20041007 Ver 1_Complete File_20040616

I
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
July 20, 2004
DWQ# 04-1007
Iredell County
Mr. Mike Holder, P.E. WETLANDS/ 401 GROUP
NCDOT Division 12
P.O. Box 47
Shelby, NC 28151 JUL 2 8 2004
APPROVAL of 401 Water Quality Certification with Additional Conditions WATER QUALITY SECTION
Dear Mr. Holder:
You have our approval, in accordance with the attached conditions and those listed below, to permanently
impact 20 linear feet (If) of Dye Creek for the purpose of replacing an existing timber bridge with a new
concrete bridge as described in your application received by the Division of Water Quality (DWQ) on June 16,
2004. The location of the project is Bridge #41 on State Road 1147 (Rocky River Road), south of Mooresville.
After reviewing your application, we have determined that this project is covered by Water Quality General
Certification Number 3404. This certification corresponds to the Regional General Permit Number
198200031 issued by the U.S. Army Corps of Engineers (USACE). Please note that you should get any other
federal, state or local permits before proceeding with your project, including those required by (but not limited
to) Sediment and Erosion Control, Non-Discharge, and Water Supply Watershed regulations. This approval
will expire with the associated 404 permit unless otherwise specified in the Water Quality Certification.
This approval is valid solely for the purpose and design that you described in your application (unless modified
below). Should your project change, you must notify the DWQ in writing and you may be required to 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 conditions. If total wetland fills for this project (now or in
the future) exceed one acre, or if total impacts to streams (now or in the future) exceed 150 linear feet,
compensatory mitigation may be required as described in 15A NCAC 2H.0506 (h)(6) and (7). For this
approval to remain valid, you must adhere to the conditions listed below and in the attached certification.
1. Disposal of old bridge material into surface waters is not allowed. Strict adherence to the USACE guidelines
for bridge demolition will be required.
2. Heavy equipment must be operated from the banks rather than in the stream channel, when possible, in
order to minimize sedimentation and reduce the likelihood of introducing other pollutants into the stream.
3. Temporary dewatering sites must be restored to pre-existing conditions unless more natural geomorphic
conditions can be provided.
4. No live or fresh concrete shall come into contact with waters of the state until the concrete has hardened.
N.C. Division of Water Quality, 401 Wetlands Certification Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
512 N. Salisbury St., Raleigh, North Carolina 27604
Phone: [phone] / FAX: [phone] / Internet: h2o.enr.state.nc.us
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper
NorthCarolina
Natarally
dir
Page 2
5. The structures required for this project shall be installed in such a manner that the original stream profiles are
not altered (i.e., the depth of the channel must not be reduced by a widening of the streambed). Existing
stream dimensions (including pattern and profile) are to be maintained above and below locations of each
pipe. The structure shall be designed and installed to allow for fish and other wildlife movement as well as
prevent headcutting of the streams.
6. The dimension, pattern and profile of the stream above and below the crossing should not be modified.
Disturbed floodplains and streams should be restored to natural geomorphic conditions.
7. All mechanized equipment operated near surface waters must be regularly inspected and maintained to
prevent contamination of stream waters from fuels, lubricants, hydraulic fluids, or other toxic materials.
8. All work shall be performed during low or normal flow conditions.
9. Erosion and sediment control practices must utilize Best Management Practices (BMP) and be in full
compliance with all specifications governing the proper design, installation, and operation and maintenance
of such BMP in order to protect surface water standards:
a. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most recent
version of the North Carolina Sediment and Erosion Control Manual. The devices shall be
maintained on all construction sites, borrow pit sites, and waste pile (spoil) projects, including
contractor-owned or leased borrow pits associated with the project.
b. For borrow pit sites, the erosion and sediment control measures must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Surface Mining Manual.
c. The reclamation measures and implementation of these measures must be in accordance with
the requirements of the Sedimentation Pollution Control Act.
10. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum extent
practicable. If placement of sediment and erosion control devices in wetlands and waters is unavoidable,
they shall be removed and the natural grade restored within 30 days after the Division of Land Resources
has released the project.
11. The North Carolina Department of Transportation (NCDOT) and its contractors and/or agents shall not
excavate, fill or perform mechanized land clearing at any time in the construction or maintenance of this
project within waters and/or wetlands, except as authorized by this Certification, or any modification to this
Certification (e.g., no work shall occur outside of the footprint of the plans provided). In addition, there shall
be no excavation from or waste disposal into jurisdictional wetlands or waters associated with this
Certification without appropriate modification. If this occurs, compensatory mitigation may be required since
it is a direct impact from road construction activities.
12. Upon completion of the project, the applicant shall complete and return the enclosed "Certificate of
Completion" form to notify DWQ when all work included in the 401 Certification has been completed. Please
include photographs upstream and downstream of the structure to document correct installation.
13. Continuing Compliance. NCDOT shall conduct its activities in a manner consistent with state water quality
standards [including any requirements for compliance with section 303(d) of the Clean Water Act] and any
other appropriate requirements of state and federal law. If DWQ determines that such standards or laws are
not being met (including the failure to sustain a designated or achieved use) or that state or federal law is
being violated, or that further conditions are necessary to assure compliance, DWQ may reevaluate and
modify this certification to include conditions appropriate to assure compliance with such standards and
requirements in accordance with 15 A NCAC 2H.0507(d). Before codifying the certification, DWQ shall notify
NCDOT and the USACE, provide public notice in accordance with 15A NCAC 2H.0503, and provide
opportunity for public hearing in accordance with 15A NCAC 2H.0504. Any new or revised conditions shall
be provided to NCDOT in writing, shall be provided to the USACE for reference in any permit issued
pursuant to Section 404 of the Clean Water Act, and shall also become conditions of the 404 Permit for the
project.
Page 3
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must
act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition that
conforms to Chapter 1506 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 Polly Lespinasse in the Mooresville Regional Office at 704-663-
1699.
Sincerely,
Alan W. Klimek, P.E.
Attachments
cc: Steve Lund, USACE Asheville Field Office
Rob Ridings, DWQ Central Office
Central Files
File Copy
I
s
5
U 4

