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HomeMy WebLinkAbout20041448 Ver 1_Complete File_20040830 o?QF W A T L-RQG C DWQ Project No.: D4/4`9? County: ?J2??sow Applicant: /VC vDv Project Name: Teq /7ly 4---e-k o = A1,,11,;-1-Z,4,1 Date of Issuance of 401 Water Quality Cert' cation: 9-?9 - p<y 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, 1650 Mail Service Center, Raleigh, NC, 27699-1650. 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 Certificati f If this project was designed by a Certified Professional I, o A?. ?? hereby state that, to the best of my abilities, due care and diligence was used in the observation of the constnzcri such that the construction was observed to on be built Jati bsta al co pliance and intent of the 401 Water Quality Certification and Buffer Rules, thed s an spe 'scat' ns , and othate that, to the best of my SignatureDateAgent's on I, ,hereby st abilities, due care and diligence was used in the observation of the constructio such that the construction was observed to n 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: 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 Permitee 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 D JAN 1 8 2005 0"MDS AND St?1 BR41CH Michael F. Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources Alan W. Klimek, P.E. Director Division of Water Quality 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), hftp://h2o.enr.state.nc.us/newetiands/ AM- 756"A OW A T??QG co r Michael F. Easley, Governor William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources _ -C Alan W. Klimek, P.E. Director Division of Water Quality September 29, 2004 Jackson County DWQ Project No. 041448 NCSR 1710 (E. Cope Creek Road) APPROVAL of 401 Water Quality Certification with Additional Conditions D = ? ? a V n Mr. J. B. Setzer, P.E. U Division Engineer O C T 0 4 2004 N C Department of Transportation 253 Webster Road 1NEt' puEDNgrv S WATER p? H Sylva, North Carolina 28779 Dear Mr. Setzer: You have our approval, in accordance with the attached conditions and those listed below, to impact 160 linear feet of Cope Creek (160 linear feet of rock fill), in order to repair the eroded embankment adjacent to NCSR 1710 (E. Cope Creek Road) in Jackson County. The project must be constructed in accordance with the application dated August 25, 2004 (received August 30, 2004), including the environmental commitments made in the application letter. After reviewing your application, we have decided that this fill is covered by General Water Quality Certification No. 3399, corresponding to the U.S. Army Corps of Engineers Nationwide Permit Number 13. 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 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 be valid, you must follow the conditions listed in the attached certification and any additional conditions listed below. 1. Erosion and sediment control practices must be in full compliance with all specifications governing the proper design, installation and operation and maintenance of such Best Management Practices in order to protect surface waters standards: a. The erosion and sediment control measures for the project must be designed, installed, operated, and maintained in accordance with the most recent version of the North Carolina Sediment and Erosion Control Planning and Design Manual. b. 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 sites, and waste pile (spoil) projects, including contractor-owned or leased borrow pits associated with the project. c. 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. o Carolina N ` Nturully North Carolina Division of Water Quality 2090 U.S. Highway 70 Swannanoa, NC 28778 Phone (828) 2964500 Customer Service Internet h2o.enr.state.nc.us FAX (828) 299-7043 1-877-623-6748 An Equal OpportunitylAffirmalive Action Employer Mr. J. B. Setzer, P.E. September 29, 2004 Page Two d. Any reclamation measures and implementation must comply with the reclamation in accordance with the requirements of the Sedimentation Pollution Control Act. 2. No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond the footprint of the impacts depicted in the Preconstruction Notice Application. All construction activities, including the design, installation, operation, and maintenance of sediment and erosion control Best Management Practices, shall be performed so that no violations of state water quality standards, statutes, or rules occur. 3. 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 six months of the date that the Division of Land Quality has released the project. 4. In-stream construction work and land disturbance within the 25-foot wide buffer zone are prohibited during the trout- spawning season of January 1 through April 15 to avoid adverse effects of sedimentation on sensitive egg and fry stages of trout. 