20080273 Ver 1_Application_20080211

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STATE o>' NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
February 7, 2008
N.C. Division of Water Quality ~'
Transportation Permitting Unit o,~Jl~ ~ / ~~
2321 Crabtree Blvd./Suite 250
Raleigh, NC 27604-2260
Attention: Mr. Rob Riding, NCDOT Project Coordinator
Subject: Secondary road improvements to SR 1331 (Shotwell Road) from SR 1328
(Stovall Road) to SR 1332 (Blue Wing Road) in Granville County. WBS
element 5C.039037.
The North Carolina Department of Transportation (NCDOT) proposes to upgrade and
pave SR 1331 (Shotwell Road) from SR 1328 (Stovall Road) to SR 1332 (Blue Wing
Road) in Granville County (Figures 1-6). Total project length is 1.81 miles.
Transportation and highway laws of North Carolina (G.S. 136-44.6, 136-44.7, 136-
44.7A, 136-44.8, and 136-44.9) require the NCDOT to develop annual work programs
for construction and maintenance of secondary roads. These general statutes specifically
set forth requirements for annual construction and paving of existing unpaved roads.
Paving of these roads is performed in priority order as established by the NCDOT for
each unpaved road within a given county. This number is based on characteristics of each
road, including number of homes, schools, churches, businesses, industries, recreational
facilities, traffic counts, presence of school bus routes, and value as a thoroughfare.
SR 1331 is scheduled to be paved as part of the Secondary Roads Construction Program.
Impacts to Waters of the United States
Site I -Waters of U S
Construction at this site will impact an unnamed intermittent tributary to Crooked Fork
[NCDENR-DVr'Q Index No. 22-59-1, Best Usage Classification C; HUC 03010104]
(Figure 3) in the Roanoke River Basin. The existing stracture conveying the creek is a
36-inch reinforced concrete pipe that is 40 feet long (see Photographs 1 and 2). This pipe
will be replaced with a 6.0_ft pipe. Permanent impacts at the site associated with this
longer pipe total 20 linear feet of fill in surface water in addition to a total of 20 feet of
rip rap along the stream banks. The work zone at this site will be temporarily dewatered
for approximately 1 day. This will involve the temporary placement of either sandbags or
Division 5, 2612 N. Duke Street, Durham, Nr 27704
Phone: [phone] Fas: [phone]

sheet piling upstream and downstream of construction. Once the stream has been
dewatered, the pipe will be replaced. To maintain water flow during construction, water
upstream of construction will be temporarily pumped out and conveyed around
downstream of the construction, if necessary. Temporary concurrent impacts to the
stream from this activity will result in dewatering 40 linear feet of stream. The materials
used for dewatering will be removed after construction.
Site 2 -Waters of US
Construction at this site will impact an unnamed intermittent tributary to Crooked Fork
[NCDENR-DWQ Index No. 22-59-1, Best Usage Classification C; HUC 03010104]
(Figure 4) in the Roanoke River Basin. The existing structure conveying the creek is a
24-inch reinforced concrete pipe that is 48 feet long (see Photographs 3 and 4). This pipe
will: be replaced with. a 64 ft pipe (on an angle). Permanent impacts at the site associated
with this longer pipe total 16 linear feet of fill in surface water in addition to a total of 10
feet of rip rap along the stream banks. The work zone at this site will be temporarily
dewatered for approximately 1 day. This will involve the temporary placement of
sandbags upstream and downstream of construction. Once the stream has been
dewatered, the pipe will be replaced. To maintain water flow during construction, water
upstream of construction will be temporarily pumped out and conveyed around
downstream of the construction, if necessary. Temporary concurrent impacts to the
stream from this activity will result in dewatering 26 linear feet of stream. The materials
used for dewatering will be removed after construction.
Site 3 -Waters of US
Construction at this site will impact an unnamed intermittent tributary to Aarons Creek
[NCDENR-DWQ Index No. 22-59, Best Usage Classification C; HUC 03010104]
(Figure 5) in the Roanoke River Basin. The existing structure conveying the creek is a
12-inch reinforced concrete pipe that is 40 feet long (see Photographs 5 and 6). This pipe
will be replaced with a 60 ft pipe. Permanent impacts at the site associated with this
longer pipe total 18 linear feet of fill in surface water on the inlet (due to a channel
change) and 8_linear feet of fill in surface on the outlet water in addition to a total of
25 feet of rip rap along the stream banks. The work zone at this site will be temporarily
watered for approximately 1 day. This will involve the temporary placement of
sandbags upstream and downstream of construction. Once the stream has been
dewatered, the pipe will be replaced. To maintain water flow during construction, water
upstream of construction will be temporarily pumped out and conveyed around
downstream of the construction, if necessary. Temporary concurrent impacts to the
stream from this activity will result in dewatering 51 linear feet of stream. The materials
used for dewatering will be removed after construction.
Site 4 -Waters of US
Construction at this site will impact an unnamed intermittent tributary to Aarons Creek
[NCDENR-DWQ Index No. 22-59-1, Best Usage Classification C; HUC 03010104]
(Figure 6) in the Roanoke River Basin. The existing structure conveying the creek is a
12-inch reinforced concrete pipe that is 32 feet long (see Photographs 7 and 8). This pipe
will be replaced with a 32 ft pipe. Permanent impacts at the site associated with this

