20001144 Ver 1_Complete File_20000901

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
*i 777
W+
4 0 4
Ila
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
October 20, 2000
Hoke County
DWQ Project No. 001144
APPROVAL of 401 Water Quality Certification
Mr. William D. Gilmore, P.E., Manager
Plannins and Environmental Branch
North Carolina Department of Transportation
P.O. Box 25201
Raleigh, NC, 27611-5201
Dear Mr. Gilmore:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
material in 0.4 acres of wetlands and 40 linear feet of streams for the purpose of replacing Bridge Number
97 over McNeills Mill Creek on SR 1452. The project should be constructed in accordance with your
application dated 23 May 2000 (received August 30, 2000). After reviewing your application, we have
decided that this fill is covered by General Water Quality Certification Number 3289. This certification
corresponds to the Nationwide Permit Number 14 issued by the Corps of Engineers. In addition, you should
acquire any other federal, state or local permits before you proceed with your project including (but not
limited to) Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This
approval will expire with the accompanying 404 permit, unless otherwise specified in the Water Quality
Certification.
This approval is valid solely for the purpose and design described in your application (unless modified
below). Should your project change, you must notify the DWQ and submit 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 the conditions. If total wetland fills for this project (now or in the future)
exceed one acre, or of total impacts to streams (now or in the future) exceed 150 linear feet, compensatory
mitigation may be required as described in 15A NCAC 2H .0506 (h) (6) and (7). For this approval to
remain valid, you must adhere to the conditions listed in the attached certification.
1.) Upon completion of the project, the NCDOT shall complete and return the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been completed.
The responsible party shall complete the attached form and return it to the 401/Wetlands Unit of the
Division of Water Quality upon completion of the 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 that 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.
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 509o recycled/101/o post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
4.0 0
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
ROAD CROSSING CERTIFICATION GENERAL CERTIFICATION FOR PROJECTS
ELIGIBLE FOR CORPS OF ENGINEERS NATIONWIDE PERMIT NUMBER 14 (ROAD
CROSSINGS), REGIONAL GENERAL PERAIIT 198200031 AND NEUSE/TAR-
PADILICO/RANDLEMAN BUFFER RULES
This General Certification is issued in conformity with the requirements of Section 401, Public Laws 92-
500 and 95-217 of the United States and subject to the North Carolina Division of Water Quality (DWQ)
Regulations in 15A NCAC 2H, Section .0500 and 15A NCAC 213 .0200 for the discharge of fill material to
waters and wetland areas as described in 33 CFR 330 Appendix A (B) (14) of the Corps of Engineers
regulations (i.e., Nationwide Permit No. 14 and Regional General Permit 198200031) and for the Neuse,
Tar-Pamlico and Randleman Buffer Rules (15A NCAC 2B .0233,.0259 and.0250). The category of
activities shall include any fill activity for road crossing and is limited to fill less than one-third of an acre.
This Certification replaces Water Quality Certification Number 2177 issued on November 5, 1987, Water
Quality Certification Number 2666 issued on January 21, 1992, Water Quality Certification Number 2732
issued on May 1, 1992 and Water Quality Certification Number 3103 issued on February 11, 1997. This
WQC is rescinded when the Corps of Engineers re-authorizes Nationwide
Permit 14 or Regional General Permit 198200031 when deemed appropriate by the Director of the DWQ.
The State of North Carolina certifies that the specified category of activity will not violate applicable
portions of Sections 301, 302, 303, 306 and 307 of the Public Laws 92-500 and 95-217 if conducted in
accordance with the conditions hereinafter set forth.
Conditions of Certification:
1. Proposed fill or substantial modification of wetlands or waters (including streams) under this General
Certification requires application to and prior written concurrence from the Division of Water Quality;
2. In accordance with North Carolina General Statute Section 143-215.3D(e), any application for a 401
Water Quality Certification must include the appropriate fee. If a project also requires a CAMA Permit,
one payment to both agencies shall be submitted and will be the higher of the two fees;
3. In accordance with 15A NCAC 2H.0506 (h) compensatory mitigation may be required for impacts to
streams and/or wetlands. In addition, buffer mitigation may be required for any project with Buffer
Rules in effect at the time of application. A determination of buffer, wetland and stream mitigation
requirements shall be made for any Certification for this Nationwide Permit. The most current design
and monitoring protocols from DWQ shall be followed and written plans submitted for DWQ approval
as required in those protocols;
4. For any project involving a stream re-alignment, a stream relocation plan must be included with the 401
application for written DWQ approval. Relocated stream designs should include the same dimensions,
patterns and profiles as the existing channel, to the maximum extent practical. The new channel should
be constructed in the dry and water shall not be turned into the new channel until the banks are
stabilized. Vegetation used for bank stabilization shall be limited to native woody species, and should
include establishment of a 30 foot wide wooded and an adjacent 20 foot wide vegetated buffer on both
sides of the relocated channel to the maximum extent practical. A transitional phase incorporating coir
fiber and seedling establishment is allowable. Also, rip-rap may be allowed if it is necessary to maintain
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 5017 recycled/1 Orb post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
a:
d o
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
the physical integrity of the stream, but the applicant must provide written justification and any
calculations used to determine the extent of rip-rap coverage requested. If suitable stream mitigation is
not practical on-site, then stream impact will need to be mitigated elsewhere;
Impacts to any stream length in the Neuse, Tar-Pamlico and Randleman River Basins requires written
