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HomeMy WebLinkAbout20040059 Ver 1_Complete File_20040217F WAIF Michael F. Easley, Governor \O?Q 9QG William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources fq ( ?ll I I Alan W. Klimek, P.E. Director > C I lluakl.), 7 Division of Water Quality DWQ Project No.: 040059 County: Swain Applicant: NCDOT Project Name: SR 1355 - Cooper's Creek Road - Culvert Extension Date of Issuance of 401 Water Quality Certification: 2117104 Certificate of Completion Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and any subsequent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or the project engineer. It is not necessary to send certificates from all of these. Applicant's Certification I, J L Wu rltlnC , 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 ti al mpliance a intent of the 401 Water Quality Certification and Buffer be built wi Va Rules, the a s an spec uns, and other surtu?aterials. Signature: !yDate: ?. <.? Agent's C I, , hereby state that, to the best of my abilities, due care and diligence was used in the observation of the construction such that the construction was observed to be built within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials. Signature: Date: If this project was designed by a Certified Professional I, , as a duly registered Professional (i.e., Engineer, Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project, for the Permitee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the construction such that the construction was observed to be built within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials. Signature Registration No. Date: WETLANDS 1401 GROUP mi 0 7 2004 WATER QUALITY SECTION North Carolina Division of Water Quality, 401 Wetlands Certification Unit, 1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address) 2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location) 919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetiands/ (? WA7F Michael F. Easley, Governor O?O RQG William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources ? w Alan W. Klimek, P.E. Director g r- Coleen H. Sullins, Deputy Director p Division of Water Quality February 17, 2004 Swain County DWQ Project No. 040059 SR 1355 (Cooper's Creek Road) APPROVAL of 401 Water Quality Certification with Additional Conditions Mr. R. G. Watson, P.E. Division Engineer N C Department of Transportation PJA a 2004 253 Webster Road Sylva, North Carolina 28779 x"141 ' f„ _ 1 ? ._i 41. I ii+_. v l I v it Dear Mr. Watson: You have our approval, in accordance with the attached conditions and those listed below, to impact 25 linear feet of an unnamed tributary to Cooper Creek (25 feet of new pipe), in order to improve SR 1355 (Cooper's Creek Road) in Swain County. The project must be constructed in accordance with your application dated December 29, 2003 (received January 12, 2004), including the environmental commitments made in the application letter. 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 must 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 in writing 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 be valid, you must follow the conditions listed in the attached certification and any additional conditions listed below. 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: 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 Alanual. 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 Alanual. 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 Alanual. d. Any reclamation measures and implementation must comply with the reclamation in accordance with the requirements of the Sedimentation Pollution Control Act. 585 Waughton Street Winston-Salem, NC 27107 Telephone: 336/771-4600 Fax: 336/771-4633 Customer Service: 1-877/623-6748 Mr. R. G. Watson, P.E. February 17, 2004 Page Two 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. In-stream work and land disturbance within the 25-foot wide buffer zone are prohibited during the trout spawning season of October 15 Through April 15, to protect the egg and fry stages of trout from off-site sedimentation, during construction. 6. Riparian vegetation must be reestablished within the construction limits of the project by the end of the growing season following completion of construction. 7. 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. 8. 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. 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 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. 11. 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. 12. 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. 13. 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. 14. 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. 15. 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. 16. Removal of vegetation and grading and backfilling at the stream crossing and adjacent to stream should be minimized. Native trees and shrubs (e.g., rhododendron, dog hobble, willows, alders, sycamores, dogwoods, black walnuts and red maple) 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. 