STATE of NORTH CAROLINA
WETLANDS 1401 GROUP
JUN "6 2004
WATER QUALITySECT10N
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P.O. BOX 25201, RALEIGH, N.C. 27611-5201 LYNDO TIPPETT
GOVERNOR SECRETARY
P.O. BOX 47, 1710 East Marion Street
Shelby, N. C. 28151-0047
June 11, 2004
Mr. Steve Lund - NCDOT Projects
US Army Corp of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, N. C. 28801-5006
Dear Mr. Lund:
The North Carolina. Department of Transportation, Division of Highways, requests the issuance of
a Section 404 Permit, General Permit 198200031.
COUNTY: Iredell
LOCATION: SR 1147 (Rocky River Road), south of Mooresville
STREAM: Dye Creek (Branch), Class C Waters (from source to Rocky River),
Yadkin River Basin
PROJECT DESCRIPTION: The project consists of the replacement of a structurally deficient
timber bridge (Bridge #41) with a new concrete bridge. The interior bents for the bridge will be
placed out of the active stream channel; therefore, minimal disturbance of the streambed is
anticipated. Class B riprap will be utilized under the bridge to provide stabilization. I have
enclosed a PCN application, a sketch of planned activities- including preliminary erosion control
plan, and location maps relative to the project.
The proposed project is located in Class C waters, therefore, hazardous spill basins are not
required. Enclosed is the NCDOT hazardous spill basin checklist.
A review of the Natural Heritage information for the T/SA species (threatened due to similarity of
appearance) listed for Iredell County, the bog turtle (Clemmys muhlenbergii), revealed no known
sites in the vicinity of the project areas. An on-site survey was conducted on June 10, 2004.
Neither the bog turtle nor suitable habitat was observed at either project site. It is anticipated that
there will be no impact on this species or its habitat. A review of the available information from