concurrence from DWQ in accordance with 15A NCAC 213.0233, 15A NCAC 2B .0259 and .0250 and
15A NCAC 2H .0500. New development activities located in the protected 50-foot wide riparian areas
(whether jurisdictional wetlands or not) within the Neuse, Tar-Pamlico and Randleman River Basins
shall be limited to "uses" identified within and constructed in accordance with 15A NCAC 2B .0233,
15A NCAC 2B .0259 and .0250. All new development shall be located, designed, constructed, and
maintained to have minimal disturbance to protect water quality to the maximum extent practicable
through the use of best management practices. Activities listed as "exempt" from these rules do not need
to apply for written concurrence under this Certification;
Placement of culverts and other structures in waters, streams, and wetlands must be placed below the
elevation of the streambed to allow low flow passage of water and aquatic life unless it can be shown to
DWQ that providing passage would be impractical. Design and placement of culverts and other
structures including temporary erosion control measures shall not be conducted in a manner that may
result in dis-equilibrium of wetlands or stream beds or banks, adjacent to or upstream and down stream
of the above structures. The applicant is required to provide evidence that the equilibrium shall be
maintained if requested in writing by DWQ. Additionally, when roadways, causeways or other fill
projects are constructed across FEMA-designated floodways or wetlands, openings such as culverts or
bridges must be provided to maintain the natural hydrology of the system as well as prevent constriction
of the floodway that may result in destabilization of streams or wetlands;
7. If this Certification is used to access building sites, all lots owned by the applicant must be buildable
without additional fill beyond that allowed under other General Certifications. Deed restrictions must be
placed on the remaining wetlands and streams on these lots to restrict future wetland and stream fill.
DWQ shall be sent copies of all deed restrictions applied to these lots;
S. That appropriate sediment and erosion control practices which equal or exceed those outlined in the
most recent version of the "North Carolina Sediment and Erosion Control Planning and Design Manual"
or the "North Carolina Surface Mining Manual" whichever is more appropriate (available from the
Division of Land Resources (DLR) in the DENR Regional or Central Offices) shall be in full
compliance with all specifications governing the proper design, installation and operation and
maintenance of such Best Management Practices in order to assure compliance with the appropriate
turbidity water quality standard;
9. All sediment and erosion control measures placed in wetlands or waters shall be removed and the natural
grade restored within two months after the Division of Land Resources has released the project;
10. Measures shall be taken to prevent live or fresh concrete from coming into contact with waters of the
state until the concrete has hardened;
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 5070 recycled/10co post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
4 2, 0
-nm _X
LD
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
I I. This Certification shall be utilized for roads from natural high ground to natural high ground. The
Certification for Nationwide Permit 18 may not be used in conjunction with this Certification to create
high ground for road access;
12. If an environmental document is required, this Certification is not valid until a Finding of No Significant
Impact (FONSI) or Record of Decision (ROD) is issued by the State Clearinghouse. All water quality-
related conditions of the FONSI or ROD shall become conditions of this Certification;
13. That additional site-specific conditions may be added to projects proposed under this Certification in
order to ensure compliance with all applicable water quality and effluent standards;
14. When written concurrence is required, the applicant is required to use the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been completed;
15. Concurrence from DWQ that this Certification applies to an individual project shall expire three years
from the date of the cover letter from DWQ or on the same day as the expiration date of the
corresponding Nationwide Permit 14 and Regional General Permit 198200031 whichever is sooner.
Non-compliance with or violation of the conditions herein set forth by a specific fill project may result in
revocation of this Certification for the project and may also result in criminal and/or civil penalties.
The Director of the North Carolina Division of Water Quality may require submission of a formal
application for individual certification for any project in this category of activity, if it is determined that the
project is likely to have a significant adverse effect upon water quality or degrade the waters so that existing
uses of the wetland, stream or downstream waters are precluded.
Public hearings may be held for specific applications or group of applications prior to a Certification
decision if deemed in the public's best interest by the Director of the North Carolina Division of Water
Quality.
Effective date: 1 June 2000
DIVISION OF WATER QUALITY
By
Kerr T. Stevens
Director
WQC # 3289
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/109o post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
s
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
DWQ Project No.: County:
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
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 this certificate to the
401Wetlands Unit, North Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC,
27699-1621. This form may be retumed to DWQ by the applicant, the applicant's authorized agent, or the
project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
1, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature:
Agent's Certification
Date:
I, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature:
Engineer's Certification
Partial Final
Date:
as a duly registered Professional Engineer in the State
of North Carolina, having been authorized to observe (periodically, weekly, full time) the construction of
the project,for the Permittee hereby state that, to the best of my abilities, due care and diligence was used in
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affumative Action Employer 50% recycled/109o post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature
Date
Registration No.
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 507o recycled/10°o post consumer paper

