20011847 Ver 1_Complete File_20011217

DWQ Project No.: ZOd/ /8 1017
County: A /le
Applicant: A14C- DOT ?. K aEk? ET
Project Name: a2ic%e * /75 S? /5/l
Date of Issuance of 401 Water Quality Certification:
AmAlk
/- A{- OZ
L'wovlcle,d G - 3 "oZ
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
I, D K aE?fA1ETI , 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: 4A K Date: <<f '?S
Agent's Certification
hereby state that, to the best of my abilities, due care
I
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:
Engineer's Certification 1,? $K/cJeYo.i'
Partial ? Final
as a duly registered 12r.gfecc;nna1 Fn ieer 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 I? ICJ ?z-z.? Registration No.
2577
Date 9' / Al-as
W ATF Michael F. Easley, Governor
`OHO RQG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
U) 7 Gregory J. Thorpe, Ph.D.
] Acting Director
p .? Division of Water Quality
January *, 2002
Alleghany County
DWQ Project No. 011847
Bridge No. 175 on SR 1416
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. Heath Slaughter, Division Environmental Officer
NCDOT Division 11
P.O. Box 250
North Wilkesboro, NC 28659
Dear Mr. Slaughter:
You have our approval, in accordance with the attached conditions and those listed below, to impact
130 linear feet of an unnamed tributary to Little River in order to replace Bridge No. 175 on SR 1416
in Alleghany County. The project must be constructed in accordance with your application dated 10
December 2001 (received 17 December 2001). After reviewing your application, we have decided
that this fill is covered by General Water Quality Certification No. 3289, corresponding to the U.S.
Army Corps of Engineers Nationwide Permit Number 14. In addition, you must 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 in writing 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 be valid, you must follow the conditions listed in the
attached certification and any additional conditions listed below.
1. In-stream work and land disturbance within the 25-foot wide buffer zone are prohibited during the
trout spawning season of October 15 through April 15, or as otherwise determined by the North
Carolina Wildlife Resources Commission, to protect the egg and fry stages of trout from
sedimentation during construction.
2. Stormwater must be directed to buffer areas or retention basins and must not be routed directly
into streams. Mowing of existing vegetated buffers is strongly discouraged, so that they may be
utilized for storm water sheet flow.
3. Sediment and erosion control measures shall adhere to the design standards for sensitive
watersheds [ 15A NCAC 4B .0024).
4. Temporary or permanent herbaceous vegetation must be planted on all bare soil within 10 days of
ground-disturbing activities to provide long term erosion control. NCDOT is encouraged to use
existing on-site vegetation and materials for streambank stabilization.
5. The culvert shall be designed and constructed so that it can be installed one foot below streambed
grade to enable waters to flow without freefalling or damming on either end during loijV flow
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetlands/
conditions and ensure passage of all aquatic life. The dimension, pattern, and profile of the
stream and floodplain above and below the culvert shall not be modified by widening the stream
channel or reducing the depth of the stream. Disturbed streams and floodplains should be
restored to natural geomorphic conditions.
6. All work shall be performed during low flow conditions.
7. Disturbance of the stream channel must be limited to only what is necessary to perform the
culvert installation. Heavy equipment must be operated from the banks rather than in the stream
channel in order to minimize sedimentation and reduce the likelihood of introducing other
pollutants into the stream.
Upon completion of the project, the NCDOT shall complete and return the enclosed
"Certificate of Completion" form to notify NCDWQ 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 NC 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 which conforms to Chapter 150B of the North Carolina General Statutes to the
Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This
certification and its conditions are final and binding unless you ask for a hearing.
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 Ms. Cynthia Van Der Wiele at 919.733.5715
or Ms. Jennifer Frye of the Winston-Salem Regional Office at 336.771.4600.
3 ker
?y
orpe, h.D.
c
or
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
NCDWQ Winston-Salem Regional Office
Central Files
File Copy

FILE COPY
TO: Mrs. Jean Manuele, USACOE
Raleigh Field Office
FROM: Maryellen Haggard, DOT Permit Coordinator
Habitat Conservation Program
DATE: December 19, 2001
SUBJECT: NCDOT bridge replacement of No. 175 on SR 1416 over an unnamed tributary to
Little River, Alleghany County
The North Carolina Department of Transportation (NCDOT) is requesting a concurrence
letter from the North Carolina Wildlife Resources Commission (NCWRC) to obtain a 404 permit
from the U.S. Army Corps of Engineers. Biologists on staff with the NCWRC have reviewed
the proposed improvements and are familiar with habitat values of the project area. These
comments are provided in accordance with the provisions of the Fish and Wildlife Coordination
Act (48 Stat. 401, as amended; 16 U.S.C. 661-667d) and the Clean Water Act of 1977 (33 U.S.C.
466 et seq.).
