20040870 Ver 1_COMPLETE FILE_20040527

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Greene County
229 Kingold Boulevard
Snow Hill, NC 28580
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
July 12, 2004
DWQ Project # 04-0870
Greene County
Page 1 of 3
Subject Property: 2003 DOC Sanitary Sewer Improvements, Greene County, NC
Contract No. 53 (Sewer, Pump Station & Force Main)
Approval of 401 Water Quality Certification and Authorization Certificate per the Neuse
River Buffer Protection Rules (15A NCAC 211 .0233) with Additional Conditions
To Whom It May Concern:
You have our approval, in accordance with the attached conditions and those listed below, to
place fill within or otherwise impact 4 feet of streams and 2,00 square feet (ft) of protected
riparian buffers for the purpose of installing the proposed sewer system, as described within your
application dated May 12, 2004 and received by the N.C. Division of Water Quality (DWQ) on
May 27, 2004. After reviewing your application, we have decided that the impacts are covered
by General Water Quality Certification Number(s) 3374 (GC3374). The Certification(s) allows
you to use Nationwide Permit(s) 12 when issued by the US Army Corps of Engineers (USACE).
This letter shall also act as your approved Authorization Certificate for impacts to the protected
riparian buffers per 15A NCAC 2B .0233. In addition, you should obtain or otherwise comply
with any other required federal, state or local permits before you go ahead with your project
including (but not limited to) Erosion and Sediment Control and Non-discharge regulations.
Also, this approval to proceed with your proposed impacts or to conduct impacts to waters
as depicted in your application shall expire upon expiration of the 404 or CAMA Permit.
This approval is for the purpose and design that you described in your application. If you change
your project; you must notify,us and you maybe required to send us anew 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 fills for this project (now or in
the future) exceed one acre of wetland or 150 linear feet of stream, compensatory mitigation may
be required as described in 15A NCAC 2H.0506 (h). This approval requires you to follow the
conditions listed in the attached certification and any additional conditions listed below.
N. C. Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
[phone] (phone), 919-733-6893 (fax), (http://h2o.enr.state.nc.us/ncwetiands)
Alan W. Klimek, P. E. Director
Coleen H. Sullins, Deputy Director
Division of Water Quality
Greene County - Contract No. 53 / DWQ Project No. 04-870
Page 2 of 3
July 12, 2004
The Additional Conditions of the Certification are:
Impacts Approved - The following impacts are hereby approved as long as all of the other
specific and general conditions of this Certification (or Isolated Wetland Permit) are met. No
other impacts are approved including incidental impacts:
Amount Approved
(Units) Plan Location or Reference
Stream 4 (feet) Impact Site 7 & 10
404 Wetlands - (acres) -
Waters - (acres) -
Buffers 200 (square ft.) -
2. Sewer Systems - The project shall comply with 15A NCAC 2H.0219(i)(2)(G) and all other
State, Federal and local sewer system regulations.
3. Water Quality Certification(s) - The proposed project must comply with all of the conditions
of General Water Quality Certification(s) (GC) 3374.
4. Erosion & Sediment Control Practices - Erosion and sediment control practices must be in
full compliance with all specifications governing the proper design, installation and operation
and maintenance of such Best Management Practices in order to protect surface waters
standards:
a. The erosion and sediment control measures for the project must be designed,
installed, operated, and maintained in accordance with the most recent version of the
North Carolina Sediment and Erosion Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion
control measures must be such that they equal, or exceed, the requirements specified
in the most recent version of the North Carolina Sediment and Erosion Control
Manual. The devices shall be maintained on all construction sites, borrow sites, and
waste pile (spoil) projects, including contractor-owned or leased borrow pits
associated with the project.
5. No Waste, Spoil, Solids, or Fill of Any Kind - No waste, spoil, solids, or fill of any kind
shall occur in wetlands, waters, or riparian areas beyond the footprint of the impacts
depicted in the Pre-Construction Notification. All construction activities, including the
design, installation, operation, and maintenance of sediment and erosion control Best
Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
6. No Sediment & Erosion Control Measures w/n Wetlands or Waters - Sediment and
erosion control measures shall not be placed in wetlands or waters to the maximum extent
practicable. If placement of sediment and erosion control devices in wetlands and waters
is unavoidable, they shall be removed and the natural grade restored within six months of
the date that the Division of Land Resources has released the project.
