20010977 Ver 1_Complete File_20010627

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Gregory J. Thorpe, Ph.D., Acting Director
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NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
September 5, 2001
Hyde County
DWQ Project No. 0109777
APPROVAL OF 401 Water Quality Certification and ADDITIONAL CONDITIONS and Tar-
Pamlico River Buffer Rules
Mr. D.R. Conner, P.E., Division Engineer
Division 1, NCDOT
PO Box 850
Edenton, NC 27932
Dear Mr. Conner:
You have our approval, as described in your application dated June 25, 2001, and in accordance with the
attached conditions and those listed below, to place fill material in 100 linear feet of streams for the purpose
of replacing Bridge Number 4 on SR 1302 in Hyde County. The project shall be constructed in accordance
with your application dated June 25, 2001. 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. This approval is also valid for the Tar-
Pamlico River Buffer Rules (15A NCAC 2B .0259). As such, you are authorized to impact 140 square feet
of protected buffers as described in your June 25, 2001 application. 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 when the accompanying 404 permit expires unless otherwise specified in the General
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). ). This approval shall
expire with the corresponding Nationwide Permit expires or as otherwise provided in the General
Certification. For this approval to be valid, you must follow the conditions listed in the attached
certification and any additional conditions listed below.
1. Stormwater shall be directed to sheetflow at nonerosive velocities through the protected stream buffers.
2. 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.
Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
e??
Michael F. Easley, Governor NCDENR
William G. Ross, Jr., Secretary NORTH CAROLINA DEPARTMENT OF
Gregory J. Thorpe, Ph.D., Acting Director ENVIRONMENT AND NATURAL RESOURCES
ROAD CROSSING CERTIFICATION GENERAL CERTIFICATION FOR PROJECTS
ELIGIBLE FOR CORPS OF ENGINEERS NATIONWIDE PERMIT NUMBER 14 (ROAD
CROSSINGS), REGIONAL GENERAL PERMIT 198200031 AND NEUSE/TAR-
PAMLICO/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 2B .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 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Gregory J. Thorpe, Ph.D., Acting Director
4 •
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NC ENR
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 2B.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;
6. 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;
8. 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 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Gregory J. Thorpe, Ph.D., Acting Director
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NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
11. 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 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Gregory J. Thorpe, Ph.D., Acting Director
DWQ Project No.:
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
T 09?'J •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
County:
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
401/Wetlands Unit, North Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC,
27699-1621. This form may be returned 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:
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:
Engineer's Certification
Partial Final
Date:
1, , 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
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 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
Gregory J. Thorpe, Ph.D., Acting Director ILTI 4 • • W'A
William G. Ross, Jr., Secretary
APWA% 0001% WPM
NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.
You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written
petition, which conforms to Chapter 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its conditions
are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please contact John Hennessy at 919-733-5694, or Deborah Sawyer at 252-
946-6481.
Sincerely,
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Washington Field Office
DWQ Washington Regional Office
File Copy
Central Files
c:\ncdot\SR 1302\wqc\010977wgc.doc
Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post consumer paper
MEMORANDUM
TO: John Dorney Regional Contact: Tom Steffens
Non-Discharge Branch WO Supervisor: Bag r Thorne
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name NCDOT - Bridge 4 on SR 1302 County Hyde
Project Number 01 0977 County2
Recvd From DOT Region Washington
Received Date 6/27/01 Recvd By Region
Project Type bridge
Certificates Stream
Permit Wetland Wetland Wetland Stream Class Acres Feet
Type Type Impact Score Index Prim. Supp. Basin Req. Req.
O Y -ON F_29-34-18-2 F C SWNSW 30,307.
