19990278 Ver 1_COMPLETE FILE_19990404

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Kerr T. Stevens, Director
NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
April 6, 1999
Alamance County
DWQ Project # 990278
APPROVAL of 401 Water Quality Certification
Mr. William Baker
City Manager
City of Burlington
P.O.Box 1358
Burlington N.C. 27216-1358
Dear Mr. Baker:
You have our approval, in accordance with the attached conditions, to place fill material in 148 feet of streams for
the purpose of constructing a road crossing (Boone station Drive Extension), as you described in your application dated 15
March, 1999. After reviewing your application, we have decided that this fill is covered by General Water Quality
Certification Number 3102. This Certification allows you to use Nationwide Permit Number 14 when the Corps of
Engineers issues it. In addition, you should get any other federal, state or local permits before you go ahead with your
project including (but not limited to) Sediment and Erosion Control, Coastal Stormwater, Non-Discharge and Water
Supply Watershed regulations. Also this approval will expire when the accompanying 404 or CAMA permit expires
unless otherwise specified in the General Certification.
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 send us a new application. If the property is sold, the new owner must be given a copy of
this Certification and approval letter and is thereby responsible for complying with all conditions. If total wetland fills for
this project (now or in the future) exceed one acre, compensatory mitigation may be required as described in 15A NCAC
2H .0506 (h). For this approval to be valid, you must follow the conditions listed in the attached certification. This
approval shall expire when the corresponding Nationwide Permit expires or as otherwise provided in the General
Certification.
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. 27611-7447. This certification and its conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If you
have any questions, please telephone John Dorney at 919-733-1786.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Winston- Salem DWQ Regional Office
Mr. John Dorney
Central Files
Denise Poulos, ECS
990278.1tr
Division of Water Quality - Environmental Sciences Branch
Environmental Sciences Branch, 4401 Reedy Creek Rd, Raleigh, NC 27607 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer - 50% recycled/10% post consumer paper
7 F-

ENGINEERING CONSULTING SERVICES, LTD.
Geotechnical • Construction Materials • Environmental
Mr. John Domey
North Carolina Division of Water Quality
4401 Reedy Creek Road
Raleigh, North Carolina 27607
Subject:
Pre-Construction Notification Application
Boone Station Drive Extension
Burlington, North Carolina
ECS Project G-2354
Dear Mr. Domey:
401 ISSUE)
March 15, 1998
Please find seven copies of the Pre-Construction Notification Application for the above referenced site.
The project consists of the extension of Boone Station Drive from its current termination point at Gum
Creek to Forestdale Road. The roadway extension will result in impact to approximately 148 linear feet
of Gum Creek. We are requesting a 401 Water Quality Certification for the proposed impact.
Please feel free to contact me at [phone] if you have any questions concerning this request or if
additional information is required. Thank you in advance for your timely consideration of this matter.
Sincerely, / e C I (l
D
ENGINEERING CONSULTING SERVICES, LTD.
Denise M. Poulos, LSS
Principal Scientist
Attachment: Pre-Construction Notification Application bA%Is &
TMENT
RECEIVED
5-C Dundas Circle, Greensboro, NC 27407 • [phone] • Fax [phone]
??I- b7?78
Offices: Washington, DC; Baltimore, MD; Frederick, MD; Richmond, VA; Norfolk, VA; Fredericksburg, VA; Danville, VA;
Roanoke, VA; Williamsburg, VA; Raleigh/Durham, NC; Wilmington, NC; Charlotte, NC; Greensboro, NC; Greenville, SC; Atlanta, GA
An ISSUED
DWQ ID: - CORPS ACTION ID: _
NATIONWIDE PERAUT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY,
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: Mr. William R. Baker, Ci Manager. City of Burlington PAYMENT
2. MAILING ADDRESS: Box 1358, Burlington, North Carolina 27216-1358 RECEIVED
SUBDIVISION NAME _
CITY: -STATE: _ ZIP CODE: _
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
Boone Station Road. Burlington, North Carolina
3. TELEPHONE NUMBER: (HOME) _ (WORK) [phone]
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Denise M Poulos ECS Ltd. 5-C Dundas Circle Greensboro North Carolina
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Alamance - NEAREST TOWN: Burlin anon
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.) Boone Station Drive
6. IMPACTED OR NEAREST STREAM/RIVER: Gum Creek RIVER BASIN: Haw/Cape Fear
7. (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES ? NO X IF YES, EXPLAIN: _
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO X
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO X IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO X IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: The project site consists of
Boone Station Drive.