44
Greene County - Contract No. 53 / DWQ Project No. 04-870
Page 3 of 3
July 12, 2004
7. Certificate of Completion - Upon completion of all work approved within the 401 Water
Quality Certification or applicable Buffer Rules, and any subsequent modifications, the
applicant is required to return the attached certificate of completion to the 401/Wetlands
Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650.
Violations of any condition herein set forth may result in revocation of this Certification and may
result in criminal and/or civil penalties. The authorization to proceed with your proposed
impacts or to conduct impacts to waters as depicted in your application and as authorized by this
Certification, shall expire upon expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved
wetland or stream impacts), 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, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its
conditions are final and binding unless you ask for a hearing.
Any disputes over determinations regarding this Authorization Certificate (associated with the
approved buffer impacts) shall be referred in writing to the Director for a decision. The
Director's decision is subject to review as provided in Articles 3 and 4 of G.S. 150B.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean
Water Act and the Neuse riparian buffer protection rule as described within 15A NCAC 2B
.0233. If you have any questions, please telephone John Dorney at 919-733-9646 or Bob
Zarzecki at 919-733-9726.
Sincerely,
(Alan W. Klimek, P.E.
AWK/bz
Enclosures: GC 3374
Certificate of Completion
cc: Albert V. Lewis, Jr., McDavid & Associates, Inc., PO Drawer 49, Farmville, NC 27828
USACE Washington Regulatory Field Office
DWQ Washington Regional Office
DLR Washington Regional Office
File Copy
Central Files
Filename: 040870
McDAVID AsSOCUTES, INC.
INC. Engineers • Planners • Land Surveyors
CORPORATE OFFICE GOLDSBORO OFFICE
[phone]•Fax[phone] [phone]• Fax[phone]
E-mail: [e-mail] E-mail: [e-mail]
120 N. Main Street • P.O. Drawer 49 109 E. Walnut Street • P.O. Box 1776
Farmville, NC 27828 Goldsboro, NC 27533
May 12, 2004
NC Department of Environment and
Natural Resources -F,
Division of Water Quality
P.O. Box 29535
Raleigh, NC 27626
40 1 43 Fr ; ?-
ATTN: Mr. John Dorney
SUBJECT: Nationwide Permit Request
Contract No. 53 - Sanitary Sewer, Pump
Station & 1o ce Main
2003 DOC Sanitary Sewer Improvements
Greene County
Dear Mr. Dorney:
In reference to the subject project, please find enclosed the following: P? j'??NJ? ^'T
1. One (1) set of the following plan excerpts:
A. 24"06" index map showing location of crossings.
B. 8'/2"x11" plan drawing of each crossing.
C. Standard Drawing (SD070010) "Erosion and Sedimentation Control for
Ditch, Creek or River Crossings Installed by Open Cut"
D. Standard Drawing (SD070020) "Erosion and Sedimentation Controls, for
Creek or River Crossing with HDPE Installed by Horizontal Directional
Drilling"
2. Seven (7) copies of signed permit forms.
3. Copy of letter to US Army Corps of Engineer.
This project consists of 13 ± miles of sanitary sewer force main serving a proposed prison
in Greene County. All force mains will be constructed within the DOT right-of-way. Force mains
constructed across creeks will be installed a minimum of 4 feet deep when open cut and 6 feet deep
when direction drilling is used.
D405BCG04 1 9:1 lam
GREENE-CO-03-DOC-CN53-NAT-PERM-REQ.LTR2 040512
Enclosed also is Greene County Check No. 69993 in the amount of $200.00 for DWQ 401
permit. Request DWQ 401 permit at your earliest convenience.
Sincerely,
McDAVID ASSOCIATES, INC.
0'ji.r, e, A&O-L-
Bradley C. Gillam, P.E.
