19950484 Ver 1_Complete File_19950509

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A, Preston Howard, Jr., P.E., Director
May 16, 1995
Stokes County
DEM Project # 95484
APPROVAL of 401 Water Quality Certification
Mr. Mike Shaffner
NC DOT
2125 Cloverdale Avenue
Winston-Salem, N.C. 27103
r3
Dear Mr. Shaffner:
You have our approval to place fill material in waters for the purpose of road maintenance at SR
1515 (Josh Road), as you described in your application dated 4 May 1995. After reviewing your
application, we have decided that this fill is covered by General Water Quality Certification Number
2735. This certification allows you to use General Permit Number 031 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 30 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 Environmental Management under Section 401
of the Clean Water Act. If you have any questions, please telephone John Domey at 919-733-1786.
Sincerely,
reston Howard, Jr. P
U
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Winston-Salem DEM Regional Office
Mr. John Domey
Central Files
95484.1tr
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post-consumer paper
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
JAMES B. HUNT. JR. DIVISION OF HIGHWAYS SAM HUNT
GOVERNOR SECRETARY
2125 Cloverdale Avenue
Winston-Salem, NC 27103
May 4,1995
Division 9
District 2
Stokes County - Josh Road (SR 1515)
Subject: Drainage Permits - Division of Environmental Management -
Above listed County and Secondary Road
Mr. John Dorney
Water Quality Planning
Division of Environmental Management
NC Dept. of Environment, Health, and Natural Resources
P.O. Box 29535
Raleigh, NC 27626-0535
Dear Mr. Dorney
In an effort to obtain the necessary drainage permits, we are
providing a package of design plans for grade, drain, base, and pave
of Josh Road (SR 1515) in Stokes County. Work to be performed
includes replacement, retaining, and/or extension of pipes as shown
on the attached plans.
By copy of this letter, we are also seeking approval from the NC
Wildlife Resources Commission and the US Army Corps of Engineers and
are submitting the enclosed material to them.
Please review this material, and if additional information is
needed, or if you have any comments, please contact our office at
[phone]. Thank you for your cooperation in this matter.
Respectfully,
1?2 C. 9
Mike C. Sha Afner
DISTRICT ENGINEER
MCS:mnp
ENCLOSURES
cc: Mr. Douglas B. Waters, Division Engineer
Mr. Don C. Alderman, Stokes County Maintenance Engineer
File

DEM ID: ,5 H (ly ACTION ID:
NATIONWIDE PERMIT APPLIED FOR (PROVIDE NATIONWIDE PERMIT #):
JOINT APPLICATION FOAM FOR
NATIONWIDE PERMITS THAT REQUIRE NOTIFICATION TO CORPS OF ENGINEERS] ' Is swu
NATIONWIDE PERMITS THAT REQUIRE SECTION 401 CERTIFICATION CONCURRENCEV UIJ
NATIONWIDE PERMITS THAT REQUIRE INDIVIDUAL SECTION 401 CERTIFICATION
WILMINGTON DISTRICT ENGINEER
CORPS OF ENGINEERS
DEPARTMENT OF THE ARMY
P.O. BOX 1890
WILMINGTON, NC 28402-1890,
ATTN: CESAW-CO-E
Telephone [phone]
WATER QUALITY PLANNING
DIVISION OF ENVIRONMENTA
NC DEPARTMENT OF ENVIR02
AND NATURAL RESOUR
P.O. BOX 29535
RALEIGH, NC 27626-053
ATTN: MR. JOHN DORNEY
Telephone [phone]
jNfj,
t
mAY - 9 i995
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EATrit L (v ?__.._.
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO THE CORPS OF
ENGINEERS. SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF
ENVIRONMENTAL MANAGEMENT. PLEASE PRINT.
1. OWNERS NA.}iE: /VC 007-
2. OWNERS ADDRESS: ZS CLIVE0014LC 8?E
"::,A o kFr" k) C-- 7 -710 .
3. OWNERS PHONE NUMBER (HOME): ( WORK) : 910 - 7101 - Z?jLv
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL,, ADDRESS,
PHONE
5. LOCATION OF PLANNED WORK (ATTACH MAP). COUNTY: 5 Tom E 5
NEAREST TOWN OR CITY: /s RL) my
-
SPECIFIC LOCATION (INCLUDE ROAD NURSERS, LANDMARKS, ETC.): S R IS IS
6. NAME OF CLOSEST STREAM/RIVER: tDAn1 Ri E(L
7. RIVER BASIN: Rt)ANottC Rhea BA SIN
8. IS THIS PROJECT LOCATED IN A WATERSHED CLASSIFIED AS TROUT, SA, HQW, ORW,
WS I, OR WS II? YES [1/r HO [ )
9. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROPERTY? YES ( ] NO ( (f
IF YES, EXPLAIN. ---
10. ESTIMATED TOTAL NUMBER OF ACRES OF WATERS OF THE U.S., INCLUDING
WETLANDS, LOCATED ON PROJECT SITE: je
3/30/92
q1o 7L Zq/0

