20040750 Ver 1_Complete File_20040510

A7, rt -,Q;"* j7
North Carolina Department of Environment and
Michael F. Easley, Governor
Natural Resources
William G. Ross Jr., Secretary
Alan W. Klimek, P.E., Director
Coleen H. Sullins, Deputy Director
Division of Water Quality
June 15, 2004
Richmond County
DWQ Project No. 04-0750
DOT Project No. 813.207711
APPROVAL of 401 Water Quality Certification
Mr. Timothy Johnson, P.E.
Division Engineer, NCDOT Div. 8
North Carolina Department of Transportation
P.O. Box 1067
Aberdeen, North Carolina 28315
Dear Mr. Johnson:
WETLANDS/ 401 GROUP
.SUN 4 2004 .
WATER QUALITY S,ECTIC)N
You have our approval, in accordance with the attached conditions and those listed below, to place fill
material in 20 linear feet of perennial stream for the purpose of replacing an existing corrugated metal
pipe culvert in an unnamed tributary to Pate Pond as part of improvements to SR 1615, in Richmond
County. The project shall be constructed in accordance with your application dated May 6, 2004. After
reviewing your application, we have decided that this fill is covered by General Water Quality
Certification Numbers 3404 and 3366, which may be viewed on our website at
http://l12o.enr.state.nc.us/ncwetlands. These certifications correspond to Nationwide Permit 14 and
Nationwide Permit 33 as issued by the U.S. Army Corps of Engineers. In addition, you should acquire
any other federal, state or local permits before you proceed with your project including (but not limited to)
Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This approval
will expire 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 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 remain valid, you must adhere to the conditions listed in the attached certification.
225 Green Street - Suite 714, Fayetteville, North Carolina 28301-5043 One
Phone: [phone] \ FAX: [phone] \ Internet: Nvw.enr.state.nc.us/ENR/ NorthCarolina
An Equal Opportunity/ Aftirmative Action Employer - 50 % Recycled \ 10 °ro Post Consumer Paper Naturally
Mr. Timothy Johnson, P.E.
June 15, 2004
Page 2
1.) Upon completion of the project, the NCDOT shall complete and return the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been
completed. The responsible party shall complete the attached form and return it to the 401/Wetlands
Unit of the Division of Water Quality.
2.) NCDOT shall conduct its activities in a manner consistent with State water quality
standards (including any requirements resulting from compliance with section 303(d) of the
Clean Water Act) and any other appropriate requirements of State law 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 re-evaluate and modify
this certification to include conditions appropriate to assure compliance with such standards
and requirements in accordance with 15A NCAC 2H.0507(d). Before modifying the
certification, DWQ shall notify NCDOT and the US Army Corps of Engineers, 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 US Army Corps of Engineers 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.
3) Any temporary in-stream riprap structures shall be completely removed after construction is
completed. Use of riprap is approved only for bank stabilization at the culvert inlet and outlet.
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 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its
conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please contact John Hennessy at 919-733-5694 or Ken Averitte at 910-
486-1541, ext. 722.
Attachments
' 'nc /y,
Ian W. Klimek, P.E.
cc: Wilmington District Corps of Engineers
Richard Spencer, USACE, Wilmington Field Office
Fayetteville Regional Office, DWQ
File Copy
Central Files
Rob Ridings, 401 Wetlands Unit
Art King, DEO, Division 8, NCDOT
Richmond.sr1615
fi* ji
NCDENR
North Carolina Department of Environment and
Michael F. Easley, Governor
Natural Resources
William G. Ross Jr., Secretary
Alan W. Klimek, P.E., Director
Coleen H. Sullins, Deputy Director
Division of Water Quality
June 15, 2004
Richmond County
DWQ Project No. 04-0750
DOT Project No. 813.207711
APPROVAL of 401 Water Quality Certification
Mr. Timothy Johnson, P.E.
Division Engineer, NCDOT Div. 8
North Carolina Department of Transportation
P.O. Box 1067
Aberdeen, North Carolina 28315
Dear Mr. Johnson:
WETLANDS/ 401 GROUP
JUN 2 4 2004
WATER QUALITY SECTION
You have our approval, in accordance with the attached conditions and those listed below, to place fill
material in 20 linear feet of perennial stream for the purpose of replacing an existing corrugated metal
pipe culvert in an unnamed tributary to Pate Pond as part of improvements to SR 1615, in Richmond
County. The project shall be constructed in accordance with your application dated May 6, 2004. After
reviewing your application, we have decided that this fill is covered by General Water Quality
Certification Numbers 3404 and 3366, which may be viewed on our website at
http://h2o.enr.state.nc.us/ncwetlands. These certifications correspond to Nationwide Permit 14 and
Nationwide Permit 33 as issued by the U.S. Army Corps of Engineers. In addition, you should acquire
any other federal, state or local permits before you proceed with your project including (but not limited to)
Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This approval
will expire 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 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 remain valid, you must adhere to the conditions listed in the attached certification.
225 Green Street - Suite 714, Fayetteville, North Carolina 28301-5043 One
Phone: [phone] \ FAX: [phone] \ Internet: ww.enr.state.nc.us/ENR/ NorthCarolina
An Equal Opportunity / Affirmative Action Employer - 50 % Recycled \ 10 % Post Consumer Paper Naturally
Mr. Timothy Johnson, P.E.
June 15, 2004
Page 2
