20121028 Ver 1_Application_20121107

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STATE OF NORTH CAROLINA qy os 4.4,7?
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DEPARTMENT OF TRANSPORTATION T� �.R'ry
BEVERLY EAVES PERDUE EUGENE A CONPTNJR
GOVERNOR SECRETARY
November 6 2012
USACE
Raleigh Regulatory Field Office
3331 Heritage Tiade Drive 0 'j 2 1 0 2 8
Suite 105 2
Wake Forest NC 27587
Attention Eric Alsmeyer
NCDOT Coordinator
Subject Replacement of Bridge No 216 over UT to South Hyco Creek on SR 1100 (Jones Road)
in Person County Pioject Number(aka WBS Element No) 17BP 5 R 44
Dear Sir
The North Carolina Department of Transportation (NCDOT) proposes to replace this bridge This
project is similar in nature to projects processed under the Low Impact Bridge Replacement Program
(LIBRP) Accordingly the LIBRP format has been utilized in the permitting of this project A site visit
was conducted by USACE and NCDENR DWQ on January 27 2012 The following are attached to this
cover letter
Attachment G Low/Minimal Impact Midge Data Sheet
USGS Topographic Map
Attachment L NCDENR DWQ Nationwide 3/WQC#3883 Data Sheet
Stormwater Management Plan
Permit Drawings
If you have any questions or need additional information please contact Mr Chris Muiray at(919)220
4633
Sincerely
J Bowman P
Division Engineer
c Division 5 file NCDOT
Rob Ridings NCDENR DWQ
Division Five—2612 North Duke Street Durham North Carolina 27704
Telephone [phone] Fax [phone]

Low/Minimal Impact Bridge Project Data Sheet
IWBS 17BP 5 R 44
I County Person
IBridge Number Bridge 910444
Description Bridge No 216 over UT to South Hyco
Creek on SR 1100 (Jones Road)
Basin Roanoke
Classification WS II HQW
Stream SIN 22 58 4 (0 5)
Type Inland
Size 15 ft
Type Single Span
Existing Structure Size 20 7 ft x 19 O ft
Suff Rating 70 7
Proposed Structure Type Single Span
Size 30 ft x 60 ft
Stream USAGE Impacts (LF) 74 linear feet
Non 404 Impacts (LF) 0 linear feet
USACE Impacts (AC) 0 acre
Wetlands Non 404 Impacts (AC) 0 acre
CAMA Impacts (AC) Not Applicable
NC DWQ Buffers I Impacts (SF) Not Applicable
Buffer Application Required (>40 ft) (Y/N) No
NC DWQ StormWated Permit Required (Y/N) No
Habitat(y/n) dwarf wedgemussel No
T&E Species Present dwarf wedgemussel No
Bio Conclusion dwarf wedgemussel No Effect
Moratorium Type Not Applicable
Dates Not Applicable
Native/Hatchery Not Applicable
Trout Species Present Not Applicable
Trout Waters Trout Conditions (Y/N) Not Applicable
WRC Reviewer Not Applicable
CAMAIAECs Not Applicable
Essential Fish I Habitat(y/n) No
Nav I Opening Not Applicable
USCG I Permit Not Applicable
Historic I Properties No
Archaeological'Resources No
Tribal 'Lands Not Applicable
4(f)I Resources No
6(f) [LWCF]I Resources No
Wild andlScenic River No
Forest Service I Lands No
TVA I Area No
FEMAIBuyout No
FEMAIFlood Study MOA
USTs Haz Mats No
Relocatees No
Location LAT 36 24230 deg
LONG 70 14978 deg
Project Comments
Completed by
Lead E gineer
CLc -
Division Environmental Officer
11/6/2012

■
APPTA
wilr
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H Sullins Dee Freeman
1 Governor Director Secretary
Attachment L Low Impact Bridge Replacement Process
Low Impact Bridge Project Number (aka WBS number) 17BP 5 R 44
County Person
Bridge No 216 over UT to Hyco Creek on SR 1100
This project can be characterized as meeting the parameters associated with the Low
Impact Bridge Process as agreed to on October 6 2009 Accordingly this project
meets the documentation requirements and approval procedures under NEPA as
defined by FHWA for Low Impact Bridge Replacements
Date November 6 2012
Applicant Name J W Bowman P E
Applicant Address 2612 N Duke Street
Durham NC 27704
Primary Contact for Project Chris Murray PWS
Phone Number [phone]
I
Is this an after the fact application Yes X No
River Basin Roanoke
Stream Classification WS II HQW (DWQ Index Number 22 58 4 (0 5)) Note Impacts at this
location are less than 0 33 acres Accordingly a State Stormwater Permit is not required
Regulatory Authorization Options for this Activity
Federal USACE Nationwide General Permit 3
I State General Water Quality Certification #3883
1 Local None
Project Description Replacement of existing one span bridge (19 foot long bridge) with a
longer one span bridge (60 foot long bridge)
Permanent Impacts See attached permit drawing and summary sheet Note stream impacts
Stormwater Information See attached stormwater management plan
Signature Ck., C 4.■••••• .....",
Print Name cw,) p J v,,IrrG
Title D \,-, iAJ „nb t
1
Transportation Permitting Unit One
1650 Mail Service Center Raleigh North Carolina 27699 1650 NorthCarolina
Location 2321 Crabtree Blvd Raleigh North Carolina 27604 Naturally
Phone [phone] FAX [phone] Naturally
6� ;/
Internet http Ilh2o enr state nc us/ncwetlands/
An Equal Opportunity\Affirmative Action Employer

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