20041029 Ver 1_Complete File_20040624

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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Uj

O Alan W. Klimek, P.E. Director
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality

July 1, 2004
Ashe Counties
DWQ Project No. 04-1029
SR 1623 (Ebenezer Rd)
APPROVAL of 401 Water Quality Certification
Mr. Mike Pettyjohn, P.E.
Division Engineer, Division 11
N C Department of Transportation
Post Office Box 250
North Wilkesboro, North Carolina 28659
Dear Mr. Pettyjohn:
WETLANDS/ 401 GROUP
JUL Z 5 '1.004
WATER QUALITY SECTION
You have our approval, in accordance with the attached conditions and those listed below, to impact 83
linear feet of three (3) different unnamed tributaries to Roan Creek (53 feet of new pipe and 10 feet of rip-
rap), and 0.0125 acres of impact of fill to a wetland, in order to widen and improve traffic safety on SR
1623 (Ebenezer Rd) in Ashe County. The project shall be constructed in accordance with your
application dated June 22, 2004 (received June 24, 2004).
After reviewing your application, we have decided that this fill is covered by General Water Quality
Certification No. 3404, corresponding to the U.S. Army Corps of Engineers Nationwide Permit Number
14. In addition, you should acquire any other federal, state or local permits before you proceed with your
project including (but not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply
Watershed regulations. This approval will expire with the accompanying 404 permit, unless otherwise
specified in the Water Quality Certification.
This approval is valid solely for the purpose and design described in your application (unless modified
below). Should your project change, you must notify the Division of Water Quality (Division) and
submit a new application. If the property is sold, the new owner must be given a copy of this approval
letter and certifications, 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 if 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 and any additional conditions listed below.
1. Instream work and land disturbance within the 25 foot wide buffer zone are prohibited during the
brown and brook trout spawning season of October 15 through April 15 to the egg and fry stages
of trout from off-site sedimentation during construction.
2. Roan Creek and its tributaries are classified as Trout waters. NCDOT shall strictly adhere to the
Best Management Practices for the Protection of Surface Waters (NCDOT August 2003) and
Sedimentation and Erosion Control Guidelines for Sensitive Watersheds [15A NCAC 4B .0124
(a)-(e)] throughout design and construction of the project.
3. Where practicable, sediment and erosion control devices that can continue to receive and treat
road surface runoff should remain in place (slight modifications acceptable) and be allowed to
naturalize to provide long term stormwater filtration.
MAN
N. C. Division of Water Quality 1650 Mail Service Center Raleigh, NC 27699-1650 [phone]
Customer Service: 1 800 623-7748
Mr. Mike Pettyjohn, P.E.
July 1, 2004
DWQ#04-1029
Page 2
4. 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 waters standards:
a. 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.
b. 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.
c. For 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.
d. The reclamation measures and implementation must comply with the reclamation in
accordance with the requirements of the Sedimentation Pollution Control Act.
5. 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.
6. 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.
7. Riparian vegetation must be reestablished within the construction limits of the project by the end
of the growing season following completion of construction.
8. 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.
9. 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.
10. The dimension, pattern and profile of the stream above and below all crossings should not be
modified by widening the stream channel or reducing the depth of the stream.
11. Disturbed floodplains and streams should be restored to natural geomorphic conditions.
12. 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. Any rip-rap used must not
interfere with aquatic life passage during low flow conditions.
Mr. Mike Pettyjohn, P.E.
July 1, 2004
D WQ#04-1029
Page 3
13. If concrete is used, work must be accomplished so the wet concrete does not contact the stream
water. This will lessen the change of altering the stream's water chemistry and causing a fish kill.
14. 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.
15. 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.
16. 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.
17. All work shall be performed during low flow conditions.
18. 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.
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, which 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 contact Sue Homewood at 336-771-4600 extension 252 or
[e-mail].
Sincerely,
Alan W. Klimek, P.E.
Attachment
cc: Wilmington District Corps of Engineers
John Thomas, USACE Raleigh Field Office
Heath Slaughter, Division Environmental Officer, NCDOT Division 11
Wetlands/401 Unit
Winston Salem Regional Office
Central Files
Mr. Mike Pettyjohn, P.E.
July 1, 2004
DWQ#04-1029
Page 4
DWQ Project No.:
County:
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
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, 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 to send certificates from all of these.
Applicant's Certification
I, , hereby state that, to the best of my abilities, due care
and diligence was used in the observation of the construction such that the construction was observed to
be built within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules,
the approved plans and specifications, and other supporting materials.
Signature:
Agent's Certification
Date:
I, , hereby state that, to the best of my abilities, due care
and diligence was used in the observation of the construction such that the construction was observed to
be built within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules,
the approved plans and specifications, and other supporting materials.
Signature:
Engineer's Certification
Partial Final
Date:
1, , as a duly registered Professional Engineer in the State
of North Carolina, having been authorized to observe (periodically, weekly, full time) the construction of
the project,for the Permittee 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
?.'?.?.?
all
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P. O. Box 25201, Raleigh, NC 276 1 1-5202 LYNDO TIPPETT
GOVERNOR Pi IONe: 919-733-2520 SITRUARY
June 22, 2004
Mr. John Thomas
WET?gNQS?401(?RQUP
U. S. Army Corps of Engineers
Raleigh Regulatory Field Office
6508 Falls of Neuse Road, Suite 120 .11J/V 2 4 1004
Raleigh, NC 27615 "ATERQUA'7r Subject: Nationwide Permit # 14 SECT??N
SR 1623 (Ebenezer Road)
Ashe County, North Carolina
Project Number: 11C.005064 (DWQ Permit Fee: $200)
Dear Mr. Thomas:
The NC Department of Transportation is scheduled to grade, drain, base and pave SR 1623, Ebenezer
Road in Ashe County. Total project length is approximately 1.1 miles. Please note that we have a gap
section from station 0+00 - 10+10 due to right-of-way restrictions. The roadway width will increase from
16' to 20' and will be paved. Impervious surface area will increase by 0.54 acres. This project will
require the replacement of three (3) wet pipes and 0.0125 acres of wetland fill as shown below:

Station Number Existing Structure
Size Proposed Pipe
Size Riprap Impacts
feet Total Impacts at
this Station ft.
28+78 30'x 18" 45'x 24" 10 25
41+63 61'x 24" 85'x 24" 10 34
54+13 41'x 24" 55'x 36" 10 24

Total Stream Impacts = 83 feet
Wetland Im act Summa Sheet
Station No. Impact Acres
28+75 (Rt. 0.0125
Construction of this project will require impacts to waters of the United States in the New River Basin.
Each of the above noted wet pipes carry different unnamed tributaries to Roan Creek (Class: WS-IV, Trout
+). This project was reviewed for the presence of threatened and endangered species on June 11, 2004.
This project will have no effect on any federally listed endangered plant or animal species. The State
Historic Preservation Office has reviewed this project and did not request any survey work.
P. O. Box 250, N. WILUSBORO, NC 28659
PHONE. [phone] FAX [phone]
Mr. John Thomas
SR 1623, Ebenezer Road, Ashe
Page 2
June 22, 2004
The proposed impacts are minor in nature and should not remove or degrade existing water quality uses.
Pipe sizes used will be the minimum necessary to create a safe roadway. By utilizing the erosion control
measures outlined in the attachments to this application, downstream water quality standards will be
protected. All appropriate BMPs will be used during construction.
Attached is a Preconstruction Notification Form, plan sheets with proposed erosion control measures, a
marked county map, a marked topography map and photographs.
By copy of this letter, it is requested that Mr. Ron Linville, Mountain Region Coordinator, with the North
Carolina Wildlife Resources Commission comment directly to you concerning the 404 Nationwide Permit
application with a copy sent to me. Please be advised that a trout buffer variance will be needed for land
disturbance within the 25' buffer of Roan Creek from stations 40+00 - 42+00 (Rt.).
By copy of this letter, I am forwarding seven (7) copies of this application package to Cynthia Van Der
Wiele, NCDENR, Division of Water Quality, 401/Wetlands Unit, for her review. It is requested that any
comments related to the 401 certification be forwarded directly to me with a copy sent to the US Army
Corps of Engineers.
We would like to begin construction as soon as possible. If further information is required, please let me
know. Your early review and consideration will be appreciated.
Sincerely,
Heath Slaughter
Division Environmental Officer
Enclosures
cc: John Thomas, US Army Corps of Engineers (1 additional copy)
Ron Linville, Western Piedmont Region Coordinator, NCWRC
Cynthia Van Der Wiele, Division of Water Quality (7 copies)
Sue Homewood, Division of Water Quality
Matt Gantt, PE, Land Quality Section
Mike Pettyjohn, PE, Division Engineer
Doug Tetzlaff, District Engineer
Doug Eller, County Maintenance Engineer
Heath Slaughter, Division Environmental Officer
Neil Trivette, Roadside Environmental Field Operations Engineer
Office Use Only: Form Version April 2001
USACE Action ID No. DWQ No.
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
1. Processing
Check all of the approval(s) requested for this project:
® Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: NW
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ?
II. Applicant Information
1. Owner/Applicant Information
Name: North Carolina Department of Transportation
Mailing Address: P. O. Box 250, North Wilkesboro NC 28659
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: hslaughter@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: Heath Slaughter, Division Environmental Officer