3
longer pipe total 12 linear feet of fill in surface water on the inlet (due to a chanpel
change) and_$_Jinear feet of fill in surface on the outlet water in addition to a total of
20 feet of rip rap along the stream banks. The work zone at this site will be temporarily
-"dewatered for approximately 1 day. This will involve the temporary placement of
sandbags upstream and downstream of construction. Once the stream has been
dewatered, the pipe will be replaced. To maintain water flow during construction, water
upstream of construction will be temporarily pumped out and conveyed around
downstream of the construction, if necessary. Temporary concurrent impacts to the
stream from this activity will result in dewatering 401inear feet of stream. The materials
used for dewatering will be removed after construction.
Riparian Buffer Impacts
The project is located in the Roanoke River Basin. Therefore, construction will be
completed without impacts to protected riparian buffers.
Waters of the U.S./Riparian Buffer Mitigation
Avoidance: All wetlands and surface waters not affected by the project will be protected
from unnecessary encroachment. No staging of construction equipment or storage of
construction supplies will be allowed in wetlands or near surface waters.
Minimization: The side slopes have been steepened to the extent possible at jurisdictional
sites. Strict enforcement of sedimentation and erosion control Best Management Practices
for the protection of wetlands and surface waters will be enforced during project
construction. Continued coordination will occur with maintenance forces and the
Environmental Officer during construction to minimize impacts to these sites.
Compensatory 1~1iti ag tion: Due to the minimal impacts proposed, no mitigation
requirements are expected. Therefore, NCDOT proposes no compensatory mitigation.
Protected Species
Plants and animals with federal classifications of Endangered, Threatened, Proposed
Endangered and Proposed Threatened are protected under provisions of Section 7 and
Section 9 of the Endangered Species Act. As of February 2008, the dwarf wedgemussel
(Alasnaidonta heterodon), smooth coneflower (Echinacea laevigata), and harperella
(Ptilirrtnium. nodoszim) are listed as federally protected species in Granville County.
Please note that the bald eagle (Haliaeetics leucocephalus) was recently delisted. SR 1331
offers nc streams for habitat for dwarf wedge mussel or harperella. SR 1331 is not
adjacent to nor is it surrounded by open water suitable of supporting foraging habitat for
the bald eagle. The roadway shoulders along SR 1331 are regularly maintained frcm the
gravel to the woods line, eliminating the possibility fcr smooth coneflower to exist in this
area. Additionally, a review of the Natural Heritage Program database (last updated
November 2007) revealed no occurrences of protected species within the project area.
Therefore, based on lack of suitable habitat observed during the 01;09/08 site visit and