Mr. Steve Lund
SR 1147, BR#41- Page Two
June 11, 2004
the National Register of Historic Places was also conducted. It is anticipated that no historic site
will be impacted by the proposed project.
Your earliest consideration for this request would be greatly appreciated. Should you have any
questions, please call me at 704480-9020.
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division
BY: - iZt?
Trish Simon
Division 12 Environmental Supervisor
Enclosures
cc: Mr: Michael L. Holder, P.E., Division Engineer
Mr. Dan Holderman, P.E. , Division Bridge Engineer
Mr. Polly Lespinasse, DENR, DWQ, Mooresville Regional Office
Mr. John Dorney, DENR, DWQ, 401/Wetlands Unit
Mr. Ron Linville, N.C. Wildlife Resources Commission (Courtesy Copy)
Mr. Brian Cole, U.S. Fish & Wildlife Service (Courtesy Copy)
Mr. Neil Trivette, Roadside Environmental Field Operations
File

Office Use Only: 0 4 1007 Form Version October 2001
USACE Action ID No. DWQ No.
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
I. Processing
1. Check all of the approval(s) requested for this project:
0 Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. . Nationwide, Regional or General Permit Number(s) Requested: GP 31.
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: Mike Holder, NCDOT
Mailing Address: P.O. Box 47
Shelby, NC 28151
Telephone Number: 704-480-9020 Fax Number: 704-480-5401
E-mail Address:
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: Trish Simon
Company Affiliation: NCDOT
Mailing Address: P.O. Box 47
Shelby, NC 28151
Telephone Number: 704-480-9044 Fax Number: 704-480-5401
E-mail Address: tsimon?7ii dot state nc us
Page 1 of 7
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 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 fun-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: Briidgg #41 Replacement SR 1147.Iredell County
2. T.I.P. Project Number or State Project Number (NCDOT Only): 12C.204911
3. Property Identification Number (Tax PIN): NCDOT Right of way
4. Location
County: Ir ell Nearest Town: Mooresville
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers, landmarks, etc.): Hwy 1155 from Mooresville.
Turn left on SR 1125 (East Brawler Avenue), left onto SR 1147 to bridge.
5. Site coordinates, if available (UTM or Lat/Long): 35'32'1 5'N/80*47'32W
(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:
Bridge on paved sewn A road
7. Property size (acres): 0.20 acres NCDOT right of way
8. Nearest body of water (stream/river/sound/ocean/lake): Dye Creek (Branch (From source
to Rocky River) Class C Waters
9. River Basin: Yadkin
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at hM://h2o.enr.state.nc.us/admin/m4p .)
10. Describe the purpose of the proposed work: This project consists of replacing a structurally
deficient timber bridge with a concrete bridge.
J I

Page 2 of 7
0
11. List the type of equipment to be used to construct the project: A trackhoe and crane
will be used.
12. Describe the land use in the vicinity of this project: The surrounding area is mostly
agricultural fields.
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.
NA
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application:
No future permit requests are anticipated
VL 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.
1 Wetland Tmnac:tc• WONE
Wetland Impact -- -- ---- - ' - - Area of Located within Distance to
Site Number Type of Impact* Impact 100 year Floodplain** Nearest Stream Type of Wetland***
indicate on map) acres es/no (linear feet
* T.id Parh impact a enarately and identifv t emnormv im nacts. bnnacts include. but are not limited to: me chanized clearing, grading, fill,
excavation, flooding, ditchingJdrainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodplams are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplam maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http://www.fema.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.)
Page 3 of 7
14
List the total acreage (estimated) of existing wetlands on the property: 0
2. Stream Impacts, including all intermittent and perennial streams
Stream
Impact Site of ct
Length
? Average Width Perennial or
Number Type of Impact* r feet)
(Iu?
ea Stream Name** of Stream Intermittent?
(indicate on
map) Before Impact (please specify)
1 Class B Riprap 20 feet (on streambanks) Dye Creek 20 Perennial
List each impact separately and identify temporary impacts. Impacts include, but are not imated to: culverts ana associama np-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gam),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightemng, 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, list 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.ussS.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mMuest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 20 feet of permanent
impacts on streambank from riprap
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U. S. NO OPEN WATER IMPACTS
Open Water Impact Area of Name of Waterbody Type of Waterbody
Site Number Type of Impact* Impact (if applicable) (lake, pond, estuary, sound,
indicate on map) acres) bay, ocean, etc.