Mitigation Wetland
MitigationType Type Acres Feet

Is Wetland Rating Sheet Attached? O Y O N Did you request more Info? O Y O N
Have Project Changes/Conditions Been Discussed With Applicant? O Y O N
Is Mitigation required? O Y O N Recommendation: O Issue 0 Issue/Cond O Deny
Provided by Region: Latitude (ddmmss) 353422 Longitude (ddmmss) 762631
Comments:
Recommend ISSUE with Conditions:
-Applicant agrees (verbal discussion w/ DOT/DIV1/DE0) to minimilize stream imp tc s b ring
quantity of stream bank removed to accomodate dp-rap.
cc: Regional Office
Central Office Page Number 1
tracking notice, WARD, August 15, 2001
I Subject: Re: tracking notice, WARO, August 15, 2001
Date: Thu, 16 Aug 2001 14:17:18 -0400
From: Bob Zarzecki <[e-mail]>
Organization: Division of Water Quality; 401 Certification Unit
To: Deborah. [e-mail], Tom. Steffens 9ncmail.net
CC: Beth Barnes <[e-mail]>
401 Comments
Subject: 401 Comments
Date: Mon, 20 Aug 2001 15:43:09 -0400
From: Tom Steffens <[e-mail]>
To: Bob Zarzecki <[e-mail]>
CC: [e-mail], [e-mail]
Bob,
The following 401 comments have been entered into the tracking system:
#01-1103 Matthews Acres c/o Phillip Harrington, .401, Received WaRO 072601, Recommend ISSUE
w/Conditions:
- Applicant must install culvert or other device to assure transmission of water /wildlife between wetland
areas that the proposed road crosses.
#01-0977 NCDOT Bridge 4, SR 1302,.401, Received 071701, Recommend ISSUE w/Conditions:
- Applicant agrees to minmalize stream impacts by reducing the quantity of streambank removed to
accomodate rip-rap. (as per conversation w/ NCDOT/DIV 1/ DEO
#01-1218 Mark Sabatini, .401 Received WaRO 081001, Recommend ISSUE w/o conditions
#01-0791 George Ansell,.401, Received WaRO 072001, Recommend ISSUE w/o conditions
#01--972 Brian Volk, .401, Received WaRO 070501, Recommend ISSUE w/o conditions
#01-1142 Larrymore Org..401 Received WaRO 072601, Recommend ISSUE w/o conditions
The following could not be located in the tracking system:
NCDOT Multi-Use Path, CAMA Major, Received WaRO 071901, Recommend ISSUE with Conditions:
- Applicant should maintain 6' wide asphalt pavement path for duration of project from STA 00+00 to
approximately STA18+00 where pavement then may be widened to 8' for remainder of project as per
plans. (as per discussion w/ NCDOT/DIV 1 /DEO)
Any questions, call or write,
Thanks,
Toms
Tom Steffens <[e-mail]>
Environmental Specialist II
DENR/DWQ/WaRO
.401 Wetlands
1 of 2 8/20/014:49 PM
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STATE OF NORTH CA.ROLL\A
DEPARTNfENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
June 25. 2001
North Carolina Deparment of Environment and Natural Resources *J 0 OL -17
Division of Water Quality '
1621 Mail Service Center
Raleigh NC 27699-1621
ATTENTION: Mr. John Hennessey
SUBJECT: Authorization request for Bridge #4 replacement within Tar-Pamilco
watershed buffer in Hyde County
The North Carolina Department of Transponation proposes to replace the aging
Hyde bridge structure 4 4 on New Loop Road (SR 1302) at Old State canal crossing with
three 40 long x 9.33 feet wide corrugated aluminum pipe arch with headwalls (see figure
1 for example)
The Old State Canal, located within the Tar-Pamlico watershed. is typically a
slow flowing stream 30-feet wide and about 3 feet deep. It is a potential secondary
nursery area- but not a primary nursery area or outstanding resource waters. No wetlands
will be impacted. The project will be within zone 1 of the riparian buffer, no work will be
in zone 2.
The replacement structure will be constructed along the existing alignment and
would take about two weeks to complete. Based on the proposed design, the new road
structure will be wider (+11.2 feet) and the canal channel width will be more narrow
(-10.05 feet) but will be able to allow for the same amount of water flow as the existing
bridge (Q 10=540 cubic feet/second). Department of Transportation plans to remove the
old concrete abutements and pilings. The existing bridge bulkheads will remain in place.
