20071182 Ver 1_Application_20070709

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DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DNISION OF HIGHWAYS LYNDO TIPPETT
GOVERNOR SECRETARY
July 3, 2007
Mr. John Hennessy
401/Transportation Permitting Unit
1650 Mail Service Center
Raleigh, N.C. 27699-1650
071182
SUBJECT: Minor Discharge of Rock Fill for Culvert Inlet Stabilization on Hwy 74 Bypass,
Cleveland County
Dear Mr. Hennessy:
The North Carolina Department of Transportation proposes to stabilize the culvert inlet to provide prevent
undermining of the culvert foundation. Approximately eight cubic yards of rock will be utilized to armor
a scourhole that has formed at the culvert inlet. The rock will be placed up to the elevation of the normal
stream channel bed and will be placed in such a manner as to not dam the flow of water. Salvaged
streambed material from the high flow culvert cell will be placed in the voids of the rocks to facilitate
normal streamflow. Rock will also be placed in front of the left culvert cell to provide stabilization and
will be positioned to allow for high flows to enter the culvert cell. Temporary cofferdams and bypass
pumping will be used for stream management during construction. Upon project completion, the areas
impacted by the temporary cofferdams will be returned to pre-project conditions and seeded and
stabilized. The scope of the work will result in a total of 10 linear feet of permanent impacts to Potts
Creek (Pilot Branch), which is classified as a Class C Waters by the Division of Water Quality.
Highway 74 is a rural/urban arterial; however, the project is not located within '/z mile of the critical
watershed area; therefore, hazardous spill basins are not required. Enclosed is the hazardous spill basin
checklist.
This office has conducted a GIS and field survey for the project for historical sites and threatened/
endangered species sites. No sites listed on the National Register of Historic Places are located in the
vicinity of the project nor did there appear to be any eligible structures. The federally listed species for
Lincoln County (USFWS listed dated March 8, 2006) include the dwarf-flowered heartleaf (Hexastylis
nan~ora). Natural Heritage Program records document the nearest dwarf-flowered heartleaf location
approximately 2.0 miles west of the proposed project area. The heartleaf is usually found on dry to moist
ravine slopes (usually north facing and of the oak-hickory-pine forest type) and in boggy areas near
springheads. There is no limited suitable habitat within the proposed project area and no species were
observed. NCDOT is recommending a finding of "no effect" for T&E species and historical structures.

Hwy 74
Page 2
July 3, 2007
As required by the Division of Water Quality Certification, I have enclosed two courtesy copies of the
pre-construction notification for a WQC#3631 (NW#18, Minor Discharge), sketches of planned activities,
and location maps relative to the project.
If you have any questions or concerns, please feel free to contact me at [phone]. Thank you for
your time and consideration to this matter
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division

Trish Simon
Division 12 Environmental Supervisor
Enclosures
Cc: Polly Lespinasse, DWQ, Mooresville Regional Office (Courtesy Copy)

Office Use Only: Form Version March OS
USAGE Action ID No. DWQ No. 2 0 0 7 7 'L $ 2
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
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 ^ Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NW#18 (WQC#3631)
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 Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, 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: Mike Holder, N.C. Department of Transportation
Mailing Address: P.O. Box 47
Shelby North Carolina 28151
Telephone Number: 704-480-9020 Fax Number: 704-480-5401
E-mail Address:
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: Trish Simon
Company Affiliation: N.C. Department of Transportation
Mailing Address: P.O. Box 47
Shelby, North Carolina 28151
Telephone Number: 704-480-9044 Fax Number: 704-480-5401
E-mail Address: tsimon(c~dot.state.nc.us
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: Culvert Inlet Stabilization Hwy 74 Bypass
2. T.LP. Project Number or State Project Number (NCDOT Only): 12B.102311
3. Property Identification Number (Tax PIN): NA
4. Location
County: Cleveland Nearest Town: Kings Mountain
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers/names, landmarks, etc.): From Kings Mountain,
west on Hw~B.ypass. The best access point is to turn onto Highway 74 business (Moss
Lake/Waco exit). Turn right onto SR 2036 (Countryside Road) and proceed ~0.3 miles turn
left onto a sewer line easement and proceed to end of cleared easement to site.
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35°15'14"°N 81°23'29"°W
6. Property size (acres): < 0.10 acres
7. Name of nearest receiving body of water: Potts Creek~Pilot Branch), Class C Waters (from
source to Mudd Fes).
8. River Basin: Broad
(Note -this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at htt~//h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Existing Conditions-one on paved highway. General Land
Use- wooded.
Page 2 of 8