Company Affiliation: North Carolina Department of Transportation
Mailing Address: P. O. Box 250, North Wilkesboro NC 28659
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: hslaughter@dot state ne us
Page 3 of 12
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 1623, Ebenezer Road
2. T.I.P. Project Number (NCDOT Only): 11 C.005064
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Ashe Nearest Town:_ Glendale Springs
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): See attached SR map
5. Site coordinates, if available (UTM or Lat/Long):
28+78 DD: 36.3720 'N, 81.3522 0 W
(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:
Residential/Farm
7. Property size (acres):.. Approximately 6.6 acres
8. Nearest body of water (stream/river/sound/ocean/lake): _ UTs to Roan Creek (Class: WS-IV,
Trout +)-
9. River Basin:
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://l12o.eiir.state.iic.us/adniin/niii)s/.)
Page 4 of 12
10. Describe the purpose of the proposed work: Grade, drain base and pave SR 1623
11. List the type of equipment to be used to construct the project: Track hoe/backhoe, motor
grader and dump trucks.
12. Describe the land use in the vicinity of this project: Residential/Farm
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.
V. Future Project Plans
Are any additional permit requests anticipated for this project in the future? If so, describe the
anticipated work, and provide justification for the exclusion of this work from the current
application: N/A
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and peremiial) 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 5 of 12
1. Wetland Impacts
Wetland Impact Area of Located within Distance to
Site Number Type of Impact* Impact 100-year Floodplain** Nearest Stream Type of Wetland***
indicate on ma acres yes/no linear feet
28+75 (Rt.) Fill 0.0125 NO 0 Pond Overflow
* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, till,
excavation, flooding, ditching/drainage, etc. I-or 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 lloodplain maps. Maps are available through the FEMA Map Scn ice Center at 1-800-358-9616, or
online at
hUp:/h?uw. fenut co.'.
*** List a wetland 13pe that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: 0.1 Acres
Total area of wetland impact proposed: 0.0125 Acres
2. Stream Impacts, including all intermittent and perennial streams

Stream Impact

Site Number
(indicate on map)

Type of Impact* Length of

Impact
(linear feet)

Stream Name** Average

Width of
Stream Before
Impact
Perennial
Intermittent?
(please specify)
Station No. 28+78 Pipe replacement 15 feet UT #1 to Roan Creek 1 foot Intermittent
(Pond overflow)
Station No. 41+63 Pipe replacement 24 feet UT 42 to Roan Creek 3 feet Perennial

Station No. 54+13 Pipe replacement 14 feet UT #3 to Roan Creek I foot Perennial

All of the above Miscellaneous
rip-rap
placement for
stabilization
30 feet
UTs to Roan Creek
1-3 feet
Perennial/
Intermittent

---- ----- • r-??• t,W .,., j uuu Iuuuuy iautxJrary 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
\%i%-\v.uses.gov. Several Internet sites also allow direct download and printing of USGS maps (e.g., w\v\v.topoTOne coin,
Nv\v\v.mapquesl cont. etc.).
Cumulative impacts (linear distance in feet) to all streams on site:. 83 In. ft. of new permanent impacts
Page 6 of 12
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
N/A
Type of Impact* Area of
Impact

(acres) Nam
e of ?Vaterbody
(if applicable) Type of Waterbody

(lake, pond, estuary, sound,
bay, ocean, etc.

