20080437 Ver 1_Application_20080311

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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
March 5, 2008
N.C. Division of Water Quality
Transportation Permitting Unit
2321 Crabtree Blvd./Suite 250 0 Q O
Raleigh, NC 27604-2260 V
Attention: Mr. Rob Riding, NCDOT Project Coordinator
Subject: Secondary road improvements to SR 1185 (Whitmore Road) from SR
1111 (Bushy Fork Road) to dead end in Person County. WBS element
SC.073050
The North Carolina Department of Transportation (NCDOT) proposes to upgrade and pave
SR 1185 (Whitmore Road) from SR 1111 (Bushy Fork Road) to dead end in Person
County (Figures 1-3). Total project length is 0.9 mile. Transportation and highway laws of
North Carolina (G.S. 136-44.6, 136-44.7, 136-44.7A, 136-44.8, and 13b-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 1185 is scheduled to be paved as part of the Secondary Roads
Construction Program.
Impacts to Waters of the United States
Construction at Site I will impact an unnamed intermittent tributary to South Flat River
[NCDENR-DWQ Index No. 27-3-3, Best Usage Classification C NSW; HUC 03020201]
(Figure 3) in the Neuse River Basin. The existing structure conveying the creek is a 24-
inch reinforced concrete pipe that is 44 feet long (see Photograph 1 and 2). Also there is
an overflow pipe Sft to the east of the main pipe. The overflow pipe is a 30-inch
reinforced concrete pipe that is also 44 feet long. These pipes will be replaced with pipes
that are 8 feet longer. Permanent impacts at the site associated with the pipe replacements
total 8 linear feet of fill in surface water in addition to a total of ZO feet of rip rap along
the stream banks. The work zone at this site will be temporarily dewatered for
approximately 2 days, if necessary. This will involve the temporary placement of
sandbags upstream and downstream of construction. Once the stream has -been
dewatered, the new pipes will be set. Temporary concurrent impacts to the stream from
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Division 5, 2612 N. Duke Street, Durham, NC 27704
Phone: (9i9) 220-4600 Fax: (9I9) 560-3371

2
this activity will result in dewatering 28 linear feet of stream. The materials used for
dewatering will be removed after construction.
Riparian Buffer
The pipe replacement work at Site 1 involves a road crossing of a stream that is subject to
the Neuse River Buffer Rules. This intermittent unnamed tributary to South Flat River is
depicted on the most recent version of the Hurdle Mills (USGS 1968) topographic
quadrangle (Figure 1) and the Soil Survey of Person County (USDA-SCS, 184) (Figure
2). Construction impacts at this site total 1,478 ft` in Zone 1 and 980 ft2 in Zone 2
(totaling 28 lft of riparian buffer impacts). The buffer zone impacts between the pon
stream and roadway in the NE quadrant of Site 1 might be considered parallel impacts,
which are `allowable with mitigation.' However, please see Photographs 2a and 2b. This
shows that a 60ft cleared ROW width already exists along this section of roadway.
'Additionally the property owner maintains grass around this pond and up to his property
line marked by green fencing at the ROW line. Therefore no new impacts to the riparian
buffer surrounding this pond are proposed and no buffer mitigation is proposed. Any
temporary disturbed grass between the green fence and the roadway will be reseeded
upon completion of the project.
Please note: One additional drainage way feature has been identified that could be
subject to protection under the Neuse River Riparian Buffer Rules (see Appendix One for
photographs and a NCDWQ-Stream Identification Form). In addition to labeling Site 1,
Figure 1 and Figure 2 also have feature `A' labeled. This feature appears on the Soil
Survey for Person County, but are absent from the USGS Hurdle Mills Quad map.
NCDOT requests your assistance in providing a buffer call on this feature.
Waters of the U.S. 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.
Compensatary Mitigation: 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 ESA. As of March 2008 there is one federally protected species listed for
Person County: dwarf wedgemussel (Alasmidonta heterodon). This intermittent stream
does not provide suitable habitat for dwarf wedgemussel. Additionally, a review of the
Natural Heritage Program database (last updated February 2008) revealed no occurrences
of protected species within the project limits. Therefore, based on lack of suitable habitat
observed during the site visit and the NHP database review, a biological conclusion of No
Effecthave been rendered for each of the dwarf wedgemussel.