5. Adequate sedimentation and erosion control measures should be implemented and maintained on the project site to avoid impacts to downstream aquatic resources. Temporary or permanent herbaceous vegetation should be planted on all bare soil within 15 days of ground disturbing activities to provide long-term erosion control. Areas around stream crossings and adjacent to streams should be seeded and stabilized with anchored erosion control matting instead of straw. Riparian vegetation must be reestablished within the construction limits of the project by the end of the growing season following completion of construction. Tall fescue should not be used in riparian areas. 6. Stormwater shall be directed to vegetated buffer areas, grass lined ditches or other means appropriate to the site for the purpose of pre-treating stormwater runoff, and must not be routed directly into streams. Mowing of existing vegetated buffers is strongly discouraged, so that they may be utilized for stormwater diffuse flow. 7. The rock used for stabilization should be large boulders or shot rock and not Class A riprap. The rock should be clean and sediment free. 8. The natural dimension, pattern and profile of the stream above and below the site should not be modified by widening the stream channel or changing the depth of the stream. Under no circumstances should rock, sand or other materials be dredged from the wetted stream channel under authorization of this permit, except in the immediate vicinity of the stabilization work. 9. Removal of vegetation adjacent to the stream should be minimized. Native trees and shrubs (e.g. Rhododendron, dog hobble, willows, alders, sycamores, dogwoods, black walnut and red maple) should be planted along the streambank to reestablish the riparian zone and to provide long-term erosion control in the vicinity along the stream within dedicated rights of way, if possible. 10. Rock should only be placed above the high water mark if necessary to maintain the steep slope along the road shoulder. Rock placed in the stream should be minimized to avoid constriction of stream flow at this location and installed so as not to interfere with aquatic life passage during low flow conditions. 11. Heavy equipment must be operated from the banks rather than in the stream channel in order to minimize sedimentation and to reduce the likelihood of introducing other pollutants into the stream. 12. 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. 13. Excavation of the stream crossings and relocations should be conducted in the dry, if possible. Sandbags, cofferdams, flexible pipe or other diversion structures should be used to minimize excavation in flowing water. 14. Discharging hydroseed mixtures and washing out hydroseeders and other equipment in or adjacent to surface waters is strictly prohibited. 15. The presence of equipment in the channels must be minimized. Under no circumstances must rock, sand or other materials be dredged from the wetted stream channel under authorization of this permit, except in the immediate vicinity of the culverts. Instream dredging has catastrophic effects on aquatic life, and disturbance of the natural form of the stream channel will likely cause downstream erosion problems, possibly affecting other landowners. 16. This certification does not authorize the discharge of waste rock and dirt into the stream or riparian zone except for permitted areas associated with culvert conditions. 17. All work shall be performed during low flow conditions (below bankfull). 18. 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 Transportation Permitting Unit of the NC Division of Water Quality upon completion of the project. NCDOT is strongly advised to send in photographs upstream and downstream of each structure to document correct installation. Mr. J. B. Setzer, P.E. September 29, 2004 Page Three 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 Mr. Mike Parker of the Asheville Regional Office at 828.296.4500. Sincerely, X. x?? R-4?;? ?---Alan W. Klimek, P.E. Attachment cc: Wilmington District, US Army Corps of Engineers Mark Davis, Division 14, DEO Ed Ingle, Roadside Environmental Angie Pennock, USACE Asheville Field Office Transportation Permitting Unit Mike Parker, Asheville Regional Office e??TFo WETLANDS / 401 GROUP AUG 3 0 2004 WATER QUALITY SECTION STATE OF NORTH CAROLINA DEPARTMENT OF TRANSPORTATION MICHAEL F. EASLEY GOVERNOR August 25, 2004 Ms. Angie Pennock, NCDOT Regulatory Project Manager U.S. Army Corps of Engineers 151 Patton Avenue, Room 208. Asheville, NC 28801-2714 Subject: Nationwide 13 Permit Application SR 1710 E. Cope Creek Road Jackson County State Project No. 14.20501.1 Dear Ms. Pennock: LYNDO TIPPETT SECRETARY 041448 The North Carolina Department of Transportation (NCDOT) is requesting permission to reconstruct the