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
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 919-733-9646.
cc: Wilmington District Corps of Engineers
Corps of Engineers Wilmington Field Office
Fayetteville DWQ Regional Office
File Copy
Central Files
Sincerely,

-1 Kerr T. Stevens
Attachment
c:\ncdot\SR 1452\wqc\001144wgc.doc
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 5095 recycled/10°7o post consumer paper

a?r'° l; I' it '1
STATE OF NORTH CAROUNI AtiT? _.?---
WETU ,?D,: Gr ,'O_1o,..
DEPARTMENT OF TRANSPORT "TI G ?r ` c?.,
JA,%F_s B. HUNT JR. P.O. BOX 2:201. RALEIGH. N.C. 27611-5-101 DAVID MCCOY
God zRZ ,OR A:, T:G ScC F 1'
May , 2000
USACOE
11r. Dave Timpy
PO Box 1890
Wilminaton- NC 28402-1890
Re: Hoke Co. Bridue No. 97 Replacement
L ovation: SR 1152. crossinu 1Ic\eds Creel PAYMENT
Dear Mr. TimDy: RECEIVED
We are providing herewith an application package and copies or hydrouraphic sun-eys
(plan and profile), quad map, and water quality map as part of a project involving the
replacement of an existing bridge with 2 lines of 112"17_ - C.M Pine Arch. Construct}or,
shall beain in t}le summer of 2000.
To our knowledge, total acreage of wetlands in the project limits is less than 0.07 acre.
This bridge is not located in a high quality water area.
Please review this material, and if additional information is needed. or you have comments.
please contact our office.
Thank you for your cooperation and assistance in this matter.
Sincereiv,
E.B. Nelson. P.E.
Div. Bridge.Maint. Enuineer
Attachmepts
cc: Bill Rosser, P.E. - Division Enuineer
John Hennessey - DWQ - 7 copies wi attachments
Mrs. Renee Gledhill-Earlev, State Historic Preservation Officer
Mike Crocker - US Fish & Wildlife Service
NCDOT BRIDGE \LAINTNENANCE-Po BOX 2S9 - SILER CITY - NC - 27344
PH. [phone]-FAN [phone]
DWQ ID:
0 0 j "at 4?
CORPS ACTION ID:
NATIONVYTDE PER..= REQUESTED (PROVIDE NATIONWIDE PERMIT
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGLITEERS
?) APPLICATION FOR SECTION 401 CERTIFCATION
3) COORDNATION WITH THE NC DIVISION OF COASTAL N1\.=.CF?,f=ti i
SEND THE ORIGLNAL AND (1) COPY OF THIS COMPLETED FORM TO i'? ???RO???fir
F`ELD OFFICE OF THE CORPS OF ENGLYEERS (SEE AGENCY ADDRESSES CZ -E=7'). SEVEN
(7) COPIES MUST BE SENT TO THE NC DIVISION OF WATER
QUALITY. ATTNi:.JOIL t DORNEY. 4401 REEDY CREED ROAD.
RALEIGH. NC 27607. PLEASE PRINT OR TYPE.
0?'v'NE ,S NAME: NG 0 o i - 9rLlp?,4s ?VtAixjrfc5MA,nlu?
=. NLUL-L?iGADDRESS: Pb goy Z89
CITY: S 1(c r G i STATE
SUBDIVISION NA N1E
/`I L
PROJECT.LOCATIONADDRESS:INCLUDING SUBDIVISION NAME (IF D rI^.-r_.REti 1 FROM
MAILING ADDRESS ABOVE):
1-16,Lr GO, 6N SIZ I?152 6V?2 MGN4`-1[LS G??IEIc
? . TELEPHONE NUMBER: (HOME) e4e (WORK) 919 -714 E -,T C.,4 9
= P CODE: Z -7 3 4 4
IF APPLIC.A.BLE: AGENT'S NAT OR RESPONSIBLE CORPORATE Or ICL- .: DRESS.
PHONE NUMBER:
5. LOCATION OF WORK (PROVIDE A,,L-kP, PRE Eti-A3LY A COF': OF i.:SGS -CF?CR??FrC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: {? o k - NEAREST TOWN: Z4 LE go V_ !;,
SPECIFIC LOCATION (L'`1CLUDE ROAD NUMBERS, L.- NDNIARKS, ECT.)
'52 /q4;Z c.2oSs nJ L, /IA c ti1Fc1LS Gr?tEjr:IL
IMPACTED OR NE-A .REST ST REANYRIVER: `` • 1 Ia S ' rk K
RIVER BASIN: LuAA'S' ,IZ
ia. IS PROJECT LOCATED NEAR WATER CLASSED AS TROL Ti-, TIDAL SALTWATER, (SA).
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURSE WATERS (OR',-;), WATER _
SUPPLY (WS-1 OR WS-R)? YES ( ) NO ( 9) I:' ? =S. E:C: LA.2N:
-b. IS THE PROJECT LGCA ?D WT- A NOR-' C:? ROLENA DIVISION OF COAST-`
?L?:NAGE1?4EN°I AREA OF EN?O?IE`+ i A? CONCERN (AEC)? ', -S l NO j
IF THE PROJECT IS LOCATED WITHIN A COASTAL COLS i z (SEE PACE 7 FOR LIST C=
COASTAL COUNTIES), WHAT IS TITv LAND USE PLAN (LLB') DESIGNATION? N4
Sa . HAVE ANY.SECTION 404 PERMI'T'S BEEN PREVIOUSLY REQUESTED FOR USE ON i lIS
PROJECT?`-YES. ( ) NO( A) --IF.YES,=PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PERNIIT.AND'ANY ADDITIONAL: INFORMATION (INCLUDE PHOTOCOPY" OF 401
CERTIFICATION):
Sb. ARE ADDITIONAL PS=-REQUESTS EXPECTED FOR THIS PROPERTY IN i : _
FUTURE? -.YES ( ) NO ( Xj IF YES, -DESCRIBE ANTICIPATED, WORK
9a. ESTTYIATED TOT.%L NL?IB ERS OF ACRES IN T ?-a CT OF L.A`4-D: .0-7 4,/-
9b. ESTI2YIATED TOTAL NUMBER OF ACRES OF W ETL .ANDS LOCATED ON PROJECT STH:
10a. NUMBER OF ACRES OF WETLANDS L\IPACTT-:D BY THE PROPOSED PROJECT BY:
FIL.LLNG: • 64
FLOODING:
DRAINAGE:
EXCAVA-17ION:
07-HER:
TOT :ki ACRES TO BE LNiPAC i D:
IGb. (1) STREA:N?i C:?aV`?tL TO BE LNIPACi D BY T PROPOSED PROJECT (i=
ILLOCAiED, PROVIDE DISTANCE BOTH BEFORE AN-Di AF-EE RELOC.A.TION:
LENGTH BEFORE:
TcR: -
V 71.1 3EFORE (based on ncrmal hian water contour): 3
'? ?R AGE DEPT'r' BE: OP.E z A-F i =R:

2.5
(_) STRE? ?i C AS T- LtiIPAC T S RESL7 T FRO%I: (CL. C:ti _ . i_ L i._ .T )or -
C 7 orP_ LN C'--
C0 0
STRLCi1OV CF A D:'wr7-OCDL`C:

T- CONSTRUCTION OF .A POti"D IS PROP 0S?D. 'XIHA T iS THE S.% CF . _Y 7,'.. iiRSry.D
DRAIYLNG TO TI-=- POND? NIA `:v ?AT IS 7 HE POND SURFACE AREA? NA •
12. DISCI'IP'ITON OF PROPOSED WORK INCLUDING DISCUSSION OF i== OF ?tECE? tiZC.
EQUIPMEN'T' TO BE USED? (ATTACH PLANS: S IIZ BY I I DRAWINGS ONLY)
IZEPLAe-E fS (LI?;) 6i r,-- W 1714 Z rNr£s 11z".)(75 " GIAP AP-e-4
LITILl 2 kJ c-: Trz r-14-- Q_: )c e-A v.47-VK
13-. 'PURPOSE OF PROPOSED WORK
1-'.. STATE REASONS «'Ii'Y IT IS BELIEVED TI?AT THIS ACTIVITY MUST BE CAR.R=-D OUTT Lei
WETLANDS ( INCLUDE ANY tiEASLRES TAKEN TO ?iLti-I2MIZE W ETI- a y'D LNIPACTS)
?'{1^C ? ??r L ?'b S S / n
15. YOU ARE REQUIRED TO CONTACT T'rF US FISH AN-D WILDLIFE SER1?7CE .AND/OR
NATIONAL MARINE FISHERIES SERIVE REGARDING THE PRESENCE OF ANY FE DERA -r','
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR
CRITICAL HABITAT IN THE PER.AfIT AREA T'H T MAY BE AFFECTED BY THE PROPOSED
PROJECT. DATE CONTACTED: Pa?(c ??e iYI?? luJ S-z? -oo
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION Or: ICER
(SHPO) REGARDING Tr. ~ PRESENCE OF HISTORIC PROPERTIES IN Tr r PE? `lIT
WHICH MAY BE AFFECTED BY THEE PROPOSED PROJECT. DATES CO T -.C i -D
12,2r-1?1ne y"21 lied S'- 25 -coo
17. DOES THE PROJECT lilVOLVc AN L:t?EN-DIiL OF PUBLIC FUNDS OT THE USE O=
PUBLIC (STATE) LAND? YES ()C) NO ( i (TIFF NO, CO TO I
1. 1~ YES, DOES Tr.' PROJECT REQUIRE PREPSRATON OF .ANN EN',,7ROir:tifE \ T.-
DOCUMENT PURUAINT TO THE REQULRENIEti T S OF THE NORTH C a R OLL`;.=.
EVVIRON YIENTAL POLICY ACT? 'v-EE( NO (x;
Y S. H.-?S `" it i B E=N - -
T.-HE DCCL? ?ti
DE?iIfENT OF aDhiItiTSTRATiON STA CLEA.4LNGHOUSE Y =S
??1SWER 17b IS YES. TT-V SUBIITAPPROPRL?i? DOCLfENi.?TIOV'rR0?1 is -
VIR
CI_.EAR.I GROUSE Wliri THE NORTH C.AROLLNA ENT
ON?fENTAT POLICY .-.Ci.? - -
QUESTIONS REGARDING THE- STATE CLEARINGHOUSE REV1 W PROCESS S HOUL.D BE
DIREM -,TO MS.' CHRYS BAGGETT,-DIRECTOR STATE CLEARD;GHOUSE, NORTH
CAROLINA DEPARTMENT.OF ADMINISTRATION, 116 WEST JONES STR-E= T . R- T-z-,G .
NORTH C.AROLINA"27603=8003; TE- =PHONE [phone].
13. THEFOLLOWING ITEMS SHOULD BE INCLUDED WITH =S a?PLIC 70',' L ?FO? OSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OFF- .T hL-?THR-,.'T L i v
tiZ-ET - NDS:
a. INT T: ND DELINEATION MAP_SHOWLNG ALL WETLAN-DS, S T!a NIS. Lk S, :? \?
PONDS ON THE-PROPSERTY (FOR NATIONWIDE PER-.1,11T NUMBERS 1 13. 21,24.:91'
AND 38). ALL STREAM (I'vTE NffTTEN'T AND PERMANEIN 1 ON =:-: PROPER
MUST-BE-SHOWN ON T-HE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS : J F=E-
OF 1 INCH EQUALS 100 FEET OF THEIR EQUIVALENT.
b. IF AVAILABLE. REPRESENTATIVE PHOTOGRAPH OF WE :. k ?.+ZDS TO L E C-
BY PRODUCT.
c. IF DELINEATION WAS PERFORMED BY A CONSUL.TAN-1. LNCLnE ?.LLD _;--
SHEETS RELEVANT TO THE PI-ACEMENT OF THE DELLVFAi'iON LLtic.
d. ATTACH A COPY OF THE STORNfWATER lL-> NAGENIEN i PLAN IF REQLiR=D,.
e. WHAT IS LAND USE OF SUR.ROLT,MING PROPOERT ' O u2AL- - h',42i,n L-M jr7
T APPLICABLE. WHAT IS PROPOSED METHOD OF SEWAGE DISFCSr r ' NI_
g SIGNED AZ?tD DATED AGENT AUTHORIZ-TION LE::=R. Ii APFLICABL-7.
NOTE: WTL-%i-DS OR WATERS OF THE US lvfAY NOT BE LMPAC i--D PRIOR
1) ISSUANCE OF A SECTION 404 CORPS OF ENGIti?EERS PEF
EITHERTF.E ISSUANCE OR WADE-R OF A 401 DIVISION CF',V =-7)
CERTIFICATION, AND
S) (IN THE TWENTY COASTAL. COS OtiZY), A LE Ti R FRO.i THE NCR i
CAROLINA DMSI0N OF COASTAL ?f A-NAGENG i ST. i? G T : °G
CTiVITY IS Co, TS:STE`+ : `,? .: ? =? `; C ° = ?. S'?_ .: _ _ .-_ ` J ?
`LANAGEtifE? i PRCGR ?tii.
-L?-0c,
OWN,ER'S/AGEINT'S SIGNATL
AGENT'S SIGNATURE VALID ONLY
AUTHORIZATION LETTER FROM
-THE OWNER IS PROVIDED).