The pipes and headwall will be submerged a foot below the original streambed. This
widening and submerging the pipes will require excavation below the waterline of about
127 cubic yards of soil. 100 feet of shoreline will be stabilized with Class II rip-rap and
will extend no more than 5 feet water-ward of the mean normal water contour.
FD
P.O. Box 850. Edenton, NC 27932 - Phone: (25:) 482-797- Fax: [phone]
Enclosed is a copy of the diagrams, vicinity map, a PCN form. and a check to cover
permit fees. NCDOT plans to begin construction immediately after all permits are
obtained.
Sincerely,
Don Conner, PE
Division Engineer-Division One
/f Sid
Kristen Shacochis
Division Environmental Officer
Cc: Mike Bell, USACE
Tom McCartney. USFWS
Ron Sechler, NNIFS
David Cox, NCNVRC
Sarah Winslow, NC DMF
Keith Harrison, Bridge Maintenance
Sterling Baker, PE, NCDOT
P.O. Box 850. Edenton, NC 27932 - Phone: [phone]- Far: (25=) 482-8722
Fonn Version April 2001
Office Use Only' 09-77
t r
USACE Action ID No. D«'Q No.
If any particular item is not applicable to this proiect, please enter "Net Applicable" or "N/A" rather than
leaving the space blank.
I. Processing
1. Check all of the approval(s) requested or this project:
f-I Section 404 Permit
Section 10 Permit
® 401 Water Quality Certification
® Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested:
3. If this notification is solely a courtesy copy because w-ritten approval for the 401 Certification
is not required, check here:
4. If payment into the North Carolina Wetlands Restoration ?rogram (NCXVRP) is proposed for
mitigation of impacts (see section VIII - Nlitigauon)_ check here:
II. Applicant Information
1. Owner/Applicant Information
Name: Kristen Shaeochis NC DOT Division 1 En-vironmental Officer
Mailing Address: P.O. 850 Edenton NC 27932
Telephone Number: 252 482-7977 Fax dumber: 252 482-8722
E-mail Address: Kshacochisriudot.state.ne.us
2. Agent Information (A signed and dated cope of the :went Authorization letter must be
attached if the Agent has signatory authority for :he owner applicant.)
Name:
Company Affiliati
Mailing Address:_
Telephone Number: Fax Num*:) er:
E-mail Address:
P-e 3 of 12
III. 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 ARCS 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 lamer 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: Bridge 4. Hyde County
2. T.I.P. Project Number (NCDOT Only): Bridge Maintenance project, not TIP
3. Property Identification Number (Tax PIN):
4. Location
County: Hyde County Nearest Town: Ponzer
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.):
5. Site coordinates, if available (UTM or Lat/Long): N 35 34.301 W 76 26.501
(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:
Existing bridge at Canal Crossing
7. Property size (acres): N/A
8. Nearest body of water (stream/river sound/ocean/lake): Old State Canal
9. River Basin: Tar-Pamlico
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http: /h2o.enr.state. nc.u:'admin/maps/.)
Page 4 of 12
10. Describe the purpose of the proposed wort: Replace bride with 3 arch culverts 75" h x
112" wide with 3 feet between pipes-NOII excavate 100 ft's at SW corner of culverts on
shoreline and keep rip rap within 25 feet of culvert headwall and feet of mean high
water
11. List the type of equipment to be used to construct the project: escavator, dumptrucks,
crane
12. Describe the land use in the vicinity of this project: Aariculr.:ral
IV. Prior Project History
If jurisdictional determinations and or permits have peen requested and"or obtained for this
project (including all prior phases of the sarz:e subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Numb:, applica7on 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 mitigaEon (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.
N/A
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 e_-cclusion of this work from the current
application: N/A
VI. Proposed Impacts to Waters of the United States/«-aters of the State
It is the applicant's (or agent's) responsibill-y to dete-mine, de:ineate and map all impacts to
wetlands, open water, and stream channels z:sociated % ith the project. The applicant must also
provide justification for these impacts in Sel.ion VII -elow. All proposed impacts, permanent
and temporary, must be listed herein, and mist be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (inten-Littent and perennial) must be shown on a
delineation map. whether or not impacts are propose:: to these systems. Wetland and stream
evaluation and delineation forms should be include;: as appropriate. Photographs may be
Paae . -)f 12
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.