Farmville Office
BCG:lba
Enclosures
cc: Lee Worsley
David Jones
Tyndall Lewis
D405BCG04
GREENE-CO-03-DOC-CN53-NAT-PERM-REQ. LTR;2
IM.
' INC. lam
040512
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SILT FENCE
CLASS I RIP-RAP CLASS I RIP-RAP
SILT FENCE
DITCH, CREEK
CARRIER PIPE OR RIVER
4' MINIMUM
SECTION VIEW
MINIMUM ACCEPTABLE
RIP-RAP DEPTH TO BE
1 1/2 TIMES MAXIMUM
LARGEST STONE SIZE.
FILTER FABRIC TO BE PLACED
UNDER. ALL RIP-RAP.
THE CONTRACTOR AT A MINIMUM SHALL INSTALL AND MAINTAIN
THE FOLLOWING SEDIMENTATION AND EROSION CONTROL MEASURE AT ALL
DITCH, CREEK AND RIVER CROSSINGS:
1. ALL LAND DISTURBED AREAS ON THE BANKS AND APPROACHES
TO DITCH, CREEK OR RIVER CROSSINGS SHALL BE GRADED NOT
TO EXCEED 2:1 RATIO IF POSSIBLE. SURFACE WATER SHALL BE
DIVERTED FROM LAND DISTURBED AREAS IF POSSIBLE.
2. IN AREAS OF CONCENTRATED RUNOFF PREVENTATIVE MEASURES
TO INCLUDE BUT NOT LIMITED TO SILT FENCES, RIP-RAP, SLOPE
DRAINAGE, OR A COMBINATION THEREOF SHALL BE !NSTALLED THE
SAME DAY CROSSINGS ARE CONSTRUCTED. SILT FENCES SHALL
BE INSTALLED ON THE LOW SIDE OR AT THE TOE OF ALL LAND
DISTURBED AREAS TO PREVENT SEDIMENTATION FROM ENTERING
THE WATERWAY.
3. ALL LAND DISTURBED AREAS ON THE BANKS AND APPROACHES
TO DITCH, STREAM OR CREEK CROSSINGS SHALL BE FERTILIZED,
LIMED, SEEDED AND MULCHED WITHIN TWENTY-FOUR (24) HOURS.
EROSION & SEDIMENTATION CONTROL FOR
DITCH, CREEK OR RIVER CROSSINGS INSTALLED BY OPEN CUT
(TEXT HEIGHT SIZE 0.14)
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INC.
US Army Corps of Engineers
Washington Regulatory Field Office
943 Washington Square Mall
Washington, NC 27889
Attn: Bill Biddlecome
Dear Mr. Biddlecome:
May 11, 2004
GOLDSBORO OFFICE
[phone] - Fax [phone]
E-mail: [e-mail]
109 E. Walnut Street - P.O. Box 1776
Goldsboro, NC 27533
SUBJECT: Nationwide Permit Request
Contract No. 53 - Sanitary Sewer, Pump
Station & Force Main
2003 DOC Sanitary Sewer Improvements
Greene County
In reference to the subject project please find enclosed the following:
One (1) set of the following plan excerpts:
McDAVIDAsSOCATES, INC.
Engineers - Planners - Land Surveyors
CORPORATE OFFICE
[phone] - Fax [phone]
E-mail: [e-mail]
120 N. Main Street - P.O. Drawer 49
Farmville, NC 27828
A. 24"x 36" Index Map showing location of crossings
B. 81/2"x 11" plan drawings of each crossing
C. Standard Drawing (SD70010) "Erosion and Sedimentation Control for Ditch,
Creek or River Crossings Installed by open cut"
D. Standard Drawing (SD70020) "Erosion and Sedimentation Control for Creek
or River Crossing with HDPE Installed by Horizontal Directional Drilling"
2. Two copies of the signed permit forms.
Request nationwide permit or permit waiver at your earliest convenience. Please advise as
we may further assist.
Sincerely,
BCG:bbr
Enclosures
cc: Lee Worsley
David Jones
Tyndall Lewis
McDAVID ASSOCIATES, INC.