NCDOT proposes to replace the existing bridge No. 175 with a 50'x 128" x 83" CSPA
with a concrete headwall. This action will potentially impact 130 linear feet of an unnamed
tributary to the Little River. Our records show rainbow trout,in the unnamed tributary just
upstream of the project site. In addition, the Little River in this area contains brown trout and
this unnamed tributary is likely used periodically for brown trout spawning. We are mainly
concerned with the rainbow trout, but will request a moratorium for both brown and rainbow
trout. We are pleased that baffles will be placed inside the culvert. We will not object to the
project as proposed provided that the following conditions are implemented:
1. Instream work and land disturbance within the 25-foot wide buffer zone are
prohibited during the trout spawning season of October 15 through April 15 to protect
the egg and fry stages of trout from off-site sedimentation during construction.
2. Disturbance of the stream channel must be limited to only what is necessary
to install the culvert. Heavy equipment should be operated from the bank
rather than in the stream channel in order to minimize sedimentation and
reduce the likelihood of introducing other pollutants into the stream.
Bridge No. 175, SR 1416 2 December 19, 2001
3. The culvert should be buried approximately F into the streambed. The dimension,
pattern, and profile of the, stream above and below the culvert should not be modified
F'
by widening the stream channel or reducing the depth of the stream. Where
disrupted, natural floodplain benching should be restored. This includes the area in
front and below culvert headwalls so that the base flow is directed through the
culvert.
4. Stringent erosion control measures should be installed where soil is disturbed
and maintained until project completion.
5. Temporary or permanent herbaceous vegetation should be planted on all bare soil
within 10 days of ground disturbing activities to provide long-term erosion control.
NCDOT should utilize onsite native vegetation and materials for streambank
stabilization, rather than excessive riprap (or hard stabilization methods). Vegetation
provides bank stabilization, as well as shade for cooler water temperatures, and
riparian edge habitat. If riprap is used, it should be limited to the lower 1/3 of the
streambank.
6. Work must be accomplished so that wet concrete does not contact stream
water.
Thank you for the opportunity to review and comment on this project during the early
planning stages. If you have any questions regarding these comments, please contact me at (336)
527-1549.
cc: Heath Slaughter, NCDWQ
Cynthia Van Der Wiele, NCDOT
1;
AISSUED FILE COPY
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P. O. Box 25201, Raleigh, NC 27611-5202 LYNDO TIPPETT
GOVERNOR PHoNH: 919-733-2520 SECRETARY
December 10, 2001
Mrs. Jean Manuele
U. S. Army Corps of Engineers
Raleigh Regulatory Field Office
6508 Falls ofNeuse Road, Suite 120
Raleigh, NC 27615
Subject: Nationwide Permit #14 & #33
Bridge #175 on SR 1416
Alleghany County, North Carolina
Project Number: 5.7052017
Dear Mrs. Manuele:
011847
?C ? ;?0(11
The NC Department of Transportation is scheduled to replace the existing substandard Bridge
#175 on SR 1416 in Alleghany County. The proposed new structure is a 50'x 128" x 83" CSPA
with a concrete headwall. The entire culvert will be buried 1' below the existing streambed grade.
Three bales, six feet in length, will be placed inside of the pipe to mimic existing stream width
through the new structure.
Miscellaneous rip-rap impacts will total 80 linear feet or less. New stream impacts =1301n. feet.
Construction of this project will necessitate impacts to waters of the United States in the New
River Basin. Bridge #175 crosses an unnamed tributary to the Little River (Class: Q. The
Division 11 Environmental Officer reviewed this project for the presence of threatened and
endangered species on November 29, 2001. The subject project has been determined to have no
effect on any listed threatened or endangered plant or animal species. Historic compliance work
will be scheduled and concurrence with the State Historic Preservation Office will be obtained if
required.
The replacement of Bridge #175 with the proposed CSPA will require temporary dewatering. An
impervious sandbag dike will be constructed upstream of the existing crossing to create a small
pool. Clean water will temporarily be pumped around the construction area and will be
discharged into a buffer area. Any dirty water located inside the construction area will be pumped
into a silt bag. The dewatered area will total approximately 400 square feet or 0.009 acres. Once
P. O. Box 250, N. WILKESBORO, NC 28659
PHONE [phone] FAX [phone] PAYA4E T
RECEIVED
e
Mrs. Jean Manuele
Bridge #175 on SR 1416
Page 2
December 10, 2001
the new structure is in place, the impervious dike will be removed and the stream will flow freely
through the new pipe.
The modifications proposed in this application should not remove or degrade existing water
quality uses. By utilizing the erosion control measures outlined in the attachments to this
application, downstream water quality standards will be protected.
Attached is a Preconstruction Notification Form, plan sheets with proposed erosion control
measures, a marked county map, a marked topography map and photographs.
By copy of this letter, it is requested that Mr. Ron Linville, Mountain Region Coordinator, with
the North Carolina Wildlife Resources Commission comment directly to you concerning the 404
Nationwide Permit application with a copy sent to me.
By copy of this letter, I am forwarding seven (7) copies of this application package to Cynthia
Van Der Wiele, NCDENR, Division of Water Quality, 401/Wetland Unit, for her review. A
$200.00 check is enclosed for the 401 certification processing fee. It is requested that any
comments related to the 401 certification be forwarded directly to the Corps with a copy sent to
me.
We would like to begin construction as soon as possible. If further information is required, please
let me know. Your early review and consideration will be greatly appreciated.