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PLATE 1, PLAN-PROFILE 487004 Made in U.S.A
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6;z • -ERIOR-(GEOIOG-CwL SURVEY. RESTON. VIRGIN x_199] 34052'30
670 6jtooomE 79°07'30"
1 MIL_ ROAD CLASSIFICATION 'ate
Primary highway, Light-duty road, hard or
hard surface improved surface
Secondary highway,
hard surface Unimproved road
Interstate Route _J U. S. Route Sate Route
\ ? - - ------------ ---=----------------
..
L_ 4Lr-
29
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-----------
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,Y RESERVATION
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iin
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la?S
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„-`?- C, BRIDGE LOC
?. - -
NORTH
_ NORTH CAROLINA DEPAn
' GRMV4YJ \ _ r
a " DIVISION OF HIGHWAYS
S - - - :N 0001`
U.S.DEPARTMENT
S O N FEDERAL HIGHW
N N"
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION`
JAMES B. HUNT 1R. P.O. BOX 25201, RALEIGH, N.C. 27611-5201 DAVID MCCOY
GOVERNOR ACTING SECRETAIZY
May 23, 2000
Division of Environmental Management
John Hennessey, WQ Certification Unit
P.O. Box 29535
Raleigh, N.C. 27626-0535
Dear Mr. Hennessey:
Please find seven (7) copies of an application form attached for your review.
If I can answer any questions you may have or if you have any comments, please call me
at 919-742-5649.
Thank you for your assistance in this matter.
Sincerely,
If, X?
E.B. Nelson, P.E.
Div. Bridge Maint. Engineer
attachments PA; } 1 v vT
RECEIVED
NCDOT BRIDGE MAINTENANCE - PO BOX 289 - SILER CITY- NC - 27341
P11. [phone]-FAX [phone]
PAYMENT
RECEIVED
STATE OF NORTH CAROLINA R,"`_ ?'!''•".! Ili r Frei.
DEPARTMENT OF TRANSPORTATION
JAI`4Es B. HUNT JR. P.O. BOX 2=201. RALEIGH. N.C. 27611-5201 DAVID NICCOY
GJ\iR.VGR ACTING SECRETARY
Mav 23. 2000
USACOE
NU. Dave Timpy
PO Box 1890
Wilmington, NC 25402-1890 0 0 Mg
Re: Hoke Co. Bridge No. 97 Replacement
Location: SR 1452, crossin« NlcNeils Creed:
Dear i%Ir. Timpy:
We are providing herewith an application package and copies of hydrographic surveys
(plan and profile), quad map, and water quality map as part of a project involving the
replacement of an existing bridge with 2 lines of 112"175" CNI Pipe Arch. Construction
shall begin in the summer of 2000.
To our knowledge, total acreage of wetlands in the project limits is less than 0.07 acre.
This bridge is not located in a high quality water area.
Please review this material, and if additional information is needed, or you have comments.
please contact our office.
Thank you for your cooperation and assistance in this matter.
Sincerely,
' ?tuk
E.B. Nelson, P.E.
Div. Bridue Taint. Engineer
Attachments
cc: Bill Rosser, P.E. - Division Engineer
John Hennessey - DWQ - 7 copies w/ attachments
Mrs. Renee Gledhill-Earley, State Historic Preservation Officer
NEke Crocker - US Fish & Wildlife Service
NCDOT BRIDGE \1.U T\ENANCE-PO BOX 2S9 - SILER CITl' - NC - 27343
PH.[phone]-FAN (9191663-0214
`r
DWQ ID: 0 0 'i j CORPS ACTION ID:
NATIONWIDE PER:NIIT REQUESTED (PROVIDE NATIONIVVIDE PERNITT ;)
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NA T IONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
?) APPLICATION FOR SECTION 401 CERTIFCATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL -,',f k ACEM-7N i
SEVD THE ORIGLNAL AND (1) COPY OF THIS COMPLETED FORM TO T-r= -?PROPRLAi?
ri?LD OFFICE OF THE CORPS OF ENGN EERS (SEE AGENCY ?ADDRESSES S=-T). SEVEN
(7) COPIES MUST BE SENT TO THE NC DIVISION OF WATER
QUALITY. ATTN:.JOI-Ni DORNEY. 4401 REEDY CREEK ROAD.
RALEIGH. NC 27607. PLEASE PRINT OR TYPE.
1. OWNER'S NA.NE: NG r? o i - ??2?r,?,? 1VkAlMrG5Na,N4Ja
?. 1LkIIENG ADDRESS: PC go f Z99
SUBDIVISION NA YIE
CITY: 5 ?c r C-1 STATE: /,-I I_ 71P CODE: 2-73.44
PROJECT.LOCATION_ADDRESS; INCLUDING. SUBDIVISION NAME (IF D rI'-RENT FROb1
MAILING ADDRESS ABOVE):
/-lakra Go, CI J SIZ 1'4 Z bvl=?z- nn?N?ir?s Ce,rv_
?. TELEPHONE NUMBER: (HOME) `34a
(WORK) 919-7,4Z-5(-44 9
4. IF APPLIC-ABLE: AG 'S N?„ti1E OR RESPONSIBLE CORPORATE OFrCLkL.-T.
PHONE NTUNIBER:
LOCATION OF WORK (PROVIDE A ?1.kP, PREFERABLY A COPY OF USGS TOPOCRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: 14 6 k IE - NEAREST TOWN: I& Iz Fa y- /7
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.)
51Z G205s n4 [a /tA f jQFclc.-S 6r2rc'rz IL
6. DYIPACTED OR NEAREST STREA NYRIVER:
RIVER BASIN: Luivu;s IF.IZ
7a. IS PROJECT LOCATED N-EAR WATER CLASSED AS TROLIT, TIDAL SALTWATER, (S.?.),
HIGH QUALITY WATERS (HQW), OU FSTANDING RESOURSF_ WATERS (ORW), WATER _
SUPPLY (WS-I OR WS-II)? YES ( ) NO ( 9) li YES. FD2LA24:
7b. IS THE PROJECT LOCATED WTITHN A NORTH CAROLINA DIVISION OF COASTAL
NU'u GE?fENT AREA OF EN VIROMEN 1. CONCER.v (AEC)? YES ( NO l X )
7C. IF THE PROJECT IS LOCATED W`ITHN A COASTAL COUNTY (SEE PACE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAN-D USE PLAN (LU`P) DESIGNATION? N1A
8a. HAVE ANY. SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? "YES ( ) NO (I,) IF_YES;=PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PERMIT:ANDANY ADDITIONAUINFORMATION (INCLUDE PHOTOCOPY OF 4101
CERTIFICATION):
8b. ARE ADDITIONAL-PERMIT REQUESTS EXPECTED FORTIES PROPERTY EIT i E.
FUTURE?- YES( ) NO (Xj IF YES: DESCRIBE AINTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBERS OF ACRES INTR.kCT OF LAND: . o-7 4L
9b. ESTLNIATED TOTAL NUMBER OF ACRES OF WE TLAINDS LOCATED ON PROJECT SITE:
10a. NUMBER OF ACRES OF WETLANDS DNIPACTED BY THE PROPOSED PROJECT BY:
FLING: • 64
FLOODING:
EXCAVATION:
OTHER :
DRAINAGE : TOTAL ACRES TO BE LMPACTED:
10b. (1) STRE.ANJ CHA:VNET. TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT A i =R: ; 11
WITH BEFORE (based on normal high water contours): 3 FT
AVERAGE DEPTH BEFORE: 2 --T AFi ER: 2 FT
(2) STREA,f CHA:\I`i,EL IMPACTS «'TLL RESLZ.T FROM: (CIECK ALL Tr -%T APPL'Y-?
G EN C A.Nl,T=-T RELCCA i iON: PL ACE`EE TI' OF PIPE L`i Cr a???L. ?
CH A_N-j,?-tI EXCAVATION: COONS TRUCTION OF .A DA_NUEFL00DD G:
OTHER:
i 1. IF CONSTRUCTION OF A POND IS PROPOSED. WHAT IS T: SIZE OF T'z=- WA'IrRSF- D
DRAINLNG TO THE POND? m1A IN-Pi AT IS THE
E.' SEC i ?D
POND SURFACE AREA? NIA
12. DISCI'IPTION OF PROPOSED WORK INCLUDING DISCUSSION OF OF MECH a ti'IC.A?
EQUIPMEN'T' TO BE USED? (ATTACH PLANS; 8 U2 BY I I DRAWINGS ONLY)
12EPLAGr-- i3211;) (nrC. 1.JITl+ Z INSS 11Z")(-7,;" ? LAAp Aa-L4
uTlLi2-"e, 7-1ZAc.14. fgyeAV.4TbI-
1S. PURPOSE OF PROPOSED WORT : __ 2c f>l a L? eX1S->~-?n? ?, 54-"Lxbjv-.7
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY bfUST BE CARRIED OUT IN
WETLANDS ( INCLUDE ANY MEASURES TAKEN TO MINLNlIZE WE TL:A?vD alPACTS)
??{y?t 7 wt L rb s5 i n ?
15. YOU ARE REQUIRED TO CONTACT THE US FISH Ai TD WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERIVE REGARDING THE PRESENCE OF ANY FEDER-%L.Y
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR
CRITICAL HABITAT IN THE PERMIT AREA THAT ?tAY BE AFFECTED BY THE PROPOSED
PROJECT. DATE CONTACTED: _Pac-L-? c 01,210 5--Z-5-co
16. YOU ARE REQUIRED TO CON-PACT THE STATE HISTORIC PRESERVATION OFIFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED
1?7c??1?c k"2tbcd S - zs -moo
17. DOES THE PROJECT LNOLVE AN L: ENDTTLRE OF PUBLIC ruT,\?DS OT -T:E USE OF
PUBLIC (STATE) LAND? YES ()C) NO ( ) (IF NO, GO TO 165)
a. IF YES, DOES THE PROJECT REQUIRE PREPERATION OF AN ENVRON-' lEN i
DOCUMENT PURUANI' TO THE REQUIREMENT'S OF THE NORTH C A BOLT- A
ENVIRONMENTAL POLICY ACT? YES ( ) NO ( X )
b. IF rS, HAS THE DOCL?iE:v-I BEEN RE: ??ED i HROUGH NOR T H C? BOLDa
DEPART'NIENT OF ADMINISTR-kTION STATE CLEARINNOHOUSE YES ( ) :"0 (
L A:NtSWER 17b IS YES, THEN SUBMIT APPROPRL-ATE DOCUME.NTATIONFROM Tzlia STATE
CLEARINGHOUSE WITH THE NORTH CAROLPl iA ENVMONMEN, 'TA... 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. R.A=G'r',
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
13. THEFOLLOWING ITEMS SHOULD BE INCLUDED WITH T'rHS APPLICATION E- PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FEI L MATERU- i IN TO
WETLANDS:
a. WETLAIND DELINEATION MAR SHOWING ALL WETLANDS, STREkMS. LAS, N-D
PONDS ONTHEPROPERTY (FOR NATIONWIDE PERMIT NUMBERS 1,, 13, 21, 26, 29,
AND 38). ALL STREAM MTMRM= =, AND PERMANENT ON THE PROPERTY
MUST.BE'SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 60 FvET
OF 1 INCH EQUALS 100 FEET OF THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETL-?:N-DS TO BE -1%IPACTcD
BY PRODUCT.
c. IF DELINEATION WAS PERFOR.MED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO THE PLACEMENT OF THE DELLNFATION LUKE.
d. ATTACH A COPY OF THE STORNIWATER,ILklNAGENfEN-I' PLAN IF REQL7aED.
e. WHAT IS LAND USE OF SLRROL-NDING PROPOERTY? IZ u2A-c- - f=4tZ/vx LA-ilr?
f. IF APPLICABLE, WHAT IS PROPOSED :METHOD OF SEWAGE DISPOSAL? NA
SIGNED AND DATED AGENT ALTHORIZ-aTION LE-1-1-ER, IF APPLICA3L-=.
NOTE: WTLA.NDS OR WATERS OF THE US iMAY NOT BE LVIPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 40.4 CORPS OF ENGL\,-HERS PE?,2ML ,
EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WA -R
CERTIFICATION, A,\TD
3) (IN THE TWENTY COASTAL COL.NTI`S ONZY), A LETTER F. OM T'rz--. NOR i
CAROLLNA DIVISION OF COASTAL IfANAGE`[EN T STATTE G T??- PROPOSED
ACTIVITY IS CO`iSISTr'`-?' `,?77 ? :_ E `;CR =: C.= "I -1 n'.-. -_
.%Lk AGEMENT P.°,CGRA-M,