10. Describe the overall project in detail, including the type of equipment to be used_
Approximated eight cubic wards of rock will be utilized to armor an inlet scourhole to
prevent undermining of the culvert foundation The rock will be placed up to the elevation of
the normal stream channel bed and will be placed in such a manner as to not dam the flow of
water Rock will also be placed in front of the left culvert cell to provide stabilization and
will be positioned to allow for high flows to enter the culvert cell.. Typical heavy equipment
(trackhoe backhoe etc) will be used for the construction of this project.
11. Explain the purpose of the proposed work: The purpose of the proposed work is to provide
culvert inlet protection to prevent the undermining of the culvert foundation for the safety of
the traveling_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.NA
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 future permit requests are anticipated at this site.
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. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should 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: Impacts from culvert inlet
foundation protection.
Page 3 of 8

2. Individually list wetland impacts. Types of 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.
Wetland Impact Type of Wetland Located within Distance to Area of
Site Number Type of Impact (e.g., forested, marsh, 100-year
Floodplain Nearest
Stream Impact
(acres)
(indicate on map) herbaceous, bog, etc.) es/no) (linear feet)

Total Wetland Impact (acres) 0
3. List the total acreage (estimated) of all existing wetlands on the property: 0
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, 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. To calculate acreage, multiply length X width, then divide by 43,560.
Stream Impact Perennial Average
Impact
Area of
Number
(indicate on Stream Name Type of Impact or
Intermittent Stream Width
Before Length Impact
ma )
?
Im act
(linear feet)
(acres)
1 Potts Creek Scourhole armoring Perennial 10 feet 10 feet .0023

1
" Temporary Cofferdams/
20 feet
.0046
Bypass Piping
* 10 feet *.0023 acre
permanent permanent
Total Stream Impact (by length and acreage) 20 feet .0046 acre
'Permanent impacts contained within area of temporary impacts temporary temporary
impacts to impacts to
open channel open channel
5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact
Name of Waterbody Type of Waterbody Area of
Site Number (if applicable) Type of Impact (lake, pond, estuary, sound, bay, Impact
(indicate on ma) ocean, etc.) acres

Total Open Water Impact (acres) 0
6. List the cumulative impact to all Waters of the U.S. resulting from the proiect:
Stream Impact (acres): .0023
Wetland Im act acres): 0
Open Water Impact (acres): 0
Total Im act to Waters of the U.S. (acres) 0.0023
Total Stream Impact (linear feet): Permanent 10 feet
Page 4 of 8

7. Isolated Waters
Do any isolated waters exist on the property? ^ Yes ®No
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
8. Pond Creation NO POND IMPACTS
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.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Current land use in the vicinity of the pond:
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. A scourhole has formed at the
culvert inlet The scourhole will be armored with rock to prevent the undermining of the
structure for the safety of the travellingpublic. The rock will be placed up to the elevation of the
normal stream channel bed and will be placed in such a way as to not dam the flow of water.
Salvaged streambed material from the high flow culvert cell will be placed in the voids in the
rock to facilitate normal streamflow.
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 January 15, 2002, 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
Page 5 of 8

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 NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strm~ide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
MITIGATION NOT ANTICIPATED
2. Mitigation may also be made by payment into the North Cazolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they aze will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (squaze feet):
Amount of Riparian wetland mitigation requested (acres):
Amount ofNon-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ® No ^
2. 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
3. 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 ^
Page 6 of 8

