
and replace with one (a, 40' x 24"CMP. Site 3 replace existing pipe (36' x 48" RCP with
one Pipe 40' x 48" CMP. Site 4 replace existing pipe (36' x 24" CMP) with one pipe 40' x
30" CMP. Site 5 replace existing nine (48' x 48" CMP) with one pipe 50' x 48" CMP.
Site 6 replace existing pipe 36' x 36" x 54" CMP) with one pine 50' x 36" x 54". Site 7
replace existing pipe (32' x 18" CMP) with one pipe 40' x 24" CMP. Site 8 replace existing
Pine (40' x 30" CMP) with one pipe 50' x 36" CMP. Proper fill will be used to bring road to
existing height. Excavated fill will be hauled to appropriate sites. Heavy equipment used will
include an excavator, crane, backhoe, and dump trucks.
11. Explain the purpose of the proposed work: To replace structurally deficient pipes and
widen asphalt to provide safer travel for the public.
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.
There have been no prior permits issued on this project.
V. Future Project Plans
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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.
None
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.
1. Provide a written description of the proposed impacts: There will be no permanent
impacts.
2. Individually list wetland impacts below: N/A
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, 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.fenia.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:
Total area of wetland impact proposed:
Page 8 of 13

3. Individuall list all intermittent and perennial stream imp acts below:
Stream Impact Length of Average Width Perennial or
Site Number Type of Impact* Impact Stream Name** of Stream Intermittent?
indicate on ma linear feet) .1 Before Impact leasespecify)
Site 1 Fill 10 feet Unnamed trib. To 10-15 feet Perennial
Warwi Creek
Site 2 Fill 4 feet Unnamed trib. To 2-3 feet Intermittent
Warwick Creek
Site 3 Fill 4 feet Unnamed trib. To 3-5 feet Intermittent
Warwick Creek
Site 4 Fill 4 feet Unnamed trib. To 3-5 feet Perennial
Warwick Creek
Site 5 Fill 2 feet Unnamed trib. To 5-7 feet Perennial
Warwick Creek
Site 6 Fill 14 feet Unnamed trib. To 10-12 feet Perennial
Warwick Creek
Site 7 Fill 8 feet Unnamed trib. To 2-3 feet Perennial
Warwick Creek
Site 8 Fill 10 feet Unnamed trib. To 3-5 feet F Perennial
Warwick Creek
* 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
dm mstrcam 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 intemct sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 56 feet
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below: None
Open Water Impact Area of Name of Waterbody Type of Waterbody
Site Number Type of Impact* Impact (if applicable) (lake, pond, estuary, sound,
indicate on ma acres ba , 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.): N/A
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, ,, .
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:
u .
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.
Pipe replacement is going to stay on the existing alignment and traffic will be detoured
around the site by using an off-site detour. This will reduce temporary impacts to wetlands and
the creek by not utilizing an on-site detour and keeping the road open. The existing pipes are
being replaced with a longer pipe to widen the road and shoulders to allow for safer travel. No
permanent impacts are expected to the wetlands.
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.
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
littp://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
Page 10 of 13
, a.
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). 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): N/A
Amount of buffer mitigation requested (square feet): N/A
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 (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federaUstate) 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
Page 11 of 13
' 1 ,.
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 213 .0259 (Tar-Pamlico), 15A NCAC 213 .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
Zone I extends out 3U tect perpendicular from near bank of channel; Zone 1 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 (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.
Impervious acreage will increase by 1.60 acres.
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.
There is no sewage disposal associated with this project.
Page 12 of 13
$ . ,,
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XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rule$ (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).
N/A

Appliean?gent's Signature Date
(Agent's signatur is valid only if an authorization letter from the applicant is provided.)
Page 13 of 13