Sincerely,
Heath Slaughter
Division Environmental Officer
Enclosures
cc: Jean Manuele, US Army Corps of Engineers (1 additional copy)
Ron Linville, Western Piedmont Region Coordinator, NCWRC
Cynthia Van Der Wiele, Division of Water Quality (7 copies)
R. C. McCann, PE, Division Engineer
Heath Slaughter, Division Environmental Officer
Neil Trivette, Roadside Environmental Field Operations Engineer
Dennis Bennett, Bridge Maintenance Engineer
i
r
Office Use Only: Form Version April 2001
USACE Action ID No. DWQ No. 011847
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
1. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: NW #14 & NW #33
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ?
H. Applicant Information
1. Owner/Applicant Information
Name: North Carolina Department of Transportation
Mailing Address: P. O. Box 250, North Wilkesboro NC 28659
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: hslau hg [e-mail]
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be
attached if the Agent has signatory authority for the owner/applicant.)
Name: Heath Slaughter, Division Environmental Officer
Company Affiliation: North Carolina Department of Transportation
Mailing Address: P O Box 250, North Wilkesboro NC 28659
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: hslau hg [e-mail]
Page 3 of 12
M. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name ofproject: Bridge #175 on SR 1416
2. T.I.P. Project Number or State Project Number (NCDOT Only): 5.7052017
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Alleghany Nearest Town: Sparta
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From Sparta, travel north on NC
18. Turn left onto SR 1416.
5. Site coordinates, if available (UTM or Lat/Long): UTM: 17 491968E 4043030N
(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:
Residential/Farm
7. Property size (acres): Approximately 0.03 acres.
8. Nearest body of water (stream/river/sound/ocean/lake): UT of Little River (Class: Q).
9. River Basin: New
(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.us/admin/maps/.)
Page 4 of 12
10. Describe the purpose of the proposed work: Upgrade existing stream crossing.
11. List the type of equipment to be used to construct the project: Trackhoe/backhoe and damn
trucks.
12. Describe the land use in the vicinity of this project: Residential/Farm
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
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 exclusion of this work from the current
application: N/A
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 5 of 12
1. Wetland Impacts
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online athttp://www.fem&go .
*** 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: 0 acres
Total area of wetland impact proposed: 0 acres
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact Length of Average
Width of Perennial or
Site Number Type of Impact* Impact Stream Name**
Stream Before Intermittent?
(indicate on map) (linear feet)
Impact (please specify)
Bridge #175 Replacing bridge 50 feet UT of the Little River 6 feet Perennial
with CSPA
Temporary 80 linear
Bridge #175 Dewatering feet or 400 UT of the Little River 6 feet Perennial
square feet
Miscellaneous
Bridge #175 rip-rap
placement for 80 feet or
less UT of the Little River 6 feet Perennial
stabilization

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, fist as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.usgs.QOV. Several Internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.m%nuest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 130 In. ft. of new Wrmanent impacts.
Page 6 of 12
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ean, etc.
N/A

• List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
The existing_ bridge must be replaced due to its condition. By utilizing the erosion control
measures as shown in the attached drawings, adverse impacts to streams in the area will be
minimized. The existing bridge is being replaced with a CSPA as a cost saving measure.
Baffles have been added to the design to maintain existing stream dimensions through the new
structure.
Page 7 of 12
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strrnizide.html.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
N/A
Page 8 of 12
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at hq://h2o.enr.state.nc.usLv /index.htm. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount of Non-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ® If you answered "yes", provide the following information:
Page 9 of 12
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Impact
(square feet Multiplier Required
Mitigation
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
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.
All appropriate best management practices for sediment and erosion control will be
implemented during construction.
XH. 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
XUL Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No
Page 10 of 12
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
/4/0
Applicant/Agent's SignatuatV 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 Iredell Mitchell
US Army Corps of Engineers Avery Clay Jackson Polk
151 Patton Avenue Buncombe Cleveland Lincoln Rowan
Room 208 Burke Gaston Macon Rutherford
Asheville, NC 28801-5006 Cabarrus Graham Madison Stanley
Telephone: [phone] Caldwell Haywood McDowell Swain
Fax: [phone] Catawba Henderson Mecklenburg Transylvania
Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham
US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes
6508 Falls of the Neuse Road Ashe Franklin Nash Surry
Suite 120 Caswell Forsyth Northampton Vance
Raleigh, NC 27615 Chatham Granville Orange Wake
Telephone: [phone] Davidson Guilford Person Warren
Fax: [phone] Davie Halifax Randolph Wilkes
Washington Regulatory Field Office Beaufort Currituck Jones
US Army Corps Of Engineers Bertie Dare Lenoir
Post Office Box 1000 Camden Gates Martin
Washington, NC 27889-1000 Carteret* Green Pamlico
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Pitt
Tyrrell
Washington
Wayne
Union
Watauga
Yancey
Wilson
Yadkin
*Croatan National Forest Only
Page 11 of 12
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Bottom: Upstream view taken from Bridge #175 on SR 1416, Alleghany County. 1.p
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