fill slope on SR 1710, 0.35 miles east of SR 1449 (Cope Creek Road). Approximately 160' of bank was eroded during a storm that occurred on July 25, 2004. NCDOT plans to reconstruct the fill slope with Class A Rip Rap. The North Carolina Natural Heritage Database was checked for records of threatened and endangered species. The are no records listed for the Cope Creek watershed. The only record of a federally listed threatened or endangered species in the entire Scott Creek watershed is for the Rock Gnome Lichen (Gymnoderma lineare). However, this species is restricted to vertical rock faces in areas of high humidity above 5000 feet elevation or in deep river gorges at lower _ elevations. There is a record for the Appalachian elktoe (Alasmidonta raveneliana) in the Tuckasegee River a short distance downstream of the confluence of Scott Creek with the r Tuckasegee River. Surveys have not revealed records of the Appalachian elktoe within Scott Creek and the Tuckasegee habitat is greater than five miles from the project site. Additionally, Cope Creek at the work site is relatively high gradient and small (approximately 5 feet in width) and not typical of habitat of the Appalachian elktoe. The streambank stabilization is limited in scope and impacts will be minimal. For these reasons, this project will have "no effect" on threatened and endangered species. The best management practices will be used to minimize and control sedimentation and erosion on this project. Impacts to Waters of the United States In order to stabilize the bank, it will be necessary to impact waters of the United States in the Little Tennessee River Basin. The specific stream to be impacted is Cope Creek, which is Class C Tr. Listed below is a summary of the proposed impacts. Site No. Existing Proposed Net Impacts Station Condition Condition Site 1 Eroding Bank Stabilized Bank 160' n/a 160 linear feet total Permits Requested NCDOT is hereby requesting authorization under Section 404 of the Clean Water Act. By copy of this letter, I am asking Mr. David McHenry, Mountain Region Coordinator, of the North Carolina Wildlife Resources Commission (NCWRC) to comment directly to you concerning the 404 Nationwide Permit request. Also, by copy of this letter, I am requesting authorization under Section 401 of the Clean Water Act from the North Carolina Department of Environment and Natural Resources (DENR), Division of Water Quality (DWQ). In addition, I am asking Mr. Ed Ingle, Area Roadside Environmental Engineer (NCDOT), to comment directly to me concerning this permit request. If you have any questions or need additional information, please contact me at (828) 488-2131. Your early review and consideration will be greatly appreciated.. Sincerely, o? . Cj' 661.C"'M " J athan L. Woodard, PE District Engineer /WHR CC: Mr. John Dorney, DWQ, DENR, Raleigh (seven copies) Mr. Mike Parker, DWQ, DENR, Asheville Mr. David McHenry, Mountain Region Coordinator, NCWRC Mr. J. B. Setzer, P.E., Division Engineer, NCDOT Mr. Mark Davis, Division Environmental Officer, NCDOT Mr. E. L. Ingle, Roadside Environmental Field Operations Engineer, NCDOT Office Use Only: Form Version May 2002 USACE Action ID No. DWQ NoO 414 4 '01 (If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".) 1. Processing 1. Check all of the approval(s) requested for this project: ® Section 404 Permit ? Riparian or Watershed Buffer Rules ? Section 10 Permit ? Isolated Wetland Permit from DWQ ? 401 Water Quality Certification 2. Nationwide, Regional or General Permit Number(s) Requested: 13 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 (verify availability with NCWRP prior to submittal of PCN), complete section VIII and check here: ? 5. If your project is located in any of North Carolina's twenty coastal counties (listed on page 4), and the project is within a North Carolina Division of Coastal Management Area of Environmental Concern (see the top of page 2 for further details), check here: ? II. Applicant Information 1. Owner/Applicant Information Name: North Carolina Department of Transportation Mailing Address: 345 Toot Hollow Road Bryson City NC 28713 Attn: J L Woodard PE District Engineer Telephone Number: (828)488-2131. Fax Number: (828) 488-3518 E-mail Address: jwoodard(2dot state nc us 2. Agent/Consultant 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: N/A Company Affiliation: N/A Page 1 of 9 Mailing Address: N/A Telephone Number: N/A Fax Number: E-mail Address: N/A 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 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: SR 1710E Cope Creek Jackson County 2. T.I.P. Project Number or State Project Number (NCDOT Only): 14.205011 3. Property Identification Number (Tax PIN): n/a 4. Location County: Jackson Nearest Town: Sylva Subdivision name (include phase/lot number): n/a Directions to site (include road numbers, landmarks, etc.): From Sylva take NC 107. Turn Left onto SR 1449 Cope Creek Road Turn right onto SR 1710 E. Cope Creek Road. Go Approximately 0.35 miles. This is the project. 