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: till, excavation, dredging,
flooding, drainage, buIldwads, etc.
4. Pond Creation NO 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.):
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:
Page 4 of 7
FA
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 bridge is to be replaced with another bridge; therefore there is no net loss of stream footage.
BridZe bents to be installed outside. of existing streambed Minimal disturbance to stream is
anticipated during the pile driving for interior bent placement.
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/strmgide.htmi.
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.
IMPACTS< 150 FEET;, MITIGATION NOT ANTICIPATED
Page 5 of 7
It
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 httn:/fit,20.enr.state.nc.us/wri)/indexLhtin. 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):
Amount of buffer mitigation requested (square 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 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
(Neuse), 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:
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.
Page 6 of 7
I
Zone* Impact
(square feet Multiplier Required
Miti on
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.
NA
XL 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.
Minimal additional impervious surface is proposed in this project
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.
NA
XIIL 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
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).
NA

Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 7 of 7
I,
?? AS-rzr F2? ?? ` V { ?? c?? ?
G'4t5TtN? ?Ll?i?
i
10J 0 al17
ro gc; lw?:? oda, ?.C7? .?1 /? (pj3 JJ
DOJ;?? OV / ?Gtl a?0'
9fsa iatav -? io,?z? SiZ 1!4? //fav
I
r
? /oS
I SKGv-/ '?
cc.?s5 rI' 2/P24P
L/ E G4?LLIC, Sn4 1I439
I )mil 5(-- ,
zo"
f LAS
574. 1?-Z3
a;3 ? EL, lo4,v

Ear Sna? 41,0V } O
C-Aco- Sr?G
Pezy a3, Zo41

? t2t??cc. cau,?r,--y
'52, 1147
IZEPL,4a6 eu i OP 81,041
41/4a
0
U
1Z 6,, iwr- 65-urS770e,
5/L a47
hi2o,oa5G--?,
Gel Doc
c3.1? ST?rJ`?
(I.r 1?4f?
jG-??/?,
5e, v
"514 7' 1=CLZC
?7 71p . 4c?

..5 1cr'Ceo C-?5
?(,,q,? - (?u?Z1,v?, COOS PU-jC776A-.)
sec
"-
?? TT T4U !A? I ?l D l7 G V? v ?V vJP -?
}N
JEf?lvv?v vv `, 10 ?acsc ?"
E?J
_.----
SkET Z Fl=
c-?i,E 1 ?r= Zo
'?2 1147
4 0¢
1ZE-?oc.AcG-rr,air 4-1
° er
_. 2344 11e>

' .'
?? 231. w
1154 6 1

i
-, e' IS :ss n 1
130
'30e
115.
s-C545"4 .n3
' d
..s '
'" 1157

150
?l
2D,•; ',
,?
.; -:?
,? \ 1i5o
1139 ,151 J \
1 152
l0
+
°+I
1/d Nlo
C47
'
132 65 137 S

IAO•"
,
/

f 3 ".hiN

.. Y
1 qp

x.:1.3 .
C544 ?'
15
? i 11 )e F`
I

44
1)1
f..

33 1
115
,153

7 ' w,I.o1 lI n
'° t? ^, aY. 13
• MOORESVILL
E
boy ?OP. 8.575
-
5
31
?J 1

5 !? I
1

1,31 A.e. 1123 iiso

30
17•.