OWNER'S/AGENT'S SIGNATUR.E
S - ZZ - o?
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).

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07 10' 668 659 0 iNTERiOA_GEOLOGICAL SURVEY. REgTON. VIRGINIA-1983 4'52'30
670 671000m E. 79'07'30"
1 MILE ROAD CLASSIFICATION
T Primary highway, Light-duty road, hard or s?s-I-C.
hard surface ?- improved surface
Secondary highway,
hard surface -- -- - Unimproved road
Interstate Route w? U. S. Route State Route
- - - - - - - - - --- - - - ---- - - - - - -
OKK
Rockfrst,
J '
-41
20 ^s sue' ? .
?m-b e r B r 1 d-?jT
--
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,Y RESERVATION 1
UOTT
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5

BRIDGE LOC
NORTH
".UA
NORTH CAROLINA DEPAR'
DIVISION OF HIGHWAYS
IN COOP!;
U.S.DEPARTMENT
FEDERAL HIGHW.
i %
S 1r v? e
N
STATE OF NORTH CAROL N WT '
DEPART EN OF TRANSPORTATION
JA?mEs B. HUNT JR. RC. Box 2:201. RALEIGH. N.C. 27611-5-101 DAVID MCCOY
Slav 23. 2000
USACOE
IN-1r. Dave Timpy
PO Box 1890
Wilmington, NC 28402-1890
?4
0 Re: Hoke Co. Bridge No. 97 Replacement
Location: SR 1452, crossing j1cNeils Cre?>:
Dear Ivlr. TimDy:
We are providing herewith an application package and copies of hvdrographic sur,-et's
(plan and profile), quad map. and water quality map as part of a project involving the
replacement of an existing bridge with 2 lines of 112 '175 ' Cpl Pine .-arch. Constructiot;
shall begin in tite summer of 2000.
To our knowledge, total acreage of wetlands in the project limits is less than 0.07 acre.
This bridge is not located in a high quality water area.
Please review this material. and if additional information is needed. or you have comments.
please contact our office.
Thank you for your cooperation and assistance in this matter.
Sincerely,
'?' /?I
E.B. Nelson. P.E.
Div. Bridge Taint. Engineer
Attachments FAYMENT
cc: Bill Rosser, P.E. - Division Engineer REGENED
John Hennessey - DWQ - 7 copies w/ attachments
Mrs. Renee Gledhill-Earlev, State Historic Preservation Officer
NEke Crocker - US Fish & Wildlife Service
NCDOT BRIDGE UAINTNENANCE-PO BOX 2S9 - SILER CITY- NC - 27344
PH. [phone]-FAN (9M 663-0214

DWQ ID:
CORPS ACTION ID:
NATIONNVIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT
PRE-CONSTRUCTION NOTIFICATION APPLICATION
F OR NA T IONWIDE PERMITS Ta-kT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGLNEERS
'?) APPLICATION FOR SECTION 401 CERTTFCATION
3) COORDINATION WITH THE NC DIVISION OF
SEND TPIE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO i = ?PRO??I?,i
FR:: LD OFFICE OF -Fz-E CORPS OF ENGINEERS (SEE AGENCY ADDRESSES S - =E T ). SE?^E
(7) COPIES MUST BE SENT TO THE NC DIVISION OF WATER
QUALITY. ATTN: JOHN DORNEY. 4401 REEDY CREED ROAD.
RALEIGH. NC 27607. PLEASE PRINT OR TYPE.
. OWNER'S NAME: NG D O I - ?2,I?G,tE ?K<41/.1T?cA14,Nu?
NLkM L- G ADDRESS: Pb 90y. 29
SUBDIVISION NAVC
CITY: S I Ic I- G I Iy STATE: N L = CODE
273 44
PROJECT-LOCATION.ADDRESS 71NCLUDINGSUBDMSION NAME (E-- D F-._.REti i FZOM
MAILING ADDRESS ABOVE):
1-16kr LO, GN SIZ 11152 BvElz M-cNt°_fLL-s Gerz,!Fj,

TELEPHONE NUMB ER: (HOME) eie (WORK) 919 - 7y 2 -,T L 4 9
. IF APPLICABLE: AGE-N'T'S NAME OR RESPONSIBLE CORPORATE OFFiCL-.L ..-.DDRESS.
PHONE N-UNIBER:
LOCATION OF WORK (PROVIDE A MAP, PRE EER?LY" .-. COPY- CF SCS T C'F CGR??L C
NIAP OR AERIAL PHOTOGRAPHY WIT11 SCALE):
COUNTY: ye, k ? - NEAREST TOW : I& LE go v- I7
SPECIFIC LOCATION (LNICLUDE ROAD NUMBERS, LAN-D.N[ARKS, ECT.)
152 1144 Z G2o51. nJ ca AA 4 /JFa1LS 6rztc'tE IL
6. 2YIP.1kCTED OR NEAREST S T REANWRIVER:
RIVERBASEN: Luivu-S iF- iZ
i a. IS PROJECT LOCATED NE i R WATER C-LASSL .-D AS TROt- i1, TIDAL S a T 'F,, a TER, (S.-?
HIGH QUALITY WATERS (HQW), OLD T ST.IN- LVG RESOURSE WATERS (ORW), `,VATER _
SUPPLY (WS-I OR NVS-II)? 't-ES ( ) NO ( 9 ) IF Y -S. E.L.
i IS i' PROJECT LOCATED ?'vI%?i .? NORT : C?ROLLN'a DIVISION OF COST: T
?L-%NAGEI IEVT ARE. OF E_vVLROMEV T a? CCNCER-V (AEC)? ; ?S l ? NO i' X
I THE PROJECT IS LOCATED WTI-HI NA COAST.-, T COGS i i (SEE ?ACE i : OR LIST ?F
COASTAL COL'NITES), WHAT IS THE LAN'D USE PLAN (LL-,P) DESIGNATION?
Sa. . HAVE ANY. SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON T -S
PROJECT? "YES' ( ) NO(A)--IF.YES, PROVIDE ACTION I.D. NUM3ER OF PR.-VIOUS
PERMIT.AND*ANY ADDITIONAL INFORMATION ( INCLUDE PHOTOCOPY" OF -'0 i
CERTIFICATION):
8b. ARE ADDITIONAL-Pa MIT REQUESTS EXPECTED FOR T'rHS PROPER" IN i
FUTURE? ".YES ( ) NO (;<) IF YES.-DESCRIBE 4 ?-i7CIPA i D WORX:
9a. ESTLI-1ATED TOTAL, NLilvIBERS OF ACRES LNi TRACT OF LAN-D: .0-7 4e-
9b. ESTLNIATED TOTAL NUlvfBER OF ACRES OF WE TL.-?-NDS LCCATE.D ON PROJECT SITE:
.0-7
10a. NUMBER OF ACRES OF WETLANDS LvIPACTED BY TIE: PROPOSED PROJECT BY:
FILING: • o4
F- 00DING:
DRALNACE :
EXCAVATION:
OTHER :
TOTAL ACRES TO BE IMPACTED:
1Go. (1) STREAIly I CI? AVi?tL TO BE LtifPACi?D BY TI:? PROPOSED PRO?CT
RZ-LOCAILD, PROVIDE DIST?:\CE 307:-. EEF,JR=. -N-D A-rTER RELOC.-'.TIO :
LENGTH BEFORE:
i i ER:

;'v-H)i'ri BEFORE b....'sed on norm:1 '
( high wat_r contours): 3.5 _
'? BRACE DEPTH BEF ORE: Z Al -1=7R
2
(=) STREA-%I C^ AN- L?f^ .CTS `I,T_L RESULT FROM:
' L i.
=N CEAti'iNtL icELGC..iG?: _..CE.,L_Ni CF ?Ta_ L`; Cr
CCOVS C 11ON GF .. D.? ?C0DED C:

'.. L= CGNSiRUCTION OF A PON-D IS PROPOSED. W ?T IS THE Sr_%_- OF :. ;V.?"? -1
ir:?Sr
DRkNi LNG TO THE POND? t1iA ?T IS THE
--`_ -
POND SURFACE AREA?
I?. DISC7=0N OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF ljiCE•? NIIC.=-
EQUIPME qT TO BE USED? (ATTACH PLANS: 8IJ2 BY I I DRAWLNGS ONZ-i-)
IZEPLAe-E l32???>6-,lL tj,7-F4 2 ijiZ5 IIZ'l)C75 " ZPAP AQe-I4
LTlLiT-w[--t 7-IzA4c-I4- r?-: XZ-4V sTbK
13. PURPOSE OF PROPOSEDWOR:{: 2er?(ac? ex??--T?„c-, s4'rvL4uv-.7 ly
'.. STATE REASONS WHY IT IS BELIEVED TF?AT THIS ACTIVITY MUST BE CARRIED OUT I]N
WETLANDS ( INCLUDE ANY IMEASURES TAKEN TO I E\4-D III. Vv ETLAND I]MF AC i S)

15. YOU ARE REQUIRED TO COti TACT T'Fli US FISH :-uND WILDLIFE SERVICE .-%.:-N-i /OR
NATIONAL MARINE FISHERIES SERIVE REGARDING THE PRESENCE OF s NV FEDERAL;'
LISitD OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECEES OR
CRITICAL HABITAT IN TH:E PERMIT AREA i L-kT'YfAY BE AFFECTED BY THE PROPOSED
PROJECT. DATECONTACTED:_Pa?(?-vac
1 YOU ARE REQUIRED TO CONTACT TiE. STAi L HISTORIC PRESERVATIIO OF: iCER
(SHPO) REGARDING THEE PRESENCE OF HISTORIC PROPERTIES IN T-r:PER.\fI T 4 - a.
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONT.-.C 1 cD
12,1c.l?1?c YA21I'dd S - Z.;-.; -- Co
17. DOES THE PROJECT LNOLtiE AN EKFEN-DIi LiZE OF PUBLIC F -;WD S GT T-= C.SE C=
PUBLIC (STATE) LAND? Y -ES NO ( j (,--,NO, CO TO IE)
a. IF YES, DOES THE PROJECT REQLZRE PREFER-kTi N OF AN EN-+ti ?GLNIC\T.=
DOCL'IPENT PURUAINT TO THE REQL RE.mEti i S OF T'1-E-: tiORT 1 C? R OLL`; =.
EN,VLRONl%IEN T AL POLICY ACT ? ? ?S ( NO
( x
YE
S. HAS TEDCCU:\C:NT BEENREF?t'v?Di'zE=GHTHE' CP." _r- Cr
DEP a ? i':?IEti T OF :'.D1fLN7STRATiON STATE CL E.-?.R?Gi:OL'SE ti =_ , :?? . .
- NNSWER 17b IS YES. THEN SUBMIT APPROPRT-k DOCUIfEti 1.47ONrROM TH-E S7A7=
CL-.ARINGHOUSE W lH THE. NORTH CAROLLA ENVLRONNfE_NT? T POLICY.-.C .
QUESTIONS REGARDING THE STATE CLEARLNGHOUSE REVIEW PROCESS S O UL D EE
DIRECTED-TO MS. CHRYS BAGGETI',-DIRECTOR STATE CLEAR gGHOUSE. NORTH
CAROLINA DEPARTMEN'T.0F ADMINISTRATION, 116 WEST JONES STR...? =T. Rk T =T GH.
NORTH-CAROLINA"27603=8003, =E-LEI-PHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH T-rHS APPLICAT':ON r. ?ROpnSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF F-? TT NIAT=- -T.. _ ENT G
WETLANDS:
a. W'ETI?kYD DE=r-kTION MAP. SHOWING ALL W iLANDS, ST . 115. L1 ? 7, A?D
PONDS ON THETROPRRTY (FOR NATIONWIDE PER-= NUMBERS 1-. 13, ? 1, _c. _P.
AND 38). ALL STREAM (IN'I'ERN=7E:-T AND PERM MANT-NT) ON TH:- PROPER
MUSTBE-SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 rill-CH. EQUra.LS ;
OF 1 INCH EQUALS 100 FEET OF THEIR EQUTVALEV T .
b. IF AVAILABLE. REPRESEtiTATIVE PHOTOGRAPH OF W'ET k `-DS TO P = Zf? :r-D
BY PRODUCT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTS N TI. LN CLL`DE a r L ^A
SHEETS RELEVANT TO THE PLACENIEN-I' OF TH7 DELLVB a T10N LLtiE.
d. ATTACH A COPY OF Tr- STORMWATER \.La NAGEMEN T PL, - IF REQUIRED.
c. WHAT IS LAND USE OF SU-2ROUNDLNG PROPOERT': " lZ a 2A• L - f=A2/N c ?r?
i. IF APPLICABLE, WHAT IS PROPOSED NIETHOD CF SEWAGE DISPC& L.' -??-
S?GNED ALND DATED AGENT AU i t?ORIZk LION LE : =R. E k apr IC 3 LE.
NOTE: IN-IZA:YDS OR WATERS OF TI-?. US ?1AY NOT nE L`fPAC i D PRIOR
1) ISSUANCE OF A SECTION 40- CORPS OF == IS PF?',f
=? EITHER THE ISSUANCE OR WAIVER OF A X01 DIVISION OF `WA=-? ? U.-
CERTIFICATION, AND
=) (LN, THE TWENTY COASTAL C0UTNiI S OtiZ`: ), .. LE i R r OVf T \ORT=.
CAROLLNA DIVISION OF COASTAL Nf,?VAGE-N G? 1 ST.=. G = P?r'??SEC
?LkNAGEIfE. Ti PRCG

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i rE OWNER IS PROVIDED).

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PLATE 1, PLAN-PROFILE 487004 blade in U.S.A'•
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1 MILE ROAD CLASSIFICATION 'per
Primary highway, Light-duty road, hard or
hard surface improved surface
Secondary hiFhwav,
hard surface Unimproved road
Interstate Route S Route
U
State . u'=
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R- e h n e r t
Y RESERVATION
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LAKE
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X10 RTH
_ _• ?`, ,>? j NORTH CAROLINA DEPAR
DIVISION Or HIGHWAYS
IN C.^..^.F`-
U.S.DEPARTMENT
S O N FEDERAL HIGHW