-°- ??• 1--.7 WIU IUUILIIy winporary 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., darr/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.
By utilizing the erosion control measures as shown in the attached drawings adverse impacts to
streams in the area will be minimized. Since this is an existing roadway, the stream and wetland
impacts cannot be avoided. However, the replacement pipe lengths will be the minimum needed
to safely construct the paved roadway. All appropriate BMPs will be used during construction
Page 7 of 12
VIII. Mitigation
DWQ - In accordance with 15A NCAC 214 .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
http://h2o.enr.state.iic.us/ncwetlands/strmgide.litmi.
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 ofI'site), 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.
N/
Page 8 of 12
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 lutn:02o.enr.statc nc usA m/index lit m. 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 (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federaUstate/local)
land?
Yes ® No ?
X.
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 ?
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
(Meuse), 15A NCAC 213 .0259 (Tar-Pamlico), 15A NCAC 2B
Water Supply Buffer Requirements), or other (please identify
Yes ? No ® If you answered "yes", provide the following information:
within 15A NCAC 213 .0233
.0250 (Randleman Rules and
Page 9 of 12
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 A feet 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.
Impervious surface area will increase _bv_ 0.54 acres. All appropriate best manauement nractices
for sediment and erosion control will be implemented during construction.
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.
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No
Page 10 of 12
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).
?'" ? ZZ c
Applicant/Agent's Si ture Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell
US Army Corps of Engineers Avery Clay Jackson Polk
151 Patton Avenue Buncombe Cleveland Lincoln Rowan
Room 208
Asheville, NC 28801-5006 Burke
Cabarrus Gaston
G
h Macon Rutherford

Telephone: [phone]
Caldwell ra
am
Haywood Madison
McDowell Stanley
Swain
Fax: [phone] Catawba Henderson Mecklenburg Transylvania
Raleigh Regulatory Field Office Alamanec Durham Johnston Rockingham
US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes
6508 Falls of the Neuse Road Ashe Franklin Nash Surry
Suite 120
Raleigh
NC 27615 Caswell Forsyth Northampton Vance
,
Telephone: [phone] Chatham
Davidson Granville
Guilford Orange
P Wake

Fax: [phone]
Davie
Halifax erson
Randolph Warren
Wilkes
Washington Regulatory Field Office Beaufort Currituck Jones
US Army Corps Of Engineers Bertie Dare Lenoir
Post Office Box 1000 Camden Gates Martin
Washington, NC 27889-1000 Carteret* Green Pamlico
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Ponder
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
Pitt
Tyrrell
Washington
Wayne
Union
Watauga
Yancey
Wilson
Yadkin
*Croatan National Forest Only
Page I I of 12
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NOTE : MAP INCLUDES ONLY STATE MAINTAINED ROADS
OR IMPORTANT NON.SYSTEM ROADS.
ROADS SHOWN AS OF NOV. 05. 20^,2.
k.? CoCVT??
f

KEY TO COUNTY ROAD NUMBERS
ALSO NUMBERS +po7
7 i4,
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Gap Section '',t3ENEZE
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f%--,° t!J ??_ `? • "?.` f r lh? 1? ?f L`? - i _ ?\1?l ?.\?'? 1 ? ??!^, ? ? ?) I ?.. ? ?`?
SR 1629\ ':`\ \;^?r ice'+\` •?`? ?? j \,?;.1,
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r,r ICC ` ,\ J, J . 7 (,/-_ •?. v II• I ?-. -??. ,I?",f r ?•?•_ Jr (,?
t 7 _ 1 ! !?1 r ./ r.•' '`'t •1965,
Copyright (C) 1998, Map(ech, Inc. ?' 1 ^'