J? A L 'A??
Bradley C. Gillam, P.E.
Farmville Office
D405BCG04 1 3:12pm
GREENE-CO-03-DOC-NATIONWIDE-PERM-REQ.LTR;2 040511
Office Use Only: , fl Form Version Apri12001
USACE Action ID No. DWQ No. 1J?
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank. WETLANDS/ 401 (JR0136
I. Processing
1. Check all of the approval(s) requested for this project:
?x Section 404 Permit WATER QUALI I Y SECTION
? Section 10 Permit
MX 401 Water Quality Certification
x? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: 12
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 Wetlands Restoration Program_NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ?
H. Applicant Information
1. Owner/Applicant Information
Name: Greene County
Mailing Address: 229 KinQold Bo ulevard
Snow Hill NC 28580

Telephone Number: 252-747-3446 Fax Number: 252-747-3884
E-mail Address:
2. Agent Information (A signed and dated copy
attached if the Agent has signatory authority for of the Agent Authorization letter must be
the owner/applicant.)
Name: Albert V Lewis,
-
Jr., P.R.
Company Affiliation: McDavid Associate
Mailing Address: PO Drawer 49 s Tnc -
Farmville, NC 278 28

Telephone Number. 252-753-2139 Fax Number: 252-753-7220
E-mail Address:
Page 3 of 12
M. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: 2003 DOC Sanitary Sewer Improvements
2. T.I.P. Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PK: N/A
4. Location
County. Greene/Pitt NearestTown: M iry- Li zza h Farmvi 1 1 e
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): See plans and attached
sheets
5. Site coordinates, if available (UTM or Lat/Long): See attached sheets
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Describe the existing land use or condition of the site at the time of this application:
NCDOT Right-of-way
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): Contentnea Creek
9. River Basin' Neuse
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at h=://h2o.enr.state.nc.us/admin/mgps/.)
Page 4 of 12
10. Describe the purpose of the proposed work: This project will provide sewer
to a proposed 1500 bed prison.
11. List the type of equipment to be used to construct the project: horizontal directional
drilling machines will be used where specified. Trencher, back hoe or
excavates will-be used in all other locations
12. Describe the land use in the vicinity o this project: NCDOT right-of-way with arm and
woods lands outside the right-of-way.
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.
None
V. Future Project Plans
Are any additional permit requests anticipated for this project in the future? If so, describe the
anticipated work, and provide justification for the exclusion of this work from the current
application: A 12" water line is planned for much of the same section of
road way but is in a separate project. (See plans for location of
proposed water line)
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. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must 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 5 of 12
1. Wetland Impacts
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
(yes/no) Distance to
Nearest Stream
(linear feet
Type of Wetland***
None

List eaen impact separately and identity temporary impacts. ampacca inc,uuu, Uu{ M{ uv. MAUL- w. a{wwla{{aocu v.w.ll16, tY°" 15f •"•,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at hhtWWwww.fema.eov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: N/A
Total area of wetland impact proposed: N/A
2. Stream Impacts, including all intermittent and perennial Streams
Stream Impact Length of Average Width Perennial or
Site Number Type of Impact* Impact Stream Name** of Stream Intermittent?
indicate on ma inear feet Before Impact lease specify)
1 No Impact of UT Contentnea Creek 51
e
2 No Impact of UT Gontentnea 5r Perennia
3 No Impact of UT Beaver ' ..Ferennial
4 No Impact of UT Cont e
5 dVo Impact. of Sandy kun 60' Perennial
6 NO Im act 0' UT Sandy-Run
7 Excavation 2' UT San
8 No Impact 0' iddle Swamp 750' Perennial
-J w._!1
List each impact separately and identity temporary impacts. impacta 1-1-C, uut Ylc .w...alu.v.. •.... «• -. -••- --------- --r -
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, 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.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.us¢s.¢ov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.tooozone.cgM
www.mapduest.cm etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 4
9 No Impact of Middle Swamp 5' Perennial'
10 Excavation 2' Middle Swamp 10' Perennial
Page 6 of 12
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres
Name Wate)
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean etc.
