20000121 Ver 1_Complete File_20000221

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
WAIVER of 401 Water Quality Certification
Mr. Dennis Johnson, NCDOT
4261 Carys Burton Road
McLeansville, NC 27301
Dear Mr. Johnson:
1 01!WAA •
NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
August 17, 2000
Orange County
WQC 401 Project # 000121
Your application for a 401 Water Quality Certification was received in the Central
Office on February 21, 2000. According to our rules [15A NCAC 2H.0507(a)], if final
action is not taken within 60 days, the Certification is waived unless DWQ has objected
in writing to your application. Therefore, DWQ has waived the requirement for a 401
Water Quality Certification for your plans to impact 450 feet of streams for the
replacement of culverts at SR 1984 over East Price Creek in Orange County as described
in your application dated. However if additional impact occurs or your development
plans change, this waiver is no longer valid and a 401 Water Quality Certification will be
required.
Please call me at 919-733-9646 if you have any questions.
cc: Raleigh DWQ Regional Office
Raleigh Field Office Corps of Engineers
Wilmington District Office Corps of Engineers
Central Files
File Copy
-P- I
R. Dorney
Wetlands/401 Unit • 1621 Mail Service Center • Raleigh, North Carolina 27669-1621
Telephone [phone] • FAX # [phone]
An Equal Opportunity Affirmative Action Employer
50% recycled/10% post consumer paper
MEMORANDUM
TO: John Dorney Regional Contact:
Non-Discharge Branch WQ Supervisor:
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name NC DOT SR 1984 Past Price Creels
Project Number 00 0121
Recvd From DOT
Received Date 2/21/00 Recvd By Region
Project Type culvert replacement, channel fill
County Orange
County2
Region Raleigh
Certificates Stream
Permit Wetland Wetland Wetland Stream Class Acres
Type Type Impact Score Index Prim. Supp. Basin Req.
Feet
Req.
Stream O Y O N ?- 16-41-2-4- WSII NSW 30,606. F F-
F_F_PY O _NF_ F_ F_r__ F___ F_
Mitigation Wetland
MitigationType Type Acres Feet
I _F_1 F_
Is Wetland Rating Sheet Attached? O Y O N Did you request more info? O Y @ N
Have Project Changes/Conditions Been Discussed With Applicant? O Y O N
Is Mitigation required? O Y O N
Provided by Region: Latitude (ddmmss) 355149
Recommendation: O Issue O Issue/Cond O Deny
Longitude (ddmmss) 790501
Comments:
The impacts to the stream total lees than 1,50 feet for the replacement of both culverts, However the
channel cleanout and rip rap of aonreximstply 900 feet of stream is unnaceptahl I viewed the site
after a , 5 inch rainfall the night before and the stream was not up sQnifigantly at the site visit that
IIIICI Q 1 J 11IV
mornij?g Will recommend the replacement of culverts but no channel dicti irhanee unless some other
type of restoration is don beside rip rap
cc: Regional Office Page Number 1
Central Office
TRIAGE CHECKLIST
Project Name: NC ?O Sg oN
Project Number: 000 I Z )
County:
The attached project has been sent to you for review for the following reasons. Please consider whether a,
site visit is needed to determine the impacts. Particular attention should focus on the below checked items.
Please feel free to call the central office staff member assigned to your region if you need assistance.
Stream length impacted.
V Stream determination (i.e. intermittent or perennial, or any channel present).
Wetland impact and distance to blue-line surface waters on USGS topo map.
Minimization/avoidance options.
NW 14. (is access to hi?_hground or wetlands)'?
Neuse buffer rules.
- Pond (water) fill (i.e. is the pond drained or holding water)?
Pond creation (i.e. in uplands, in a drained channel. or in wetlands). Please locate streams and
channels (if any) so that the central office can determine.
Mitigation ratios.
Stormwater pond placed in wetlands.
Ditching in wetlands.
- Is the applicant's proposed stream/wetland mitigation site available and viable?
Applicant/consultant has a history of non-compliance (check drawings and application for
accuracy).
Has project been split from previous work to avoid mitigation requirements`
- Consistent with pre-application meetings?
- Cumulative impact `co?ncerns. L
OTHER: WS " S ?5 ?
e? 5T? °?
r

s?
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
JmMEs B. HUNT JR. Y.O. BOX 25201, RALEIGH, N.C. 27611-5201 DAVID MCCOY
GOVERNOR SECRETARY
4261 Canlp Burton Rd.
McLeansville, N.C. 27301
February 10, 2000
Division of Environmental Management ; • ,1 _
John Hennesy, WQ Certification Unit
P.O. Box 29535
Raleigh, N.C. 27626-0535
.J a

Dear Mr. Hennesy:
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 [phone].
Thank you for your assistance in this matter.
PAYMENT
RECEIVED
Sincerely yours,
%DVVV I AA I - A, W'?
Dennis L. ohnson
Division Bridge Maint. Engineer
attachments
DWQ ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PE)v1TT n)
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFCATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEti1ENT
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: N. C. Department of Transportation
2. MAILING ADDRESS: 4261 Camp Burton Rd.,
CITY: McLeansville
SUBDIVISION NAME
STATE: North Carolina ZIP CODE: 27301
PROJECT LOCATION ADDRESS. INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE): Heritage Hills subdivision in Orange Count
3. TE -EPHONE NUMBER: (HOME) _N/A (WORK) [phone]
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Dennis L. Johnson
4261 Camp Burton Rd.
McLeansville, NC 27301
[phone]
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Orange . NEAREST TOWN: Chapel Hill
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.)
Two pipe locations on_SR1984 acorss East Price Creek in Heritage Hills
subdivision
6. 24PACTED OR NEAREST STREAMIRIVER: East Price CReek
RIVER BASIN: Cape Fear
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURSE WATERS (ORW), WATER _
SUPPLY (WS-I OR WS-II)? YES ( X ) NO ( ) IF YES, EXPLAIN: HQW
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIROMEVTAL CONCERN (AEC)? YES ( ) NO (X )
7c. 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?
8a. 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):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES( ) NO (X) IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: 0.5
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
-0-
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:
FLOODING:
DRAINAGE :
EXCAVATION:
OTHER:
TOTAL ACRES TO BE IMPACTED:
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: 250 FT AFTER: 250 FT
WIDTH BEFORE (based on normal high water contours):
8
FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: x
CHANNEL EXCAVATION: X COONSTRUCTION OF A DAM/FLOODING:
OTHER: Replace pipe at (2) locations; clean out channel and place
filter fabric and rip rap in 200 ft. sections at 2nd pipe location
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. DISCTIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPNIENT TO BE USED? (ATTACH PLANS; 31/2 BY I 1 DRAWINGS ONLY)
Replacement of undersized pipes
13. PURPOSE OF PROPOSED WORK: Increase pipe openings and open up channel to
prevent local flooding.
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY ti1EASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVE REGARDING THE PRESENCE OF ANY FEDERALY
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: 02-10-00
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PER1IMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED
02-10-00
17. DOES THE PROJECT i tVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF
PUBLIC (STATE) LAND? YES ( ) NO ( X) (IF NO, GO TO 16) _
a. IF YES, DOES THE PROJECT REQUIRE PREPERATION OF AN ENVIRONMENTAL
DOCUMENT PURUANT TO THE REQUIREMENT'S OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES( ) NO ( )
b. IF YES, HAS THE DOCUMENT BEEN REFIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ( ) NO ( )
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUNIENTATIONFROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLIi iA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMEN'T' OF ADM]NISTRATION, 116 WEST JONES STR..._ I', RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING rMMS 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, STRE,4"MS, LAKES; AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PER.IfIT N INMERS 14, 18, 21, 26, 29,
AND 38). ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE hTAP. MAP SCALES SHOULD BE 1 INCH EQUALS 60 FEET
OF 1 INCH EQUALS 100 FEET OF THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE UYIPACTED
BY PRODUCT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE AL.L DATA
SHEETS RELEVANT TO THE PLACEINIENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
c. WHAT IS LAND USE OF SURROUNDING PROPOERTY?
Residential rural farmland
IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WTLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:..
1) ISSUANCE OF A SECTION 404 CORPS OF ENGIVi TEERS PERMIT,
2) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3) (IN THE TWENTY COASTAL COUN'T'IES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL INfANAGEMENT STATD G THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL _
MANAGEMENT PROGRAM,
2 t o as
OWNER'S/AGENT'S SI TURF V DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
JAMES B. HUNT JR. P.O. Box 25201, RALEIGH, N.C. 27611-5201 DAVID MCCOY
GOVERNOR SECRETARY
4261 Camp Burton Rd.
McLeansville, N.C. 27301
February 10, 2000
Division of Environmental Management
John Hennesy, WQ Certification Unit PAYMENT
P.O. Box 29535 RECEIVED
Raleigh, N.C. 27626-0535
Dear Mr. Hennesy:
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 [phone].
Thank you for your assistance in this matter.
Sincerely yours,
Dennis L. )o 'son
Division Bridge Maint. Engineer
attachments