-2-
11. NUMBER OF ACRES OF WATERS OF THE U.S.,
THE PROPOSED PROJECT:
' FILLED: j'
DRAINED:
FLOODED:
EXCAVATED:
TOTAL IMPACTED: _
12. DESCRIPTION OF PROPOSED WORK (ATTACH PLANS): G2AOC ; BASt AND pAvt
AN Eh /S T/NG ol! 9 A VE22 eC?LIO _ //?? /?L MO!/NG f?7/> /A fT3sc l yT/On 1 _ AND
?ltc AGi°1CvP/e1H E.QosYO/ l Cvd,-iron ' ?rrsSalEs
13. PURPOSE OF PROPOSED'WORK: /?/?!o!/E?/F NT Ta 721'E /la-u-9
14.' STATE REASONS WHY THE APPLICANT BELIEVES THAT THIS ACTIVITY MUST BE
CARRIED OUT IN WETLANDS. ALSO, NOTE MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS. z?y ?1yi?G 7//- Pogo /T i?/ct /?En/FiT ?l fs/o? s ?'QT /I?iDE TI/?/?E
?f S !+/E? L 1?i'c A aTA?6NT leo la . 4'e L- AA Lu/J/Q /ATE .4 c T10,? {vial ,Ot" 721Kc: l l 'lam
.rl???/A/2r [t/ETiAN ? /??'?CT5?Nt9 A my O?j1?/2 T?1fF ate" F2os/v/? Tf/?T MA'/
vccv2.
15. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE
(USFWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) REGARDING THE PRESENCE
OR 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. HAVE YOU DONE SO? YES (?r NO ( )
RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE FORWARDED TO CORPS.
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?
HAVE YOU DONE SO? YES (,/j NO ( )
RESPONSE FROM THE SHPO SHOULD BE FORWARDED TO CORPS.
17. ADDITIONAL INFORMATION REQUIRED BY DEH:
A. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, AND LAKES ON
THE PROPERTY.
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. IF A STORMWATER MANAGEMENT PLAN IS REQUIRED FOR THIS PROJECT, ATTACH
COPY.
E. WHAT IS LAND USE OF SURROUNDING PROPERTY?
F. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
OWNER'S SIGNAT ATE
INCLUDING WETLANDS, IMPACTED BY

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PROPOSED DRAINAGE CROSS LINE TREATMENT
ALONG SR /S/-5 STOKES COUNTY
LOCATED: NC 66 -NorzTx_ Z _SR 14,00 -Npp-n" -s SRI-A13. Wcsr 7-o.
SR /411 -5ourn LEFT oN SR IS15

STATION EXISTING
DESCRIPTION
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DESCRIPTION
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SOME: NTS APPROVED BY. DRAWN BY MI\JF
.. DATE: S - -9S • MCS
ST O1cES COUNTY
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DATE: S -9S
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CRAWING NUMBER
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