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
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes ^ No
2. If "yes", 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.
Re
Zone* ,_ Impart ~~ Multiplier r,r. qutre „
3 (2 for Catawba)
1.5
Total
* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration /Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (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. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level.
No increase in impervious surface is proposed.
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.
No wastewater is generated from the project.
Page 7 of 8

XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ^ No
Is this anafter-the-fact permit application? Yes ^ No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ^ No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description:
The culvert inlet stabilization will not result in additional development of the surrounding area.
XV. 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).
NA
_,
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8

Hwy 74, Culvert Inlet Stabilization
Floodplain Bench Construction
Rock Stabilization in left culvert corner
Proposed Rock placement in inlet
scourhole to protect structure foundation
4

07i02i2007
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/Triple
/ Box
Bar~elConc/
Culvert /
i_
RIP-RAP TO BE PLACED UP
TO APPROX. THE INVERT ELEV.
OF THE BOX CULVERT,STREAMBED
MATERIAL TO BE PLACED ON THE
RIP-RAP TO FILL IN THE VOIDS AND
CREVICES.
NOTES:
PULPING SYSTEM TO BE USED TO DIVERT
STREAM AROUND THE CONSTRUCTIONSITE
AS NEEDED
class II
PLAC D
ABOV~ T
WATE S
14:21 DOT BRIDGE MAINTENCE ~ 917044805401 N0.028 D02
O
MANHOLE RIM ASSUME
ELEVATION OF 100.0'
PLAN
I'=20'
ANY CONTAMINATED WATER WITHIN THE
CONSTRUCTION SITE IS TO BE PUMPED
INTO SILT BAG
UPON COMPLETION OF THE PROJECT ALL
SILT FENCES ARE TO BE PLACED AS NEEDED.
ALSO SEEDING AND MULCHM~G OF DISTURBED
AREAS
SHEET IOF 2
NCDO7 DIV 12
BRIDGE MAINTENANCE
SCOUR HOLE
STABILIZATION
C-423 CULVERT
CLEV CO.
1
POTTS CREEK
6/07

07i02i2007 14:21 DOT BRIDGE MAINTENCE ~ 917044805401
N0.028 D03
EXISTING STREAMBED PROFILE
r-5.0'
Triple Sorrel Conc
Box Culvert
INVERT ELEv.91,1•
v
.. - - - -..... ~ _.~.__..r. ' . , ~ ..;. :90.0
. .
. .
_ ~ .' - ~ 88.0
.. _ : - . - - - -- -- •;•• : . - ..~. 86.0
~ 0' 2' 4' 6' 8' 10' ^ 12' • !4' . I6' . I$' . 20' .
Triple Barrel Conc
Box Culvert
INVERT ELEV, 91.1'
RIP-RAP TO BE PLACED UP
TO APPROX. THE INVERT ELEV.
OF THE BOX CULVERT.STREAM6ED
MATERIAL TO BE PLACED ON THE
RIP-RAP TO FILL IN THE VOIDS AND
CREVICES.
LARGER CLASS II RIP-RAP
TO BE PLACED IN TO THE
INLET ENO SCOUR HOLE
SEE ADDITIONAL NOTES ON
PLAN SHEET I.
EXISTING STREAMBED
.. . - .;. _ : _~...~ __.. _.;. :90.0
0' 2' 4' 6' 8 ` 10' 12' , 14 • 16' ~ 18' ' 20' .
SHEET 2 Of 2
PROPOSED STREAMBED RECONSTRUCTION
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NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: 1 ~. County:~'1PVPlanrl Project ID:
River Basin: Broad Bridge No: Culvert Inlet Stabilization/Bench
Construction
Route: Hw~ypass Stream: Potts Creek (Pilot Branch), Class C
Waters
Water Quality Criteria:
Yes No
Stream Crossing Blue Line On USGS r r
ORW r r
WSI r ~
WS II,III OR IV, Crossing Within O.Smi of W.S. Critical Area I- r
Roadway Criteria:
Route Designation-
Yes No
Arterial Urban r r
Arterial Rural r r
Additional Site Information:
Yes No
Is a Hazardous Spill Basin Required? r r
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).