5. Site coordinates, if available (UTM or Lat/Long): N 35D 22' 34" W83D 11' 06" (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. Property size (acres): 0. 7. Nearest body of water (stream/river/sound/ocean/lake): Cope Creek DWO Class C TR 8. River Basin: Little Tennessee (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/ma-ps Page 2 of 9 9. Describe the existing conditions on the site and general land use in the vicinity of the project at the time of this application: Residential 10. Describe the overall project in detail, including the type of equipment to be used: Stabilize the fill slope and bank using back hoes dump trucks and manual labor. The area eroded during the storm that occurred on July 26 2004. Sections of the pavement will need to be removed in order to correctly rebuild the fill slope. The bank will be rebuilt and stabilized with Class A Rip Rap. 11. Explain the purpose of the proposed work: Rebuild/stabilize the eroded area. 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. No prior permits have been requested. 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 additional permits are anticipated 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 Page 3 of 9 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. Provide a written description of the proposed impacts: NCDOT proposes to stabilize 160' of bank along Cope Creek 2. Individually list wetland impacts below: Wetland Impact Site Number - (indicate on ma) N/A Type of Impact* Area of Impact (acres) Located within 100-year Floodplain** ( es/no) Distance to Nearest Stream feet) Type of Wetland*** . c.v:.,.a a e ..l..... Boa ..lo rrraAina fill * List each impact separately and identify temporary impacts. impacts include, but are nut Ill ILVIU W. 111cbu6luLbu • .......g, g.. ..•s, - 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 at httl2:/hvww.fema.aov. *** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater. marsh, forested wetland, beaver pond, Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only). List the total acreage (estimated) of all existing wetlands on the property: 0 Total area of wetland impact proposed: -0 3. Individually list all intermittent and perennial stream impacts below: Stream Impact Site Number (indicate on ma) Site 1 Type of Impact* Bank Stabilization Length of Impact (linear feet) 160 Stream Name** Cope Creek Average Width of Stream Before Impact 5 Perennial or Intermittent? leasespecify) Perennial Page 4 of 9 * 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, 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.usQs.eov. Several internet sites also allow direct download and printing of USGS maps (e.g., ,«vw.topozone.com, www.mgpguest.com, etc.). Cumulative impacts (linear distance in feet) to all streams on site: 160 4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic Ocean and any other water of the U.S.) below: 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, ocean, etc. N/A r„ .1..v.7.. * List each impact separately and identify temporary impacts. impacts mciuae, Dui are nut 11nmGU w: uu, eXC auOri, GIVGS 6, flooding, drainage, bulkheads, etc. 5. 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 an y 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.): n/a Size of watershed draining to pond: n/a Expected pond surface area: n/a 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. Impacts can not be avoided to stabilize the fill slope Page 5 of 9 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.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 2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at (919) 733-5208 to determine availability and to request written approval of mitigation prior to submittal of a PCN. For additional information regarding the application process for the NCWRP, check the NCWRP website at http•//h2o.enr.state'.ne.us/M/index.htm. If use of Page 6 of 9 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 (required by DWQ) Does the project involve an expenditure of public (federal/state) funds or the use of public (federal/state) 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 (919) 733-5083 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 (required by DWQ) 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: 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 Multiplier Required (square feet) Mitigation Page 7 of 9 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). e Applicant/Agent's Signaturew I ` Date (Agent's signature is valid only if an authorization letter from the applicant is provided.) 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