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
Wetlands are not present on the proiect site.
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: _ EXCAVATION:
FLOODING: _ OTHER : _
DRAINAGE : TOTAL ACRES TO BE IMPACTED:
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION: -`
LENGTH BEFORE: _ FT AFTER: _ FT ,.
WIDTH BEFORE (based on normal high water contours): - FT
AVERAGE DEPTH BEFORE: _ FT AFTER: _ FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: _ PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: _ CONSTRUCTION OF A DAM/FLOODING:
OTHER: A culvert will be placed into the stream. This will result in an impact of 148 linear feet.
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? _ WHAT IS THE EXPECTED POND SURFACE AREA? _
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
The project involves extending Boone Station Drive from its current termination point at Gum Creek to
Forestdale Drive Trackhoes excavators, loaders, trucks, etc. will be used to construct the roadway.
13. PURPOSE OF PROPOSED WORK: The purpose of the project is to extend Boone Station Drive to
Forestdale Drive Currently Boone Station Drive ends at Gum Creek.
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
It is necessary to cross Gum Creek in order to complete the project.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: -
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED _.
17. DOES THE PROJECT NVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF
PUBLIC (STATE) LAND? YES X NO ? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO X
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO ?
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERINUTTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PROJECT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.(d) ATTACH A COPY OF THE
STORiZv WATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? The surrounding properties contain
residential and commercial development.
(fl IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? Municipal sanitary
sewer system.
SIGNED AND DATED AGENT AUTHORIZATION LETTER, LF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE RVIPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DMSION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH C OLINA COASTAL MANAGEMENT
PROGRAM, / , A
W.R. Baker, City Manac
OWNER'S/AGENT'S SIGNATURE DATE
8/99
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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SOURCE:
USGS TOPOGRAPHIC MAP FIGURE 1
BURLINGTON (DATED 1969, C!3
PHOTOREVISED 1981) AND, LTD SITE LOCATION MAP
GIBSONVILLE (DATED 1970, BOONE STATION DRIVE
REVISED 1994) NC ENGINEERING BURLINGTON, NC
QUADRANGLES
SCALE: 1" = 2000' CONSULTING
SERVICES ,LTD ECS PROJECT G-2354
CLASS "1" RIP RAP
24" THICK, TYP.
EACH END
CHANNEL E AVATION LIMITS
SLOPE TO XIST. GROUND
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ENGINEERS & ARCHITECTS CULVERT IMPROVEMENTS
740 chapel hill road p.o. box 1179
burlington, n.c. 27215 336/226-5534 sc.,,u:1" = 40' aATE : 2/18/99 ID,, ar PLW
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740 chapel hill road p.o. box 1179
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CULVERT IMPROVEMENTS
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7
ENGINEERING CONSULTING SERVICES, LTD.
Geotechnical - Construction Materials - Environmental
Mr. John Dorney 01 ISSLIED March 15, 1998
North Carolina Division of Water Quality
4401 Reedy Creek Road
Raleigh, North Carolina 27607
Subject: Pre-Construction Notification Application
Boone Station Drive Extension
Burlington, North Carolina
ECS Project G-2354
Dear Mr. Dorney:
Please find seven copies of the Pre-Construction Notification Application for the above referenced site.