4
the NHP database review, biological conclusions of No Effect have been rendered for
each of these species.
Historical Compliance
This project has been screened by all pertinent parties to ensure historic compliance. A no
comment-no historic properties clearance was received from Renee Gledhill-Earley with
the NCSHPO, dated 02/05/08.
Summary
Application is hereby made for a NCDENR-DWQ Section 401 Water Quality
Certification (WQC) No. 3627 and riparian buffer authorization for above-described
activities. An automated payment procedure has been implemented between the NCDOT
and NCDWQ. This procedure will enable the Division to apply for the 401 WQC without
submitting a check for this permit application. This procedure will provide payment to
the NCDWQ by charging the permit application fee of $200.00 directly to the appropriate
NCDOT WBS element 5C.039037. Apre-construction notification is attached with this
request.
Per General Condition 27 [Notification provision], the USAGE is not copied on this
permit request. The proposed activities meet the conditions of the Department of the
Army Section 404 Nationwide Permit (NWP) 14 and the proposed impacts do not exceed
the 1/10 acre of loss of Waters of the United States. Additionally this project does not
involve impacts to a special aquatic site. Therefore we intend to comply with all
applicable NWP conditions during construction of this project, working under NWP 14
with no notification required to the USAGE.
If you have any questions or need additional information, please contact Ms. Heather
Montague at [phone].
Sincerely,
~., tn~ ~ w n~.~ i~rvl
'~` J.W. Bowman, P.E.
Division Engineer
cc: Ms. Tasha Johnson, NCDOT District 2 Engineer
Mr. Mike Harris, NCDOT Granville County Maintenance Engineer
Mr. Tim Robbins, NCDOT Roadside Environmental Field Ops Technician

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Photograph 2. View below outlet at Site 1, looking East.

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Photograph 5. View above inlet at Site 3, looking West.
Photograph 6. View below outlet at Site 3, looking East.

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Pegin Project
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SHEET 1\O. 1 OF 16

Site 1
STA 46+36
Placement of Impervious dike
for dewatering
\ II
Note:
~;,~~,~;,~ Proposed rip rap
-E TF Existing Transporotion Facility
® Proposed SW fill
;~ ~,~~ IOft
,> >~ ---rip raP
ETF
20fit~ gravel SR 1331
roadw~Iay width
W
ETF
IOfit
~ SW flll
I proposed
20fit paved
Shotwell Rd roadway width 60ft ROW
~~IOft
rip rap
~a----------
~ IOft
tai SW flll
~y
Plocement of impervious dike
for dewatering
Site 1 -Construction Plan
SR 1331 Shotwell Road
Granville County
Figure 3 1"=30'
02/07/0_

Site 2
sra s6+zz Note:
~;,~„~;,~ Proposed rip rap
-E T F Existing Transporation Facilit~
® Proposed SW fill
Plocement of impervious dike
for dewatering
cow
/ pasture
//,
---------------------- ~~fift-----------------------------------------
----------------------------- ---
rip rap
ETF _-- ~ Sft
~SW fill
25ft~gravel 20fit~paved Proposed
SR 1331 ~~ ~ Shotwell Rd 60ft ROW
roadwlay width roadwlaIy width
W W
E T F------ 8 f t --- -
~SW fill
----- - ---- =*l/:STNS##--------------------------
a .- i ~ rip rap
/'
Placement of Impervious dike
for dewatering

Site 2 -Construction Plan
SR 1331 Shotwell Road
Granville County
Figure 4 1"=30'
02/07/08