Top: Wetland located at station 28+75 (Rt.) on SR 1623, Ashe.
Bottom: Wetland located at station 28+75 (Lt.) with pond levee in background.
EROSION CONTROL SCHEDULE
(1) All adequate temporary erosion control measures will be installed before
clearing and grubbing operations begin.
(2) As construction progresses, temporary and permanent erosion control
devices shall be installed in a timely matter, according to any special permit
requirements and or requirements set out in G. S. ;13, ;-S7.
MANDATORY STANDARDS FOR LAND-DISTURBING ACTIVITY
Pursuantto G.S.113A-57 (3) provisions for a ground cover
sufFicientto restrain erosion must be accomplished within 15
working days flr 30 calendar days following completion of
construction or development, whichever period is shorter, except
as provided in 15A NCAC 4B.0024 (e).
DESIGN STANDARDS IN SENSITIVE WATERSHEDS
Pursuant to G. S. 113A-57 (3) provisions for a ground cover
sufficient to restrain erosion must be providedforany portion of -a
- land-disturbing activity in a "HQW zone within 15 working days or 30
calendar days following completion of construction or
development, whichever period is shorter-
(3) All siltation and erosion control devices shall be properly maintained until no
longer needed.
(4) Dn projects performed by D.O.T. Maintenance Forces; request
i
be made to the Division Roadside Environmental Unitforstage ndpromptly
permanent seeding.
(5) Any removal of siltation devices will be based on the condition of established
ground cover of that area the device is serving.
CONSTRUCTION S=EQUENCE FOR INSTALLING ROADWAY CULVERTS
1 - Clear only enough area and install the downstream measures such as silt check dams,
silt screens, and basins as noted on plans.
2 - Excavate the 2' base tail ditch.
3 - Excavate and install the roadway culvert-
4 - Install sediment control measures at inlet as noted on plans.
S- Install additional pipe outletprotection and inlet protection as noted.
1
SECTION 1042
RIP RAP A MATER I ALA
1042-I PLAINT P-LIP IZAP.
done foi• Main rip r?iu sha11 consist of field stone oI• rot](7h vnhe ;:rn quarry
Stone. The stole shall be sound, tout h, dense, I•eslst`nt tD the action of air
and water, and stlitalile in all other respects for the vvrpose intended.
W)iere broken concrete from deniolislied sirticiures or pavement is avail-
able, it may be used in place of scone provided that such Use meeis -with the
approval of ihe Lngineer.-However, ihe Use of broken concrete which
contains reinforcing steel will not be Dermitied.
The stone or broken concrete shall be graded Lo ;?]ee the folloriJizig
requirements:
L 1{ oi- Class I Rip Trap- ?Stoinesl]a11 var v in lveigll L from 5to 200 pounds:
Ai least .30. nerceni of ihe. i_oial Wei" It of ille riD rap sl]all be in
individual Dieces Weiglli»ga minimum of 60 --pounds-eacli_ Not riloi-e
ilian 1.0 percent of the to-Lil ?eiglli of ihe rip ra]) may be in individual
:. -L: es weiglzil]g less than 15 mounds e-
)'cll_
2. To2• Cl?cs 2 Hil) IZat). Slone shall varv in weiC']t from 25 to 250
Dounds. A ileasi GO Ue1'cent of the .otal weight o ihe 1']p rap Shall be in
individual pieces iveigl]ing a -mini-mmn. of 2 00 Dour ??Ch_ _Not more
than 5 )ercei)t of the total weight of the rip rap n]av be iii inclividual
pieces tivteigl]ing le_;s than 50 Dounas each.
.OaI
HIGH QU ALIT17 N17ATERS
1. Uncovered areas are limited at any given time to a maximum total area of
20 acres.
?. Erosion and sedimentation control measures shall be designed to provide
protection from the 25-year storm.
3. Large Type -A basins shall be designed and constructed with a settling
efficiency of at least 70% for the 40 micron soil particle size transported
by runoff from the 2-year storm.
4. Newly constructed channels shall be constructed with side slopes no
steeper than 2:1, unless slopes are to be stabilized by methods other than
vegetation
5. A ground cover sufficient to restrain erosion must be provided for any
disturbed area.
EROSION CONTROL DETAILS AND
SPECIFICATIONS
STANDARD DESCRIPTION SS'mOL
462.01.(5e.Qtion).....Rip Rap Fill Slope Protection ..................
876.04 ....................Rip Rap Lined Ditch...................................
1060.08:(Secti.Qn)„.fitting For Erosion Control............
VWV
1605.01 Temporary Silt Fence .....:...............
1606.01 .................. Special Sediment Control fence......................
16,.01 Temporary Slope Drain ................. 1
1630.02 ...................Silt Basin Type B..................................... M
1630.03 ................... Temporary Silt Ditch.................................. TS D-
1630.04 ................... Stilling Basin...............
............................
L?jj
1630.05 .................. Temporary Diversion.................................. -T D--.-
1632.01 ...................Rock Inlet Sediment Trap Type-A.................. :D: o? a
1632.02 ...................Rock Inlet Sediment Trap Type-B................... . .
•t oR 1D
1632.03 ...................Rock Inlet SPediment Trap Type-C.................. c J
1633.01 .................:. Temporary Rock Silt Check Type-A....... ........ ® JJ
1633.02 ................... Temporary Rock Silt Check Type-B...............
1634.01 ................... Temporary Rock Sediment Dam Type-A.......... =
1634.02 .................... Temporary Rock Sediment Dam Type-B.........
1636.01 Rock Pipe Inlet Sediment Trap Type-A ............ .
1635.02 ....................Rock Pipe Inlet Sediment Trap Type-B............g :?•
? . .
1636.01 ....................Rock Silt Screen .......................................
Small Stream or Branch ..................................................................
Pipe Outlet Energy Dissipater .................................... Q o
..................... o Q Q
0 a a 0
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DITCHLINER REQUIREMENTS
ASHE COUNTY
SR 1623
STATION TO STATION LT/RT TYPE
1+00 6+90 RT RIP RAP
7+00 12+00 LT
RIP RAP
12+00 20+00 LT ROVING
23+00 26+00 LT ROVING
26+00 32+00 LT RIP RAP
32+00 32+50 LT ROVING
32+50 38+00 LT
RIP RAP
38+00 46+80 LT ROVING
46+80 50+80 LT
RIP RAP
51+00 52+00 LT ROVING
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DATA FORT( WeYlaact `ez-1-
ROUTINE WETLAND DETER](INATION
(1987 COE Wotlands Delincatiou Hanual)
Project/Site: SQ_ IteZ$ f-.hPV,e7Pr ?Zd Date: (011,16q
Applicant /Owner: G D County:,Ish e,
Investigator: Nea-4 ,SJ State: /uc,
Do Normal Circumstances exist on the site? (2zD No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yea Transect ID:
Is the area a potential Problem Area? Yea Plot ID:
(If needed, explain on reverse.)
VEGETATION
Dominant Plant Speclea Straus Indicator Dominant Plant Species Stratum Indicator
1. J uh(- u c' e ?-r LAS LAS Ac { 9.
2. ! SD D. herb 10.
3. __77,*1 Ct+i e S ( , Q 9 V0 S Kerb FA(, 0 11-
4. _e!D oGhCris GS ya. he(b _FACLJ 12•
5. r? fc cCC- SOP. he(b 13.
6. 14.
7. 15.
8. 16.
Precent of Dominant Species that are OBL, FACW or FAC (excluding FAC -) lee

Remarks:
4)D rigiud k ^rL
1, a u 2
HYDROLOGY
_ Recorded Data (Describe in Remarks):
Stream, Lake, or Tide Gauge
_ Aerial Photographs
_ Other
_ZNo Recorded Data Available Wetland Hydrology Indicators:
Primary?ndicators:
nundated
?aturated in Upper 12 inches
_ Water marks
Drift lines

Field Observations: _
Sediment Deposit
Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Waters: (in.) ,,/Oxidized Root Channels in

Depth to Free Water in Pit:
(in.) Upper 12 inches
_ Water-Stained Leaves

Depth to Saturated Soil:
(in.) ocal Soil Survey Data
FAC-Neutral Test
_ Other (Explain in Remarks)
Remarks:
•
?• DATA FORM
ROUTINE WETLAND D=RHINATION
(1987 COE Wetlands Delineation Manual)
(Wlcald ?Sh eef
Project/Site:_Sp- )(Oz3 E"bPhPZ?r Q?
Applicant /owner: N[_ noZ- Date: 6 Q
Investigator: &Cc,, t S(, , County:
?P,t yca? State: Nc
Do Normal Circumstances exist on the sita7
Is the site significantly disturbed (Atypical Situation)? ? NO Community ID:
Is the area a potential Problem Areal ID:

(If needed, explain on reverse.)
:
Y e s Plot ID:
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1. _ F-eS et 6 9.
2. _iV1k,S _,;4r buy fee. CU 10.
3. I\?,lhi 1S Son Aerb 11.
4. B16L(, - CVlerir re 12.
5. 13.
6. 14.
7. 15.
8. 16.
Precent of Dominant Species that are OBL, FACW or FAC (excluding FAC -)
Remarks:
HYDROLOGY
_ Recorded Data (Describe in Remarks): Wetland Hydrology Indicators:
Stream, Lake, or'Tide Gauge Primary Indicators:
_ Aerial Photographs Inundated
_ Other
No Recorded Data Available _
_ Saturated in Upper 12 inches
- Water marks
_ Drift lines
Field Observations: _ Sediment Deposit
_ Drainage Patterns in Wetlands

Depth of Surface Waters: L
(in
) Secondary Indicators (2 or more required):
_
. _ oxidized Root Channels in
Depth to Free Water in Pit: lz
(in
) Upper 12 inches
. _ Water-Stained Leaves
Depth to Saturated Soil: 1 Z in
( ) _ Local Soil Survey Data
.
- _ FAC-Neutral Test
_ Other (Explain in Remarks)
Remarks:
k'
Project Name <SQ. 16z neZe? Nearest Road 5 I l?Z3
County 5 Wetland Area 02• acres Wetland Width boo feet
Name of evaluator ea4lj Slau4 huk,l_ Date W_
Wetland Location
? on pond or lake
on perennial stream
?on intermittent stream
within interstream divide
other
Soil serie
predominantly organic - humus, muck,
or peat
?predominantly mineral - non-sandy
predominantly sandy
Hydraulic factors
steep topography
L,- ditched or channelized
?total wetland width 2100 feet
Adjacent land use
(within 1/2 mile upstream, upslope, or radius)
forested/natural vegetation %
- agriculture, urban/suburban %
impervious surface %
Dominant vegetation
(1) i-CAVIGuS E' "Ct-t -
(2) CC.re) ?P -
(3) ?leochur< < s,??
Flooding and wetness
semipermanently to permanently
flooded or inundated
easonally flooded or inundated
]Zintern-duanly flooded or temporary
surface water
no evidence of flooding or surface water
Wetland type (select one)*
Bottomland hardwood forest - Pine savanna
Headwater forest - Freshwater marsh
Swamp forest _ Bog/fen
tl
d
l
?
Wet flat an
we
Ephemera
Pocosin _ Carolina Bay
Bog forest - Other
*the ratinp- system cannot be applied to salt or brac
------- kish marshes or stream channels
-------------- -- -
---
weight
R Water storage o7 x 4.00 =
A Bank/Shoreline stabilization o?2 x 4.00 =

al
ll
* x 5.00 = ( ,?
E ''
utant remov
T Po
I Wildlife habitat x 2.00 =
AT Aquatic life value 3 x 4.00 =-1
G Recreation/Education x 1.00 =
*Add 1 point if in sensitive watershed and >10% nonpoint disturbance within 1/2 mile upstream,
u sloe or radius --------
------------ ------------------------------------------------------------------

Top: Wetland located at station 28+75 (Rt.) on SR 1623, Ashe.
Bottom: Wetland located at station 28+75 (Lt.) with pond levee in background.