.

DWQ ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PEP-MIT T-0
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERIMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFCATION
3) COORDINATION WITH THE INC 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: N. C. Department of Transportation
2. MAILING ADDRESS: 4261 Camp Burton Rd.,
SUBDMSION NAME
CITY: McLeansville STATE: North Carolina ZIP CODE: 27301
PROTECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF D=E-RENT FROM
MAILING ADDRESS ABOVE): Heritage Hills subdivision in Orange County
3. TELEPHONENUMBER: (HOME) N/A (WORK) [phone]
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Dennis L. Johnson
4261 Camp Burton Rd.
McLeansville, NC 27301
[phone]
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Orange - NEAREST TOWN: Chapel Hill

SPECIFIC LOCATION (INCLUDE ROAD N(IMBERS, LANDMARKS, ECT.)
Two pipe locations on SR1984 acorss East Price Creek in Heritage Hills
subdivision
6. IMPACTED OR NEAREST STREALMA VER: East Price CReek
RIVER BASIN: Cape Fear
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURSE WATERS (ORW), WATER _
SUPPLY (WS-I OR WS-II)? YES ( X ) NO ( ) IF YES, EXPLAIN: HQW
7b. IS THE PROJECT LOCATED WITHII`1 A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF E:YVIROMENTAL CONCERN (AEC)? YES ( ) NO (X )
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEEPAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
8a. 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):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES( ) NO (X) IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAID: 0.5
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECTS=:
-0-
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING:
FLOODING:
DRAINAGE :
EXCAVATION:
OTHER:
TOTAL ACRES TO BE IMPACTED:
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: 250 FT A1TER: 250 FT
WIDTH BEFORE (based on normal high water contours): 8 FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(2) STREAM CHANNEL. IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACENIENT OF PIPE IN CHANNEL: x
CHANNEL EXCAVATION: X COONSTRUCTION OF A DANtInOODING:
OTHER: Replace pipe at (2) locations; clean out channel and place
filter fabric and rip rap in 200 ft. sections at 2nd pipe location
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. DISCTIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 31/2 BY 11 DRAWINGS ONLY)
Replacement of undersized pipes
13. PURPOSE OF PROPOSED WORK: Increase pipe openings and open up channel to
prevent local flooding.
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS) -
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SHRIVE REGARDING THE PRESENCE OF ANY FEDERALY
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: 02-10-00
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
02-10-00
17. DOES THE PROJECT D;VOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF
PUBLIC (STATE) LAND? YES ( ) NO ( X) (IF NO, GO TO 16) _
a. IF YES, DOES THE PROJECT REQUIRE PREPERATION OF AN ENVIRONMENTAL
DOCUMENT PURUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES( ) NO ( )
b. IF YES, HAS THE DOCUMEV°I' BEEN REFIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ( ) NO ( )
IF ANSWER 17b IS YES, THEY SUBMIT APPROPRLkTE DOCUMENTATIONFROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA EYVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARL`7GHOUSE 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
ACTIVI'T'Y 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 (INTERMTITENT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE I INCH EQUALS 50 FEET
OF 1 INCH EQUALS 100 FEET OF THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE I2N1PACTED
BY PRODUCT.
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 STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPOERTY?
Residential rural farmland
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WTLANDS 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
3) (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL. lvf kNAGE2,%fENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL _
MANAGEMENT PROGRAlK
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