Site 3
STA 83+13
Placement ofi Impervious dike
for dewatering
cow
pasture
E1F
Note:
~;;r~,~„~ Proposed rip rap
-ETF Existing Transporation Facility
Proposed SW fill
~~
~~' \ 15 f t
~ // rip rap
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~~~ Sfit-----------------------------------------------------
;~SW fill
20fit~gravel SR 1331 Shotwell Rd 20fit paved Proposed
roadw~lIa~y width ~' roadwlaIy width 60ft ROW
- - - W - - - - - - - - - - - - - - - - - - ~ ~ - - - - - - - - - - - - - - - - - - - W - - - -
EiF-
r ISft fill
--.-ter r --------------------------------- - ------------------------
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Placement of impervious dike
fior dewatering
Site 3 -Construction Plan
SR 1331 Shotwell Road
Granville County
Figure 5 1 "=30'
02/07/08

srte a
sTa lot+os
Note:
~;;r~;~,:~ Proposed rip rap
Placement of impervious dike -ETF Existing Transporation Facility
for dewatering ~ ® Proposed SW fill
~~
~~\
ll ~ loft
` ;~I~i rip roP
ri ~ ~
---------------------------------- -
--- r------------
-----------------------------------------
12fit
SW fiill
ETF-
- - - - - - - - - - - - - - - - - - - - - '- - - - - - - - - - - - - - - - - - - - - - - - -
20ft~gravel ~ proposed
SR 1331 ~ Shotwell Rd 20fit paved
roadway width 60ft ROW
I. ; , roadw lay width
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ETF - ~~
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\~ Placement of impervious dike
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Site 4 -Construction Plan
SR 1331 Shotwell Road
Granville County
Figure 6 1 "=30'
02/07/08

Ot~fice Use Only:
Form Version ;March f)j ..
20080273
USACE Action ID No. DWQ No.
([f any particular iten~ 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: NWP 14 (non-reporting)
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. [f 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: ^
IL Applicant Information
Owner/Applicant Information
Name: NCDOT Division 5, J.W. Bowman
Mailing Address: 2612 N. Duke St. Durham NC 27704
Telephone Number: [phone] Fax Number. [phone]
E-mail Address: wbowman(c~,dot.state.nc.us
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:
Telephone Number:
E-snail Address:
Fax Number:
Page 1 of R

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
USAGE 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: Proposed replacement of structures conveying unnamed tributaries to
Crooked Fork and to Aarons Creek in association with up adin~ and paving on SR 1331
(Shotwell Road) in Granville County.
2. T.LP. Project Number or State Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN)
N/A
4. Location
County: Granville Nearest Town: Oxford
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers/names, landmarks, etc.): From Oxford take Hwy 9b
North towards Virgilina for approximately 16.5 miles. Then make a left onto SR 1332
(B1ueWin~ Road) and travel approximately 0.4 mile and make a left onto SR 1331 (Shotwell
Road- .
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):
Site l: 36.5033 °N
Site 2: 36.5044 °N
Site 3: 36.5112 "N
Site 4: 36.562 °N
78.7767 °`vV
78.7730 °W
78.7702 °W
78.7678 °W
6. Property size (acres): 1.3.2 acre (Project is 1.81 mi long)
Narr~e of nearest receiving body of water: UTs to Crooked Fork and Aarons Creek
8. River Basin: Roanoke
(Note -this must be one of North Carolina's seventeen designated major river basins. The River
Basin map is available at http:/11120.e:.r.state.nc.us!admin/mapsi.)
Page 2 of 8

9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Sites are surrounded by wooded areas and agricultural land.
10. Describe the overall project in detail, including the type of equipment to be used: Grade,
drain pave, and erosion control at SR 1331 (Shotwell Rd). The NCDOT will also dewater
the work sites during construction. Equipment may include excavator, backhoe, bulldozer,
grader and crane.
11. Explain the purpose of the proposed work: The project is part of the secondary road paving
program. The existing_gravel roadway will be paved with asphalt.
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 USAGE 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.LP. project, along with
construction schedules. N/A
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.
N/A
VI. Proposed Impacts to Waters of the United States/VVaters 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 maybe 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: Existing_pipes will be replaced with
longer length pipes in association with this secondary road protect. The NCDOT will also
dewater the work sites during construction, as necessary.
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 dne to tenth ctntctnre and flnnrlina
Wetland Im act
p
Type of Wetland Located within Distance to Area of