17. All work shall be performed during low flow conditions. Mr. R. G. Watson, P.E February 17, 2004 Page Three 18. 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, 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 telephone Ms. Cynthia Van Der Wiele at 919.733.5715 or Mr. Mike Parker of the Asheville Regional Office at 828.251.6208. Sincerely, Alan W. Klimek, P.E. Attachment cc: Wilmington District Corps of Engineers Mark Davis, Division 14, DEO Ed Ingle, Roadside Environmental Steve Lund, USACE Asheville Field Office Wetlands/401 Unit Mike Parker, NCDWQ Asheville Regional Office Central Files MEMORANDUM TO: John Dorney Regional Contact: Non-Discharge Branch WQ Supervisor: Date: SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS Facility Name NCDOT - SR 1355 Project Number 04 0059 Recvd From DOT Received Date 1/12/04 Recvd By Region Project Type culvert replacement County SIVA1N County2 Region Asheville Certificates Stream Stream Impacts (ft.) Permit Wetland Wetland Wetland Stream Class Acres Feet -i1, IType Ty pe Impact Score Index Prim. Supp. Basin Req. Req. +!-1 ]f 14 Stream O Y O N F_ 2-79-56 ? TR F40,402- ? 25.00 25.00 F- F__F_O Y _0N F_F__F_F__F_F_F_ F_ Mitigation Wetland MitigationType Type Acres Feet Is Wetland Rating Sheet Attached? O Y 0 N Did you request more info? O Y O N Have Project Changes/Conditions Been Discussed With Applicant? O Y O N Is Mitigation required? O Y @N Recommendation: O Issue O Issue/Cond O Deny Provided by Region: Latitude (ddmmss) 352925 Longitude (ddmmss) 832205 Comments: DOT is proposing to replace an existing culvert on NCSR 1355 because of necessary maintenance and safety improvements_ Total culvert extension is 25 linear feet. It is recommended that WO C ertification No. 3404 be issued, cc: Regional Office Central Office Page Number 1 'ter. t 7 <~ y STATE Or NORTH CAROLINA DEPARTMENT OF TRANSPORTATION December 29, 2003 MICHAEL F. EASLEY GOVERNOR LYNDO TIPPETT SECRETARY Mr. Steve Lund, NCDOT Regulatory Project Manager U.S. Army Corps of Engineers 151 Patton Avenue, Room 208 Asheville, NC 28801-2714 Subject: Nationwide 14 Permit Application SR 1355 Cooper's Creek Road, Swain County State Project No. 14.087014 (DWQ Minor Permit Fee 5200) Dear Mr. Lund: The North Carolina Department of Transportation (NCDOT) is applying for a Nationwide 14 Permit for the replacement of a culvert on SR 1355 in Swain County. The proposed improvements have been identified as necessary maintenance and safety improvements. The shoulder at the end of the road is washed out. I am sending a drawings for pipe culvert replacement as well as a marked county map and USGS quad map. We propose to install the new culverts slightly below the existing streambed elevations where bedrock is not encountered to minimize impacts to aquatic habitats and allow the existing stream gradients to remain as unchanged as physically possible. No threatened or endangered species are known to be present in or near the project area; therefore, no significant impacts are anticipated from project construction. The best management practices will be used to minimize and control sedimentation and erosion on this project.. The rock silt screens and other erosion control devices will be in place prior to pipe culvert construction and will remain in place until the project is stabilized. Impacts to Waters of the United States It was necessary to impact waters of the United States in the Little Tennessee River Basin. Specifically, NCDOT replaced one metal culvert in UT to Cooper Creek (DWQ Class C TR). Listed below is a summary of the proposed impacts. Site No. Existing Proposed Net Impacts Station Condition Condition Site 1 20' x 24"CMP 45' x 36" CMP 25' Replacement 100+68 25 linear feet total Permits Requested NCDOT is hereby requesting authorization under Section 404 of the Clean Water Act to proceed with the construction project outlined above. By copy of this letter the North Carolina Wildlife Resources Commission (NCWRC) to comment directly to you concerning the 404 Nationwide Permit request. Also, by copy of this letter, I am requesting authorization tinder Section 401 of the Clean Water Act from the North Carolina Department of Environment and Natural Resources (DENR), Division of Water Quality (DWQ). In addition, I am asking Mr. Anderson and Mr. Ed Ingle, (NCDOT) to comment directly to me concerning this permit request. If you have any questions or need additional information, please contact me at (828) 488-2131. Your early review and consideration will be greatly appreciated. Sincerely, ?'p -:?. - , nz M. T. Gibbs, P.E. District Engineer cc: Mr. John Dorney, DWQ, DENR (seven copies) Mr. Mike Parker, DWQ, DENR Mr. Owen Anderson, Mountain Region Coordinator, NCWRC Mr. R.G. Watson, P.E., Division Engineer, NCDOT Mr. Mark Davis, Division Environmental Officer, NCDOT Mr. E. L. Ingle, Roadside Environmental Field Operations Engineer, NCDOT Office Use Only: Form Version October 2001 t 0 10 i' 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. Processing 1. Check all of the approval(s) requested for this project: ® Section 404 Permit ? Section 10 Permit ® 401 Water Quality Certification ? Riparian or Watershed Buffer Rules 2. Nationwide, Regional or General Permit Number(s) Requested: NW 14 3. If this notification is solely a courtesy copy because written approval for the 401 Certification is not required, check here: ? 