1. Wetland Impacts
Wetland Impact
Site Number
(indicate on map)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(yes/no) Distance to
Nearest Stream
(linear feet)
T,,pe of Wetland***

* List each impact separately and identity temporary impact. impacts mciudc. out are not trmttea to: mecnamzcxr ctcandg, giaudig, Lill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both vucture and flooding.
** 100-Year floodplains are identified through the Federal Emergenc\ Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps ;ire available through the FEMA Map Service Center at 1-800-358-9616, or
online at http://ww,,v.fcma.,gov.
*** 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: zero
Total area of wetland impact proposed:
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
(indicate on map)
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
(please specify)

* List each impact separately and identify temporary impacs. impact include, out are not limned to: culverts and associateu lip-lap,
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, ditch ing/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint ;or both the original and relocate streams must be included.
** Stream names can be found on USGS topographic maps. If a strearn has no name, list as LT (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.gs.Qov. Several interact sites also allow direct download and printing of USGS maps (c.g., www.topozonc.com,
www.mapquest.com, etc.).
Page 6 of 1
Cumulative impacts (linear distance in feet) to as stream; on site:
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 map)

Type of Impact* .-area : f

Impa:
1 acre Type of Waterbody
N?.e of ?Vat.od?-
;f applical`::l (lake, pond, estuary, sound,
bay. ocean, etc.)

List each impact separately and :dcntifv tem-,orary impa.:s. Impac s include, b,..ire not lir._ted to: nu, excavation, dredging,
flooding, drainage, bulkheads, etc_
4. Pond Creation
If construction of a pond is proposed, associated wet'.and and stream impacts should be
included above in the wetland and steam impact sections. Also. the proposed pond should
be described here and illustrated on any maps included «;th this application.
Pond to be created in (check all that apply): [] uplands [ stream E] wetlands
Describe the method of construction (e.g., dam/emba akment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock water*M' g, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Atinimization)
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 msv attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site p:an was developed. If applicable, discuss construction
techniques to be followed during construction. to reduce impacts.
To replace existing a;ing bridge structure n-ith ; culverts. The bridge needs to be replaced
because it is an old wooden structure and has become too difficult to maintain. The
culverts Neill provide less maintenance needs
P2ge 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 `-eater than or equal to one acre of impacts to
freshwater wetlands or `-eater 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 NCW'RP concurrence shall be placed on hold as
incomplete. An applicant may al-so choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http:/ih2o.enr.state.nc.us.,,ncwet]ards/str-rna-ide.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.
None needed.
Pac.e 8 of 12
2. Mitigation may aLo be mace by payment into the Nor-.h Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's Nvritten agreement. Check the box indicating that
you would like to pay into the NC`VRP. Please note that payment into the NCWRP must be
reviewed and approved before it can -e used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401 «'etlands Unit if payment into the
NCWRP is available as an option. For addi-onal information regarding the application
process for the NCNVRP, che-A the NC`VRP we?-+site at h7-7://'h-'o. enr.state.nc.us,wm/index.htm. If
use of the NCWRP is proposed, pleas check the approprate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (squ-e feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public fords 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 em- ronmental documentation.
Yes [:] No
If yes, has the document review peen 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 prorosed 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.
Pa-: 9 of 12
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 213 .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ® No F? If you answered `yes". pro,.-ide the following information:
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* I Impact
(square feet) Multiplier Required
Mitisation
1 140 3 , none
2 ( 1.5
Total
Lone i extenu; out )u iee: perpenuicui ar irum near _wmx um cn mr wl, L.l)nc W1
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.
XI. 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.
1346.4 square feet for existing bridge. 373 square feet for proposed culverts, 500 square
feet for proposed rip rap (both below and above water).
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.
N/A
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Page 10 of 12
Yes F-1 No
Is this an after-the-fact permit application?