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 12/28/07.
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.073050. Apre-construction notification is attached with this
request.
Per General Condition 27 [Notification provision], the USACE is not copied on this
permit request. The proposed activities meet the conditions of the Department of the
Army Section 404 Nationwide Permit (NWP) l4 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 l4
with no notification required to the USACE.
If you have any questions or need additional information, please contact Ms. Heather
Montague at [phone].
Sincerely,
.W. Bowman, P.E.
Division Engineer
cc: Ms. Tasha Johnson, NCDOT District 2 Engineer
Mr. Anthony Talley, NCDOT Person County Maintenance Engineer
Mr. Tim Robbins, NCDOT Roadside Environmental Field Ops Tech

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02/20/08
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.Office Use Only: °• Fonn Version March OS
2 0 0 8 0 4 3 7
USACE Action ID No. DWQ No.
(lt any particular item is not applicable to this project, please enter "Not Applicable" or "NiA".)
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-reportin~~
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: 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(adot.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 I~TUmber:
E-mail Address:
Fax Number:
Page : of 8

Office Use Only: Form Version March OS
USACE Action ID No. DWQ No. ~~ ~~~ H 3 7
fit any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
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-reportingL
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
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(cr~,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-mail Address:
Fax Number:
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, attd roads: ALSO ~it~vide 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: Proposed replacement of a structure conve~g an unnamed tributary to
South Flat River in association with upgrading and paving on SR 1185 (Whitmore Road) in
Person Count
2. T.I.P. Project Number or State Project Number (NCDOT Only): WBS # SC.073050
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Person Nearest Town: Roxboro
Subdivision name (include phase/lot number): N/A
Directions to site (include mad numbers/names, landmarks, etc.): From the South side of
Roxboro, take Hwy 49 south west for approximately 12.8 miles. Make a left onto SR 1111
(Bushy Fork Road) aka. Robert Whitfield Road. Follow SR 1111 for 1.6 miles and make a
left onto SR 1185 (Whitmore 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 1: 36.2898 °N 79.0759 °W
6. Property size (acres): 6.5 acre (Project is 0.9 mi long)
T. Name of nearest receiving body of water: UT South -Flat River
8. River Basin: Neuse
(Note -this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http:/,~h2o.enr.state.nc.usr'admin/maps/.)
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 1185 (Whitmore Road). The NCDOT will also
dewater the work site during construction as necessary Equipment may include excavator
backhoe, bulldozer, Qrader, and crane.
11. Explain the purpose of the proposed work: The project is part of the secondar r~ paving
program. The existin,~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 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. 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/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.
Page 3 of 8

1. Provide a written description of the proposed impacts: Existing_pipe (at Site 1) and the over
flow pipe will be replaced with lon eg r leng_th~ipes in association with this secondary road
protect. The NCDOT will also dewater the work site duringconstruction as necessary
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 T e of Im act
yp p
(e.g., forested, marsh, 100-year Nearest Impact

(indicate on map)
herbaceous, bog, etc.) Floodplain Stream (acres)
(yes/no) (linear feet)
N/A
Total Wetland Impact (acres) N/A
3. List the total acreage (estimated) of all existing 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 Impact Area of
Number Stream Name Type of Impact Intermittent? Stream Width Length Impact
(indicate on map) Before Impact (linear feet) (acres)
Site 1 Sout U 1 t River Fill (piped length) Intermittent 1'0 8 0.0002
Rip rap armoring
Along stream bank ZO 0.0004
Temporary 28 0.0006
dewatering . concurrent concurrent
Total Stream Impact (by length and acreage) Z8 0.0006
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 W"aterbody 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
Page 4 of 8

6. List the cumulative impact to all. Waters of the U.S. resulting from the protect:
Stream Impact (acres): 0.0006
Wetland Impact (acres): NONE
Open Water Impact (acres): NONE
Total Impact to Waters of the U.S. (acres) 0.0006
Total Stream Impact (linear feet): 28
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
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 Expected pond surface area: N/A
VII. Impact Justification (Avoidance and Minimization)
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 construction
techniques to be followed during construction to reduce impacts. All wetlands and surface
waters not affected by construction will be protected from unnecessary encroachment during
construction. Strict enforcement of Best Management Practices for the protection of wetlands
and surface waters will be enforced during construction. Only the smallest amount of till
necessa~ to complete the project will be placed in waters of the United States or riparian
buffers.
VIII. Mitigation
DWQ - In accordance with 15A iv'CAC 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
Page 5 of $