4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for mitigation of impacts (see section VIII - Mitigation), check here: ? II. Applicant Information 2. 1. Owner/Applicant Information Name: North Carolina Department of Transportation Mailing Address: P.O. Drawer 250 Brvson City. NC 28713 Attn: M. T. Gibbs. P.E., District Engineer Telephone Number: (828) 488-2131 Fax Number: (828) 488-3518 E-mail Address: maibbsndot.state. nc.us Agent Information (A signed and dated copy of the Agent Authorization attached if the Agent has signatory authority for the owner/applicant.) Name: N/A letter must be Company Affiliation: N/ Mailing Address: N/ Telephone Number: N/A E-mail Address: N/A Fax Number: N/A Page 1 of 8 III. Project Information Attach a vicinity map clearly showing the location of the property with respect to local landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property boundaries and development plans in relation to surrounding properties. Both the vicinity map and site plan must include a scale and north arrow. The specific footprints of all buildings, impervious surfaces, or other facilities must be included. If possible, the maps and plans should include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion, so long as the property is clearly defined. For administrative and distribution purposes, the USACE requires information to be submitted on sheets no larger than 11 by 17-inch format; however, DWQ may accept paperwork of any size. DWQ prefers full-size construction drawings rather than a sequential sheet version of the full-size plans. If full-size plans are reduced to a small scale such that the final version is illegible, the applicant will be informed that the project has been placed on hold until decipherable maps are provided. 1. Name of project: Replacment on SR 1355 in Swain County 2. T.I.P. Project Number or State Project Number (NCDOT Only): 14.087014 3. Property Identification Number (Tax PIN) n/a 4. Location County: Swain Nearest Town: Bryson City Subdivision name (include phase/lot number): n/a Directions to site (include road numbers, landmarks, etc.): From Bryson City take US 19 North approximately 3.7 miles. Turn left onto SR 1355 Cooper's Creek Road. Go approximately 3.4 miles. This is the project. 5. Site coordinates, if available (UTM or Lat/Long): 35D 29' 24.95" W83 D 22' 4.65" (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 7. Property size (acres): 0.004 Nearest body of water (stream/river/sound/ocean/lake): UT to Cooper Creek DWQ Class: C TR 9. River Basin: Little Tennessee Broad (Note - this must be one of North Carolina's seventeen designated major river basins. The River Basin map is available at littp://112o.ciir.state.nc.us/admin/niaps /.) Page 2 of 8 10. Describe the purpose of the proposed work: Replacement of Pipe 11. List the type of equipment to be used to construct the project: Back Hoes Dump Trucks Manual Labor. etc. 12. Describe the land use in the vicinity of this project: Residential. v oodlands 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 Nvere 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. No additional permits have been applied for in the past. 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: No additional permits are anticipated. VI. Proposed Impacts to Waters of the United States/Waters of the State It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to wetlands, open water, and stream channels associated with the project. The applicant must also provide justification for these impacts in Section VII below. All proposed impacts, permanent and temporary, must be listed herein, and must be clearly identifiable on an accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a delineation map, whether or not impacts are proposed to these systems. Wetland and stream evaluation and delineation forms should be included as appropriate. Photographs may be included at the applicant's discretion. If this proposed impact is strictly for wetland or stream mitigation, list and describe the impact in Section VIII below. If additional space is needed for listing or description, please attach a separate sheet. Page 3 of 8 1. WetlandImpacts Wetland Impact Site Number (indicate on ma) Type of Impact* Area of Impact (acres) Located within 100-year Floodplain** (yes/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, tut, excavation, flooding, ditch inJdrainage, etc. For dams, separately list impacts due to both structure and flooding. ** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FERIA) Flood Insurance