1171 175.
- ti ..
:<?
1131 1

:130 3 F
v

.!

1179
J 1126 i

IiI

.

2 3

I 1
.::::: . a

-
1W ti

`?? :

5 ?, duo 11 f0
176

z 1274
1131 n07 .?-.6Z

G
o
121,

1
`1751
nu

263

07 7u`
121.

J 47
1117
a;... _ 32
.
177. o
C42
' I ISn
2>e
_Se

1125 1
t.+
P
J
1115
12u 1147

41 z
40
790.
722.
1137 2903 37 34
m 2_-22
21

36
177? .12
o
IM

, 1143
-
39 1142

113. IT 11Y
S
tV05 <
C O U- Nom-
T y
MOORESVILLE AND VIGNITY

uG?10-r
JL-)c-U-, COW P-1
s2 t t.4--
2cnc Ac6 mc-z)- tp a,e. d-.44
?/oil

(Joins sheet 56)

E
n
a
U
N
O
m N
O
m E
a w
E
o ?
a
c U
c 2
E
t .Iuuls sneer uLr

1125
I53)

130
ONE A3 \\
ZONE C
., o
,? 15
I j
i ;
I
ii
A
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: /Z County' !,"6 -'? Project ID: 126, 004! lI River Basin: 41A Bridge No: 4-1
lcl?
Route: 56 i14-7 Stream:
Water Quality Criteria: Gc.•??? G Yes No
Stream Crossing Blue Line On USGS r°" r
ORW r r'"
WSI r f-?
WS 11,111 OR IV, Crossing Within 0.5mi of W.S. Critical Area r r?
Roadway Criteria:
Route Designation-
Yes No
Arterial Urban r
Arterial Rural r r
Additional Site Information:
Yes No
Is a Hazardous Spill Basin Required? F r
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
(Photo #3) Dye Creek Looking Downstream from
Bridge #41.
(Photo #1) Bridge #41 on SR 1147 (Photo #2) Bridge #41 on SR 1147
(Photo #4) Dye Creek Upstream of
Bridge #41.
&
STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GovERNOR SECRETARY
041007
MEMO TO: John Dorney, DENR/DWQ/401NVetlands Unit
FROM: Trish Simon, Division 12 Environmental Supervisor ?I f
DATE: June 11, 2004
SUBJECT: Pre-Construction Notification/401 Automated Payment

Enclosed are seven copies of a pre-construction notification for a NCDOT bridge project
in Iredell County for your review.
Project information for the 401 Automated Payment Procedure
• Work order number: 150465-55120005-128.204911-4685-49041
• TIP #: NA
• Project Category: $200.00 Fee
WETLANDS / 401 GROUP
is JUN 1 °6 2004
WATER QUALITY SECTION
Post Office Box 47 Shelby, North Carolina 28151-0047
Certificafe Qf Completion
sn ? ? UO
DWQ Project No.: b¢ -/QZb 7 Counfv:
O
Applicant: ?CJG T - tuts ?o? / _ S G s
Project Dame: = L ?m?
Date of Issuance of 401 Water Quality Certification:
e
Upon completion of all work approved within the 401 'a
? Quality Certification and Buffer Rules and
any subsequent modifications, the applicant is required'tn r tarn 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, N. L - A, le,,- hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the constriction was observed to be
built within substantial compliance and intent of the 4a1 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature:
Date: ? j/-95-
Agent's Certification
I, , hereby state that, to the best of my abilities due care and
diligence was used in the observation of the constru ion 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:
If this project was designed by a Certified Professional
I, . as a duly registered Professional
(i.e.,
Engineer, Landscape Architect, Surveyor, etc.) 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: Registration No.: Date:

1, SR 1147, Iredell Bridge #41. SR 1147, Iredell
? s

tw} ? ? ?t? 1-
1 '?i
? ?+`r
7

ri -

r
. 416 ,y ? 4.ri =
? i : _
;1'.` a