Yes ? No
YIV. Other Circumstances (Optional):
It is the applicant's responsibili.y to submit the a_-pliczation sufficiently in advance of desired
construction dates to allow processing Mme for Wiese pewits. However, an applicant may
choose to list constraints associated with :on_ztructon or sequencing that may impose limits on
work schedules (e.g., drag-dovtin schedules for 1_<es. dates associated with Endangered and
Threatened Species, accessibility probletr_s. or othe- issues outside of the applicant's control).
No other constraints. CAATA permit expires on o/1 5/02

AS/ /
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization: letter from the applicant is provided.)
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee Fredell Mitchell
US Army Corps of Engineers Avtry Clay- Jackson Polk
151 Patton Avenue B=combe Clevelanc Lincoln Rowan
Room 208 Bu.ke Gaston Macon Rutherford
Asheville, NC 28801-5006 Ca.*?arrus Graham -Madiscn Stanley
Telephone: [phone] Cardwell Haywood -'\icDo:;-ell S%vain
Fax: [phone] Ca:awba Henderso= Meckrenbur- Transylvania
Raleigh Regulatory Field Office Al_mance Durham Johnson Rockingham
US Army Corps Of Engineers AD-hany Edgecom:z Lee Stokes
6508 Falls of the Neuse Road A-?ie Franklin \Tash Surry
Suite 120 C--;well Forsti-th North=pten Vance
Raleigh, NC 27615 Chatham Granville Oran-. Wake
Telephone: [phone] Davidson Guilford Person Warren
Fax: [phone] Davie Hali.^ax Rande:ph Wilkes
Washington Regulaton. Field Offic: Beaufort Currituck ones
US Army Corps Of Engineers Bettie Dare LenoL*
Post Office Box 1000 C=den Gates Martiz
Washington. NC 27889-1000 C-.eret" Gre--n Pamlico
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] C _ven Hyde Perquimans
Pitt
Tyrrell
Washington
Rayne
Union
Watauga
Yancey
Wilson
Yadkin
'Croatan National Forest Only
Pa_! 11 of 12
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1390 Carteret Nlontgomen. Robeson
Telephone: [phone] Columbus \[core Sampson
Fax: [phone] Cumberland New Hanover Scotland
US Fish and Wildlife Service / National Marine Fisheries Service
US Fish and Wildlife Senice US Fish and Wildlife Serve National Marine Fisheries Service
Raleigh Field Office Asheville Field Office Habitat Conservation Division
Post Office Box 33726 160 Zillicoa Street Pivers Island
Raleigh, NC 27636-3726 Asheville. NC 23801 Beaufort, NC 28516
Telephone: [phone]_0 Telephone: (82S) 665-119: 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]
Di-vision of Water Quality
Wetlands Restoration Pro--=
1619 Mail Senice Center
Raleigh, NC -699-1619
Telephone: [phone]\
Fax: (919)73:-5321
State Historic Preservation Office
Department Of Cultural Resources
4617 Mail Service Center
Raleigh, NC 27699-4617
Telephone: [phone]
Fax: [phone]
CAI Lk and NC Coastal Counties
Division of Coastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bettie Craven Hyde Pender
Raleigh, NC 27699-1638 Brunswick Currituck New Hanover Perquimans
Telephone: [phone] Camden Dare Onslow Tyrrell
Fax: [phone] Carteret Gates Pamlico Washington
NC'v'v-RC and NC Trout Counties
Western Piedmont Region Coordinator Alleghany Caldwell Watauea
3855 Idlewild Road Ashe `Mitchell Wilkes
Kemersville, NC 27284-9180 Aver}- Stokes
Telephone: [phone] Burke Surry
Mountain Region Coordinator Buncombe Henderson Polk
20830 Great Smoky Mtn. Expressway Cherokee Jackson Rutherford
Waynesville, NC 28786 Clay Macon Swain
Telephone: [phone] Graham Madison Transylvania
Fax: [phone] Haywood McDowell Yancey
Pare 12 of 12
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