Site Number
Type of Impact
(e.g., forested, marsh, 100-year Nearest Impact

(indicate on map)
herbaceous, bog, etc.) Floodplain Stream (acres)
(yes/no) (linear feet)
NiA
Total Wetland Impact (acres) N/A
S. Llst the total acreage (estimated) of alt exlstmg wetlands on the property: N/A
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 or Average
Stream Width Impact Area of

Number Stream Name Type of Impact
Intermittent?
Before Impact Length Impact

(indicate on map) (linear feet) (acres)
Site 1 Crooked Fork Fill (piped length) Intermittent 3'0 20 ~ 0.001
Rip rap armoring

along stream bank 20 0.00 i
Temporary 40 0.002
dewatering concurrent concurrent
Site 2 Crooked Fork Fill (piped length) Intermittent 1.0 16 0.0003
Rip rap armoring

along stream bank 10 0.0002 I
~
Temporary 26 0.0005
dewatering concurrent concurrent

Site 3 UT to
Aarons Creek
Fill (piped length)
Intermittent 2.0
26 ~
0.001 ~
Rip rap arnoring

along stream bank 25 0.00.001
Temporary 51 0.002
dewatering concurrent concurrent ~
Site 4 UT to Fill (piped length) Intermittent ~ 20 I O.C01 ~
i Aarons Creek i I
i Rip rap armoring I

I
along stream bank ~0 0 00~
~ Temporary 40 0.002 ~
dewatering concu~~ent concurrent
Total Stream Impact (by length and acreage) 157 ~ 0.0065

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5. Individually list all apen 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 map) ocean, etc.) (acres)
N/A
Total Open Water Impact (acres) N/A
6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): 0.0065
Wetland Impact (acres): NONE
Open Water Impact (acres): NONE
Total Impact to Waters of the U.S. (acres) 0.0065
Total Stream Im act (linear feet): 157
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.
N/A
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
Current land use in the vicinity of the pond: N/A
Size of watershed draining to pond: N/A
VII. Impact Justification (Avoidance and Minimization)
Expected pond surface area: N/A
Specifically describe measures taken to avoid the proposed impacts. It maybe 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 ccnstntctior
techniques to be followed during construction to reduce impacts. All wetlands and surface
waters not affected by construction will be protected from unnecessarv encroachment during
construction. Strict enforcement of Best 1ylanapement Practices for the protection of wetlands
Page 5 of 8

and surface waters will be enforced during construction Only the smallest amount of fill
necessary to complete the project will be placed in waters of the United States or riparian
VIII. l~'Iitigation
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.
USAGE - 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
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 USAGE 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!stnn~;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 (restora±ion, 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.
Due to the minimal impacts posed no mitigation requirements are expected Therefore
NCDOT proposes no compensator miti ate
2. Mitigation may also be made by payment into the North Carolina 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 are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process far the NCEEP, check the NCEEP
website at http:i;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:
Page 6 of 8

i
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 ofNon-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
IX. Environmental Documentation (required by DWQ)
1. 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 aNEPA/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 ^
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent'sl 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.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC ZB .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.

Zone'T Impact
(square feet)
Multiplier Required
Mitigation
~ I N/A 3 (2 for Catawba) N/A
I 2 N/A 1.5 N/A
~ Total N/A N/A
* 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.
Page 7 of 8

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. N/A
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. There will be no new impervious surface with
this paving- 20ft gravel roadway with 20ft asphalt. Erosion and sediment control devices along
the project are comprised of temporary rock silt checks, temporary silt basins, and temporary
fe_n_ce. The temporary structures will be removed once the vegetation has been established and
these areas will be reseeded.
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.
This project will not generate wastewater.
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 an after-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:
Upgrading SR 1331 will not result in additional development.
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 impale 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).

_-
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8