None

' List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. 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.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minirni?ed once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
Horizontal directional drilling shall be used to accomplish stream and
wetland crossings. Horizontal drilling will minimize impact to crossing.
Where horizontal directional drilling is not feasible, excavation will
occur. Where excavation occurs, erosion control measures will be
installed to minimize sediment runoff.
Page 7 of 12
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, 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 USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP 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
httT)://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.
N/A -
Page 8 of 12
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the.application
process for the NCWRP, check the NCWRP website at hhn://h2o.enr.state.nc.uS/=/index.htm. If
use of the NCWRP is proposed, please check the appropriate box on page three 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 of Non-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ?x
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 (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Suppl Buffer Requirements), or other (please identify )?
Yes No ? If you answered "yes", provide the following information:
Page 9 of 12
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
1 120 2 3 N/A
2 80 ft2 1.5 N/A
Total 200 ft2 NI A
• Zone 1 extends out 30 feet perpendicular from near banK of channel; cone 2. extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
N/A
XL Stormwater (DWQ Only)
Describe impervious acreage (both 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.
None
XII. Sewage Disposal (DWQ Only)
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.
None
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500)•or any Buffer Rules?
Yes ? No x?
Is this an after-the-fact permit application?
Yes ? No
Page 10 of 12
XIV. 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).
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell Union
US Army Corps of Engineers Avery Clay Jackson Polk Watauga
151 Patton Avenue Buncombe Cleveland Lincoln Rowan Yancey
Room 208 Burke Gaston Macon Rutherford
Asheville, NC 28801-5006 Cabamus Graham Madison Stanley
Telephone: [phone] Caldwell Haywood McDowell Swain
Fax: [phone] Catawba Henderson Mecklenburg Transylvania
Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham Wilson
US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes Yadkin
6508 Falls of the Neuse Road Ashe Franklin Nash Sury
Suite 120 Caswell Forsyth Northampton Vance
Raleigh, NC 27615 Chatham Granville Orange Wake
Telephone: [phone] Davidson Guilford Person Warren
Fax: [phone] Davie Halifax Randolph Wilkes
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 Carteret* Green Pamlico Wayne
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans *Croatan National Forest Only
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
Page 11 of 12
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
I

US Fis
US Fish and Wildlife Service
Raleigh Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
Telephone: [phone]
h and Wildlife Service / National M
US Fish and Wildlife Service
Asheville Field Office
160 Zillicoa Street
Asheville, NC 28801
Telephone: [phone]
.arine Fisheries Service
National Marine Fisheries Service
Habitat Conservation Division
Pivers Island
Beaufort, NC 28516
Telephone: [phone]
North Carolina State Agencies
Division of Water Quality
401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Telephone: [phone]
Fax: [phone]
State Historic Preservation Office
Department Of Cultural Resources
4617 Mail Service Center
Raleigh, NC 27699-4617
Telephone: [phone]
Fax: [phone]
Division of Water Quality
Wetlands Restoration Program
1619 Mail Service Center
Raleigh, NC 27699-1619
Telephone: [phone]
Fax: [phone]
CAMA and NC Coastal Counties
Division of Coastal Management Beaufort Chowan
C Hertford
Hyde Pasquotank
Pender
1638 Mail Service Center Bertie
Brunswick raven
Currituck New Hanover Perquimans
Raleigh, NC 27699-1638 Camden Dare Onslow Tyrrell
Telephone: [phone] Carteret Gates Pamlico Washington
Fax: [phone]
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator Alleghany Caldwell Watauga
Wilkes
3855 Idlewild Road Ashe Mitchell
Rernersville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Surry
Mountain Region Coordinator Buncombe Henderson
on
k
J Polk
Rutherford
20830 Great Smoky Mtn Expressway Cherokee
a ac
s
Macon Swain
Waynesville, NC 28786 y
G Madison Transylvania
Telephone: [phone] Haywood McDowell Yancey
Fax: [phone]
Page 12 of 12
GREENECOUNTY • 229 KINGOLD BLVD., SUITE D • SNOW HILL, N.C. 28580
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