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/strmgide.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.
Due to the minimal impacts proposed, no mitigation requirements are expected. Therefore,
NCDOT proposes no compensator~~ation.
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 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): 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
Page 6 of 8

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'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.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 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.
Zone* Impact
(square feet) Multiplier Required
Mitigation
1 1,478 3 (2 for Catawba) N/A
2 980 1.5 N; A '
Total 2,458 NiA
* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additions! 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 Pa-ytnent into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC ?B .0242 or .0244, or .0260. N/A
Page 7 of 8

,.
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 is 2.6 acre existing impervious surface (avg 24 foot wide
gravel road, 0.9 mile project) of the 6 5 acre project size The proposed impervious surface is
LESS than the original with a 20 foot wide paved roadway. Therefore no new impervious surface
is posed with this project. Erosion and sediment control devices along the project are
comprised of temporary rock silt checks, temporary silt basins and temporary silt fence. 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 1185 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 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).
o3~os~o8
~ ~ Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8

Appendix One

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Photograph 4. View of `Feature A' below pipe outlet, looking North
SR 1185 (Whitmore Road) -Person County

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North Carolina Division of Water Quality -Stream Identification Form; Version 3.1
Date: ~~ 2~ ~' Project: S,Q ~~$5 (W1+i~rb/e ~) Latitude: 3(, Zq I ~}
Evaluator:~~~Gr~6n ~ Site: ~ Longitude: 7q O7 I y.
Total Points: Other
Stream is at least intermittent ~ county: der s on e. Quad Name: u ~4~ ~~1~
if >_ 19 or erennial if >_ 30 9'
A. Geomor holo (Subtotal = /~ 5 Absent Weak Moderate Strong
1a. Continuous bed and bank 0 1 2 3
2. Sinuosity 0 1 2 3
3. In-channel structure: riffle-pool sequence 0 1 2 3
4. Soil texture or stream substrate sorting 0 1 2 3
5. Active/relic floodplain 1 2 3
6. Depositional bars or benches 1 2 3
7. Braided channel 1 2 3
8. Recent alluvial deposits 0 1 2 3
9 a Natural levees 0 - 1 2 3
10. Headcuts 0 1 2 3
11. Grade controls 0.5 1 1.5
12. Natural valley or drainageway 0 0.5 1
13. Second or greater order channel on existing
USGS or NRCS map or other documented
evidence.
o = 0
Yes = 3
"Man-made ditches are not rated; see discussions in manual
B. Hvdroloav (Subtotal = f~ S 1
14. Groundwater flow/discharge 0 1 2 3
15. Water in channel and > 48 hrs since rain, or
Water in channel - d or rowin season /"~
~~ 1 2 3
16. Leaflitter ~o '-t~ru-S ~ O 4 1.5 1 0.5 0
17. Sediment on plants or debris 0.5 1 1.5
18. Organic debris lines or piles (Wrack lines) 0 0.5 1 1.5
19. Hydric soils (redoximorphic features) present? o = 0 Yes = 1.5
C. Bioloav (Subtotal = ~ 1
20 . Fibrous roots in channel 3 2 1 0
21 .Rooted plants in channel 3 2 1
22. Crayfish 0 0.5 1 .5
23. Bivalves 1 2 3
24. Fish 0 0.5 1 1.5
25. Amphibians 0.5 1 1.5
26. Macrobenthos (note diversity and abundance) 0 0.5 1 1.5
27. Filamentous algae; periphyton 0 1 2 3
28. Iron oxidizing bacteria/fungus. 0.5 t 1.5
29 °. Wetland plants in streambed FAC = 0.5; FACW = 0.75; OBL = 1.5 SAV = 2.0• ner = 0
~~s'sL
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hems to ana z't focus on the presence of upland plants, Item 29 focuses on the presence of aquatic or wetland ptari'tsr----
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Sketch: ~, ,`na~~ t~s I
Notes: (use back side of this form for additional notes.; ~ ~YU Q~ ~ 1'tvt.C
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draha ~.r ,~., o~ as+~ ~ c.ow as +~X ~'L 1 t 8 ~
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