Rate Maps (FIRM), or FENIA-approved local Floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or online at *** List a \vetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond, Carolina Bay, bog, etc.) List the total acreage (estimated) of existing wetlands on the property: 0 Total area of wetland impact proposed: 0 2. Stream Impacts, including all intermittent and perennial streams Stream Impact Site Number (indicate on ma) Type of Impact* Length of Impact linear feet) Stream Name** Average Width of Stream Before Impact Perennial or Intermittent? (please secif ) I Culvert Replacement 25' UT to Cooper Creek 6' Perennial * List each impact separately and identify temporary impacts. Impacts include. but are not limited to: culverts and associated rip-rap, dams (separately list impacts due to both structure and flooding). relocation (include linear feet before and after, and net loss/gain). stabilization activities (cement wall. rip-rap, crib wall, gabions, etc.), excavation. ditching/straightening, etc. If stream relocation is proposed, plans and profiles shoeing 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 wvw W.uses.t?oy. Several internet sites also allow direct download and printing of USGS maps (e.g., ww\v.topozone.com. www.manquest.com. etc.). Cumulative impacts (linear distance in feet) to all streams on site: 25' Page 4 of 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 applicable) Waterbody (if ap Type of Waterbody (lake, pond, estuary, sound, bay, ocean, etc.) lt u w. ... " List each impact separately anu IUentuy temporary ImpaClS. 1111paClJ 111c1000. UUL we uUi I l I I I 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.): n/a 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. The shoulders at the culvert are washed out. VIII. Mitigation DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC Division of Water Quality for projects involving greater than or equal to one acre of impacts to freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial streams. Page 5 of 8 USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide Permits, published in the Federal Register on March 9, 2000, mitigation will be required when necessary to ensure that adverse effects to the aquatic environment are minimal. Factors including size and type of proposed impact and function and relative value of the impacted aquatic resource will be considered in determining acceptability of appropriate and practicable mitigation as proposed. Examples of mitigation that may be appropriate and practicable include, but are not limited to: reducing the size of the project; establishing and maintaining wetland and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of aquatic resource functions and values by creating, restoring, enhancing, or preserving similar functions and values, preferable in the same watershed. If mitigation is required for this project, a copy of the mitigation plan must be attached in order for USACE or DWQ to consider the application complete for processing. Any application lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as incomplete. An applicant may also choose to review the current guidelines for stream restoration in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at http://li2o.enr.state.ne.us/ncwetiands/strm!ide.litnil. 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. N/A 2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that you would like to pay into the NCWRP. Please note that payment into the NCWRP must be reviewed and approved before it can be used to satisfy mitigation requirements. Applicants will be notified early in the review process by the 401/Wetlands Unit if payment into the NCWRP is available as an option. For additional information regarding the application process for the NCWRP, check the NCWRP website at http://}h2o.enr.state.nc.tis/%?!p/index.litni. 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 Page 6 of 3 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 (919) 733-5083 to revie,.v 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 213 .0233 (Meuse), 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 Miti°ation 1 3 2 1.5 Total * Zone I extends out 30 feet perpendicular trom near bank of channel; [.one 2 extends an additional 20 feet from the edue of Zone I. Pale 7 of 8 If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as identified within 15A NCAC 2B .0242 or .0260. 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. N/a 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. No wastewater will be generated from the proposed project. 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 E] 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 ;2,? 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W v'T ? ] , ?_ n r ?f8?r? Gwrg-ciem N 1 1 bs3' 23'10.00° W I I I 1083" 2710.00" W I I I I083o 's Name: WHITTIER Location: 035° 29'24.95" N 083° 22'04.65" W Date: 11/26/2003 Caption: SR 1355 Coopers Creek Road Scale: 1 inch equals 2000 feet ?e. AAL .. Alt