The project consists of the extension of Boone Station Drive from its current termination point at Gum
Creek to Forestdale Road. The roadway extension will result in impact to approximately 148 linear feet
of Gum Creek. We are requesting a 401 Water Quality Certification for the proposed impact.
Please feel free to contact me at [phone] if you have any questions concerning this request or if
additional information is required. Thank you in advance for your timely consideration of this matter.
Sincerely,
ENGINEERING CONSULTING SERVICES, LTD.
Denise M. Poulos, LSS
Principal Scientist
Attachment: Pre-Construction Notification Application
Water Quality Certification Check for $200.00
104!?tyr
RneGi
D
5-C Dundas Circle, Greensboro, NC 27407 - [phone] - Fax [phone]
Offices: Washington, DC; Baltimore, MD; Frederick, MD; Richmond, VA; Norfolk, VA; Fredericksburg, VA; Danville, VA;
Roanoke, VA; Williamsburg, VA; Raleigh/Durham, NC; Wilmington, NC; Charlotte, NC; Greensboro, NC; Greenville, SC; Atlanta, GA
.+ .S
401ISSUED PAYMENT
RECEIVED
DWQ ID: - CORPS ACTION ID: -
NATIONWIDE PERNHT REQUESTED (PROVIDE NATIONWIDE PERNIIT #) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN 7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY,
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: Mr. William R. Baker. City Manager. City of Burlington
2. MAILING ADDRESS: Box 1358, Burlington, North Carolina 27216-1358
SUBDIVISION NAME _
CITY: -STATE: - ZIP CODE: _
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
Boone Station Road, Burlington, North Carolina
3. TELEPHONE NUMBER: (HOME) _ (WORK) [phone]
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADD.RESS,'
PHONE NUMBER:
Denise M. Poulos, ECS, Ltd., 5-C Dundas Circle, Greensboro, North Carolina
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Alamance - NEAREST TOWN: Burlington
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.) Boone Station Drive
6. IMPACTED OR NEAREST STREAM/RIVER: Gum Creek RIVER BASIN: Haw/Cape Fear
7. (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES ? NO X IF YES, EXPLAIN: _
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO X
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES E] NO X IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO X IF YES, DESCRIBE ANTICIPATED WORK: _
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: The project site consists of
Boone Station Drive.
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
Wetlands are not present on the oroiect site.
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: _ EXCAVATION:
FLOODING: _ OTHER : _
DRAINAGE : - TOTAL ACRES TO BE IMPACTED: _
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: _ FT AFTER: - FT
WIDTH BEFORE (based on normal high water contours): _ FT
AVERAGE DEPTH BEFORE: _ FT AFTER: _ FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: _ PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: _ CONSTRUCTION OF A DAM/FLOODING: _
OTHER: A culvert will be placed into the stream. This will result in an impact of 148 linear feet.
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? _ WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
The project involves extending Boone Station Drive from its current termination point at Gum Creek to
Forestdale Drive. Trackhoes, excavators, loaders, trucks, etc. will be used to construct the roadway.
13. PURPOSE OF PROPOSED WORK: The purpose of the project is to extend Boone Station Drive to
Forestdale Drive. Currently, Boone Station Drive ends at Gum Creek.
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
It is necessary to cross Gum Creek in order to complete the project.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: _
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED -
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF
PUBLIC (STATE) LAND? YES X NO ? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO X
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO ?
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
Q
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERiNfITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PROJECT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.(d) ATTACH A COPY OF THE
STORNIWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? The surrounding properties contain
residential and commercial development.
(fl IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? Municipal sanitary
sewer system.
SIGNED AND DATED AGENT AUTHORIZATION LETTER, LF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
;. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH C OLINA COASTAL MANAGEMENT
PROGRAM,
W R Baker, City Manager ?? - ?r??3/ 8/ 99
OWNER'S/AGENTS SIGNATURE DATE
(AGENTS SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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burlington, n.c. 27215 336/226-5534 SCME :1 40' DATE : 2/18/99 mG. er PLW
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