1.) Upon completion of the project, the NCDOT shall complete and return the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been
completed. The responsible party shall complete the attached form and return it to the 401/Wetlands
Unit of the Division of Water Quality.
2.) NCDOT shall conduct its activities in a manner consistent with State water quality
standards (including any requirements resulting from compliance with section 303(d) of the
Clean Water Act) and any other appropriate requirements of State law 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 re-evaluate and modify
this certification to include conditions appropriate to assure compliance with such standards
and requirements in accordance with 15A NCAC 2H.0507(d). Before modifying the
certification, DWQ shall notify NCDOT and the US Army Corps of Engineers, 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 US Army Corps of Engineers 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.
3) Any temporary in-stream riprap structures shall be completely removed after construction is
completed. Use of riprap is approved only for bank stabilization at the culvert inlet and outlet.
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 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 276 1 1-7447. This certification and its
conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please contact John Hennessy at 919-733-5694 or Ken Averitte at 910-
486-1541, ext. 722.
Attachments
cc: Wilmington District Corps of Engineers
Richard Spencer, USACE, Wilmington Field Office
Fayetteville Regional Office, DWQ
File Copy
Central Files
Rob Ridings, 401 Wetlands Unit
Art King, DEO, Division 8, NCDOT
Richmond.sr1615
y r +.
.? ar dSTATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
lf?cimi--j. F. EASLEY DIVISION OF HIGHWAYS LYtino TIPPET-r
GOVERNOR May, 6 2004 SECRETARY
Richard K. Spencer cc: Mr. Rob Ridings
Regulatory Division NCDWQ
U.S. Army Corps of Engineers r t f 401 Wetlands Unit
P.O. Box 18904 1650 Mail Service Center
Wilmington, NC 28402-1890 Ra %27699-1650
Subject: Nationwide Permit #14 & 33 DS/4Q1 GRQUF
SR- 1615 Richmond County 444 1 (1 ,,Iv
Mr. Project # 8B.207711 (DWQ Permit Fee $200)
WATER QUALITySECTIpN
. Spencer:
The North Carolina Department of Transportation, Highway Division 8 is requesting Nationwide
Permit Number(s) 14 & 33 for project 8B.20771 I on SR-1615 in Richmond Co.
The proposed project will replace an existing deficient crossing pipe as follows:
Site 1) Replace existing 40'x 72 " CMP with one 60'x 103"x 71"CMP
The total percentage of impervious surface within the project area will remain at less than 30%.
All erosion control devices will be appropriate to the location and in compliance with the current
version of the NCDOT Best Management Practices manual.
There are no wetlands or High Quality Waters within the project areas. The pipe replacement is
located on an UT of Pate Pond. (the pond and connection to Joes Creek. are Class C, Sw, stream in
the Lumber River Basin.)
Due to the amount of anticipated flow, dewatering will be required at this site. There were no
threatened or endangered species observed within the project area during the required minimum
criteria check. This is a dead end road with no houses or businesses located past the construction
site. It is anticipated that no detour will be required at this site
If you require any additional information, please contact me.
Sincer PAYMENT
RECEIVED -?t Art C. King
Division Environmental Officer
Highway Division 8
Cc: T.F. Welch PE
Tim Johnson PE
P.O. Box 1067, ABERDEEN NORTH C_-1ROLIN.-k 28315
PHONE [phone] FAX [phone]
nAn750
r•
Office Use Only: 0 40750 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.
1. Processing
WETLANDS / 401 rRC?U?
1. Check all of the approval(s) requested for this project:
® Section 404 Permit I,AI` ?????Q
? Section 10 Permit
® 401 Water Quality Certification WATER QUAL/N SECTIOIu
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: 14 & 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
Owner/Applicant Information
Name: North Carolina Department of Transportation
Mailing Address: Timothy Johnson, P.E., Division Engineer
North Carolina Department of Transportation, Division 8
P.O. Box 1067
Aberdeen, North Carolina 28315
Telephone Number: (910) 9442344 Fax Number: (910) 9445623
E-mail Address: TJohnson&dot.state.nc.us
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: T. F. Welch, PE
Company Affiliation:_ NC Department of Transportation
Mailing Address: PO Box 289
Siler Citv NC 27344
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: twelchna.dot.statemc.us
-5-
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 1615 Richmond County
2. T.I.P. Project Number or State Project Number (NCDOT Only): 8B.207711
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Richmond Nearest Town: Hamlet
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From Hamlet follow US 74 east
for approx. 2 miles and turn right on NC 381, go approx 2 miles and turn left on SR 1615
Location is approx. 1 '/z miles
5. Site coordinates, if available (UTM or Lat/Long): N 34* 51.73' W 79* 39.17'
(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:
Rural
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): Pate Pond
9. River Basin: Lumber
(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/.)
-6-
10. Describe the purpose of the proposed work: Replace existing 1 line of 72" x 40' CMP with
1 line of 103" x 71" x 60' CMP.
11. List the type of equipment to be used to construct the project: Excavator
12. Describe the land use in the vicinity of this project: Rural/Residential
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.
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:
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.
-7-
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***
None

