19950851 Ver 1_COMPLETE FILE_19950816

State of North Carolina
Department of Envircnment,
Health and Natural Resources
Division of Environments Management
James B. Hunt, Jr., Gove•-)or
Jonathan B. Howes, Sec-atary
A. Preston Howard, Jr., F Director
APPROVAL of 401 Water Quality Certification
Town of Madison
120 North Market Street
Madison, N.C. 27025
Dear Sir:
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C) FE F=1
August 17, 1995
Rockingham County
DEM Project # 95851
FIDE COPY
You have our approval to place fill material in 0.17 acres of wetlands or waters for the purpose
of sanitary sewer forcemain under the Dan River at Madison, as you described in your application
dated 11 August 1995. After reviewing your application, we have decided that this fill is covered by
General Water Quality Certification Number 2664. This certification allows you to use Nationwide
Permit Number 12 when it is issued by the Corps of Engineers.
This approval is only valid for the purpose and design that you described in your application. If
you change your project, you must notify us and you may be required to send us a new application.
For this approval to be valid, you must follow the conditions listed in the attached certification. In
addition, you should get any other federal, state or local permits before you go ahead with your
project.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory
hearing. You must act within 60 days of the date that you receive this letter. To ask for a hearing,
send a written petition which conforms to Chapter 150B of the North Carolina General Statutes to the
Office of Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 276 1 1-7447. This certification and
its conditions are final and binding unless you ask for a hearing.
This letter completes the re%iew of the Division of Environmental Management under Section 401
of the Clean Water Act. If you have any questions, please telephone John Domey at 919-733-1786.
Attachment
cc: Wilmington District Corp-, of Engineers
Corps of Engineers Raleigh Field Office
Winston-Salem DEM Regional Office
Mr. John Domey
Central Files
Michael Hanna; Dewbem- & Davis
Sincerely,
eston Howard, Jr. E.
J
95851.1tr
P.O. Box 29535, Raleigh, No-h Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity A"rmative Action Employer 50% recycled/ 10% post-consumer paper

bEM ID: ACTION M 1y
Nationwide permit g4gWo0d (Provide Nationwide Permit ft 12
JOINT FORM FOR
Nationwide permits that require notiScation to the Corps of Engineers
Nationwide permits that require application for Section 401 certification
DMSI01? OF g PLANNING ' pry ? ?r T .
NC DEPARTMWT OF MmRd
AND NATURAL RESOURMS
P.O. Boar 29333
NC 27626-0535
MR JOHN DORNEY
Telepboae [phone]
ONE (1) COPY OF THIS COMPI.EM Appi1CATION SHOULD BE SENT 'PO THE CORPS OF ENGINEERS,
SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT,
PLEASE PRINT.
L Oarners Name: Town of Madison
L OwtretsAddrear 120 North Market Street. Madicnn_ N r
Wg-),= TON DM TRICT ENOD EER
CORPS OF ENa NEERS
DEPARTmwr OF THE ARMY
P. O. Boat 1890
Wilmiagoon. NC 28402.1890
ATM: CESAW.co-E
Telepbooe (919) 2S1-4511
3. Owners Pbooe Number (Home): (Work): 910 427-0221
4. If Appticxble: Agent': name or zrsponsr'hle corporate offrc3ul. addrrss. phone number
5..Looadoa of work (MUST ATTACH MAP). County: Rockingham
Nearest Town or car. Ma d i s o n
SPecrflc Location (Include read numbers, landmarks, cm): C r o'ss i n the Dan River 0 feet north
of the NC 704 Bridge
6. Name of QoMt St[ua MMver: Dan ' Rive r
7. RiverBasiz Roanoke
S. Is this project located in a wamhcd classified as Trout. SA. HQW, ORW, WS I, or WS II? YES [ ] No [ ]
9. Have any Section 404 permits been prt~viously requested for use on this property? YES [ ] NO [x]
If yes, explain.
10. Estimated total number of acres of waters of the U.S.. including wetlands. located on project site:
0.17
11. Number of acres of waters of the us" including wetlands, impacted by the proposed project:
Filled:
t, A'.1
Mooded:
Excavated: 0.17
Total Impacted: 0. 17
Rt:At Cflft'lA'RA
ANniHingiA Wnt'7IWH WnA4

12. D"cription Of p uposed work (Attach PLANS-9 M' x 11- drawings ody).
In. e t a 11 6" t Sanitary
Sewer Forcemain across (under) the Dan River at Madison.
13. Purpose Of Proposedwosic T provide sewer service to east side of Dan River.
14. Sine ream why the applicant believes that this ac:iviry must be canoed out in wedaads. Alsa
taken ?. note measures
mmtmmruwetlandimpacts. _ Going ,order the river is the most practica way to cross.
13. You are It" to cozftct the U.S. Fish and Wildlife SQyim (USFWS) M&WNatiooal Marine Hsheries Service
(NMFS) regarding the P=en= or any i~edes!ally listen orp Mposed for listing endanMW octhreatened
q)ecihabitat m the peamit aria that may be affamed by the proposed p n ax Have you donee so? YPS [j?a NO
RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE FORWARDED TO CORPS.
16. You are required to contact ft State Wagoric pfd. O?,., (SHPO) regarding the Pmscwe of bistm c
Properties in the permit ar¢a which may be affected by the proposed Project? Havre you done so? YES[ ] No[x]
RESPONSE FROM THE SHPO SHOULD BE FORWARDED TO CORPS.
17. Additional infornuuion required by DEM.
A. Wetland delineation map showing all wetland-% snteams, and lakes on the propeny
B. If available. rep esentative photopapb of walands to be impacmd by ptoject.
C. If delineation was pecf=md by a c onmItant. include all data ahem relevant to the placement of the
delineation line.
D. If a stormwatc r management plan is required for this project, attach copy.
E' What $ land "se of surrounding PrOPay? V a u n t Flood Plan
R If appHmWe. whatrs pmposcd method of sewage disposal? discharge into Town of Madison
collect&pn System.,
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August 11, 1995
Mr. John Dorney
Division of Environmental Management
NC Department of Environment, Health and Natural Resources
P.O. Box 29535
Raleigh, NC 27626-0535
Re: Town of Madison
NC704 Water and Sewer Extension
Permit Notification
Dear Mr. Dorney:
551 Pincy Forest Road
N). [lox 1509
Danville, VA 24-543
804 797-4497
Fax [phone]

Enclosed please find seven (7) copies of a joint notification form for a Nationwide Permit No.
12 for the above referenced project.
If you have any questions or comments, please do not hesitate to call.
Sincerely,
DEWBERRY & DAVIS

K. Michael Hanna
Project Engineer
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