20081811 Ver 1_401 Application_20100410

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Mostoo Salem
April 19, 2010
112@1ROW[RO
Public Works Department
Engineering Division
APR 2 1 2010
North Carolina Division of Water Quality cry ofWinsvon-sa1<m
DENR. WATER'DUALRY P.O. Box 2511
401 Wetlands Unit WETtAWSARD STORM4ATER BRANCH NC 27102
1650 Mail Service Center ]d 336.727.2141
Raleigh, NC 27699-1650 F 336.727.2361
xww.ciryo(wnrg
RE: Modification of 401 Water Quality Permit -DWQ Project No. 08-1811
for the road widening improvements to SR 1686 (Shattalon Drive)
Forsyth County, North Carolina. City Project No. 200502.
Dear Sir or Madam:
Please find the enclosed copies of the Pre-Construction Notification (PCN) Impact Table, Permit
drawing 2, Revised Aerial Map, and copy of the previously issued permit for the above
referenced project.
There will be a total of 32 linear feet (LF) of additional permanent stream impacts to an unnamed
tributary to Bethabra Branch. These impacts are associated with the replacing 61 LF of existing
36" RCP with 70 LF of 42" RCP pipe and headwall. Of the 32 linear feet, 9 linear feet will be
due to the extension of the existing pipe culvert and the remaining 23 LF of permanent impacts
will result from Class I rip rap stabilization of the pipe outlet and stream bank. The outlet
stabilization will be keyed into the stream bank and stream bed. An existing storm drainage
manhole at STA 27+90 +/- will be blocked and flow diverted by pumping for temporary
dewatering during the pipe installation.
If you have any questions or need additional information, please call me at 747-6833.
Sincerely,
ENGINEERING DIVISION
Aq 7r.4;(0-Ae
Todd Love, P.E.
Project Engineer
Cc: with attachment
USACOE
J-
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
? Wetlands ® Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number- Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
? Yes ? Corps
W1 ? P ? T ? No ? DWQ
? Yes ? Corps
W2 ? P ? T ? No ? DWQ
? Yes ? Corps
W3 ? P ? T ? No ? DWQ
? Yes ? Corps
W4 ? P ? T ? No ? DWQ
? Yes ? Corps
W5 ? P ? T ? No ? DWQ
? Yes ? Corps
W6 ? P ? T ? No ? DWQ
2g. Total wetland impacts

2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average
am
t Impact
length
number - (PER) or (Corps -404. 10 re
s
Permanent (P) or intermittent DWQ - non-404, width (linear
feet)
Temporary (T) (INT)? other) (feet)
S1 ®P ®T Culvert Bethabra Branch ® PER
? INT ® Corps
® DWQ 8.0 117(perm)
25 (temp)

S2 ® P ® T
Culvert UT1 Tributary to
Bethabra Branch ? PER
® INT ? Corps
® DWQ
2.5
32(perm)
? PER ? Corps
S3 ? P ? T ? INT ? DWQ
- ? PER [:1 Corps
1 T
S4 ? P F ? INT ? DWQ
- ? PER El Corps
? P F
1 T
S5
? INT
? DWQ
- F-1 PER ? Corps
1 T
? P F
S6
? INT
? DWQ
149(perm)
3h. Total stream and tributary impacts 25 (temp)
3i. Comments: Temporary impacts are due to temporary erosion control measures at Site 1. Permanent impacts at the sites
.,P H .P tn mmnnsPr1 culvert installation at Site 1 and Pipe Extension and Replacement at Site 2.
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version

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CITY ROADWAY PROJ. NO. 200502 NOT TO DATE
SCALE Ev 4/15/1
SHATTALON DRIVE AERIAL MAP
AERIAL MAP O