* L' h
ist eac 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 at http://www.femagov.
•'* List a wetland type that best describes wetland to he 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:
Total area of wetland impact proposed:
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
indicate on ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
leasespecify)
Perm pipe 60 ft UT into Pate Pond 11 ft Perennial
Rip rap 20 ft
Temp 20 ft

f 7 _L
L,,JL ca %,11 nnp"L ?cpzu-aucry and identity temporary impacts. impacts mciude, 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-%16, or online at
wtivw.uses.¢ov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www•.mapquest.com, etc,).
Cumulative impacts (linear distance in feet) to all streams on site: l00 ft
-8-
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, ocean, etc.
None

List each impact separately ana identity temporary impacts. Impacts include, but arc not limited to: 611, 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.
N/A
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.
-9-
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/ncwetiands/strinizide: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.
N/A
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 http://h2o.cnr.state.nc.us/«m/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):
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):
-10-
I
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 213 .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 213 .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
(square feet Multiplier Required
Mitigation
1 3
2 1.5
Total
cone , extends out 3u reet perpena,cuiar from near b= 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.
N/A
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.
Neither the current impervious cover (asphalt pavement) nor the new proposed impervious cover
(asphalt pavement) will exceed 30% of the total site area Erosion control devices appropriate to
the site will be utilized on this project which may include silt fences check dams and storm
water retaining basins.
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
XM. 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).
75-A65
Applicant/Agent's Signgfure Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
- 12-
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NOTES:
i . INSTALL TEMP. cE; MS, DIVERT S ;, AM FLO`"J
THRU DIVERSION PIPE AND FABRIC LINED CHANNELS.
2. PUMP CONTAINED AREA TO SILT -AG.
3. INSTALL PIPE AND BACKFILL.
L. REMOVE TEMPORARY DIVERSION DEVCES.
DRAWN BY: PROJECT: 51k 1615
EZ;c1,,?,oncS C oU,-,+
DATE:
u7 ; ni' o pare Po ? d
STREAM DIVERSION
NO SCALE
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A=FIC COVER
103
STONE =- =aM `'r/
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NOTES:
1. INSTALL SEEZMS , a1V ERT STREAM FLow
BY Put-VING WATER ARouna WORK AttEA.
2. FUME CONTAINED AREA TO SILT EAG.
3. INSTAI! FIFE AND EACKFI".
REMOVE T;MF0.--,A.RY DIVERSION V1C=S.
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J
STATE OF NORTII CAROLINA
toe
?U ?
l2 ?
lit °FhR ?0ltj
YDs%. ?R4fEy?gC0y.
DEPARTMENT OF TRANSPORTATION 1411 Q,
MICHAEL F. EASLEY P.O. BOX 25201, RALEIGH, N.C. 27611-5201 LYNDO TIPPE'rr
GOVERNOR SECREI'ARY
July 6, 2005
North Carolina Division of Water Quality
401 /Wetlands Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
Reference: DWQ Project No. 040750
NCDOT/SR 1615 Richmond County
Dear Sir or Madam:
Attached is certification of completion for the work perfonned under the above
referenced permit. The certification is signed by our field agent. If additional
information is required please advise.
Sincerely,
Timothy J inson P.E.
Division Engineer
Attachment
c: Barry Harrington
Tim Welch, PE
Art King
File
DIVISION 8, P. O. BOX 1067, ABERDEEN, NC 28315
Telephone: [phone] Fax: [phone]

Certificate of Completion
DWQ Project No.:
o.L?- o-I5D
Applicant: N C. T) OT
County:
R;C-rMon d

Project Name: SR 1to15 R-?c.\e-j ,r-,6 Coup+u Pro?ec"?C $B. ao-n 1(
Date of Issuance of 401 Water Quality Certification: :Yun P, IS , a(!> O
Upon completion of all work approved within the 401 Water Quality Certification and 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 maybe
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, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature:
Agent's Certification
Date:
I, f F. WELCH , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature:
Date: 6-21- 05
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: