20061836 Ver 1_Complete File_20061129

Certificate of Comp letion

DWQ Project No. County: (?5 't O n ??.
Applicant: ?CbOT ` 17; Ji Si*p e--) I Z ?c?

Project Name: 5K 2-7H ? AII i soh
Date of Issuance of 401 Water Quality Certification: Noyexhe-l oo
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 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, , c- mdef , 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
built within substantial compliance and intent of the 401 Water Quality Certification and Buffer
Rules, the approve plans ancj pecifications, and other supporting materials.
Signature: Date:
Agent'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
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 )vas 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 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:
SR 2741, Allison Street: Pipe extension/Rock Ladder
O FgoG
`?OF wh f
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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
November 29, 2006
DWQ# 06-1836
Gaston County
Mr. Mike Holder, P.E.
NCDOT Division 12
P.O. Box 47
Shelby, NC 28151
APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear Mr. Holder:
You have our approval, in accordance with the attached conditions and those listed below, to permanently
impact 9 linear feet (If) for (4 If for extension of the existing culvert and 5 If for the construction of a rock ladder)
and to temporarily impact 20 If (for a temporary cofferdam) of an unnamed tributary" to the Catawba River to
extend the existing culvert to provide adequate road shoulder as described in your application received by the
Division of Water Quality (DWQ) on November 27, 2006. The location of the project is State Road 2741
(Allison Street) in Gaston County. After reviewing your application, we have determined that this project is
covered by Water Quality General Certification Number 3404. 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 is valid solely for the purpose and design that you described in your application (unless modified
below) and will expire with the associated USACE 404 permit unless otherwise specified in the Water Quality
Certification. 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 in the attached Certification and those listed below:
The extension of the existing culvert and construction of the rock ladder 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). A representative from the North Carolina Department of Transportation
(NCDOT) environmental staff shall be present on site during the construction of the rock ladder to
provide guidance to the NCDOT Maintenance Personnel and/or selected contractor. Existing stream
dimensions (including pattern and profile) are to be maintained above and below the locations of each
culvert. The applicant may be required to provide evidence that the equilibrium has been maintained, if
requested in writing by the DWQ.
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.
North Carolina Division of Water Quality 610 East Center Avenue, Suite 301
Internet: www_ncwaterc Alit Y en•b Mooresville, NC 28115
Phone [phone]
FAX [phone]
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N hCarolina
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An Equal Opportunity/Affirmative Action Employer - 50%a Recycled/10% Post Consumer Paper
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Mr. Mike Holder
Page 2
4. No live or fresh concrete shall come into contact with waters of the state until the concrete has hardened.
5. 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.
6. 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.
7. All work shall be performed during low or normal flow conditions.
8. Discharging hydroseeding mixtures and washing out hydroseeders and other equipment in or adjacent to
surface waters is strictly prohibited.
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 so as not to contravene any state
water quality standard [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).
F
Mr. Mike Holder
Page 3
Before codifying the certification, DWQ shall notify NCDOT and the USACE, provide public notice in
accordance with 15A NCAC 21-1.0503, 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.
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, 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 by 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,

for Alan W. Klimek, P.E.
Attachments
cc: Steve Lund, USACE Asheville Field Office
Sonia Gregory, DWQ Wetlands Unit
File Copy
N 0 6 r3 6
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DIVISION OF HIGHWAYS LYNDO TIPPETT •-
GOVERNOR SECRETARY
/GAG
November 20, 2006T??4s
Mr. Steve Lund ?.
US Army Corp of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, N. C. 28801-5006
SUBJECT: Pipe extension on SR 2741 (Allison Street), Gaston County
Dear Mr. Lund:
The North Carolina Department of Transportation proposes to extend a reinforced concrete pipe
on SR 2741 (Allison Street) in Gaston County to provide for an adequate road shoulder width for
the safety of the public. The existing 52-foot, 42" RCP will be extended 4 feet for a total pipe
length of 56 feet. The existing pipe grade sets the grade of the pipe extension; therefore, the
newly extended pipe outlet will be perched. A -5 foot rock ladder will be constructed at the pipe
outlet to facilitate some aquatic passage. The stream is a small, intermittent stream, but is located
in a residential area; therefore, temporary cofferdams and bypass pumping will be utilized, as
necessary. Due to the existing site conditions and the nature of the project, NCDOT
requests a waiver from the Regional Condition 2(b)(e) permit depth specification, for the
construction of this project. Upon project completion, any area impacted by the project and the
temporary cofferdams will be restored to pre-project conditions and the area seeded and
stabilized. The total scope of the work will result in 10 feet of permanent impacts to an unnamed
tributary to Catawba River (Lake Wylie below elev. 570) NC portion, which is classified as a
WS-V & B watershed by the Division of Water Quality.
The project is not located within '/2 mile of any critical watershed area nor is SR 2741 a rural or
urban arterial; therefore, hazardous spill basins are not required. Enclosed is the hazardous spill
basin checklist.
This office has conducted a GIS and field survey for the project for historical sites and
threatened/endangered species sites. No sites listed on the National Register of Historic Places
are located in the vicinity of the project nor did there appear to be any eligible structures. The
federally listed species for Gaston County (USFWS listed dated April 27, 2006) include Bald
eagle (Haliaeetus leucocephalus), Schweinitz's sunflower (Helianthus schweinitzii), and Bog
turtle (Glyptemys muhlenbergii).
SR 2741, Allison Street
Page 2
November 20, 2006
Natural Heritage Program records document the nearest Bald eagle location approximately 3.5
miles south of the proposed project area, on Lake Wylie at the North Carolina/South Carolina
line. Bald eagles typically nest in tall, living trees near open water. The proposed project is
located approximately I mile west of the upper portion of Lake Wylie in a residential subdivision.
No bald eagles were observed during the site visit. Although there were some fully developed
trees in the area, none will be removed as part of the pipe extension; therefore, no impact on the
species is anticipated. Natural Heritage Program records document the nearest Schweinitz's
sunflower location approximately 4.0 miles southwest of the proposed project area. The
sunflower is usually found in upland open areas protected from shade or excessive competition.
There is limited potential habitat within the proposed project area; however, no species were
observed during the site visit. The pipe extension will create a minimal disturbance in the area;
therefore, no impact on the species is anticipated. NCDOT is recommending a finding of "no
effect" for T&E species and historical structures.
I have enclosed a pre-construction notification for a NW#14, sketches of planned activities, and
location maps relative to the project.
Project information for the 401 Automated Payment Procedure is as follows:
0 Work order number: 150456-55120005-12.203611-3855
• TIP #: NA
• Project Category: $200.00 Fee
If you have any questions or concerns, please feel free to contact me at [phone]. Thank
you for your time and consideration to this matter
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division
BY: e?4?
Trish Simon
Division 12 Environmental Supervisor
Enclosures
Cc: John Hennessy, DWQ, 401 /Transportation Permitting Unit
Polly Lespinasse, DWQ, Mooresville Regional Office
Ron Linville, Wildlife Resources Commission (Courtesy Copy)
Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No. _? 6 8 3 6
(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: NWP 14
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: Mike Holder, N.C. Department of Transportation
Mailing Address: P.O. Box 47
Shelby, North Carolina 28151
Telephone Number: 704-480-9020 Fax Number: 704-480-5401
E-mail Address:
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: N.C. Department of Transportation
Mailing Address: P.O. Box 47
Shelby, North Carolina 28151
Telephone Number: 704-480-9044 Fax Number: 704-480-5401
E-mail Address: [e-mail]
Page 1 of 8
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: Pipe extension on SR 2741, Allison Street.
2. T.I.P. Project Number or State Project Number (NCDOT Only): 12.203611
3. Property Identification Number (Tax PIN): NA
4. Location
County: Gaston Nearest Town: Belmont
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers, landmarks, etc.): From Belmont, south on Hwy 273,
turn left onto SR 2740, right on SR 2741 and proceed to project site.
5. Site coordinates, if available (UTM or Lat/Long): 035°11'57"N/081°01'10"W
(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): <0.10 acres (NCDOT right of wav).
7. Nearest body of water (stream/river/sound/ocean/lake): UT to Catawba River(Lake Wylie
below elev. 570) NC portion WS V&B Watershed (from the upstream side of Paw Creek Arm
of Lake Wylie to NC/SC state line).
8. River Basin: Catawba
(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.ne.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project at
the time of this application: Existing Conditions - pipe crossing on dead-end residential
subdivision road. General Land Use- residential.
Page 2 of 8
10. Describe the overall project in detail, including the type of equipment to be used: NCDOT
proposes to extend a 52-foot, 42" RCP by adding a 4-foot section onto the existing pipe. The
addition of the 4-foot section will perch the pipe; therefore, a -5 ft rock ladder will be
constructed at the pipe outlet to facilitate some aquatic passage. The project will result in a
total of 10 feet of new impact from pipe extension and rock ladder. Installation is to be
accomplished with the use of trackhoe.
11. Explain the purpose of the proposed work: The purpose of the proposed work is to extend a
reinforced concrete pipe to bring the road shoulder at the crossing up to NCDOT standards.
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.
None 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
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: There will be minor pipe fill 4 feet)
and minor rock impacts (-5 feet) for the rock ladder construction.
2. Individually list wetland impacts below: NO WETLAND IMPACTS
Page 3 of 8
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***

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing,
grading, fill, excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and
flooding.
** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate
Maps (FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at
1-800-358-9616, or online at http://www.fema.mov.
*** 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
Average Width
Perennial or
Site Number Type of Length of Impact Stream Name** of Stream Intermittent?
(indicate on Impact* (linear feet) Before Impact (please specify)
map)
UT to Catawba River
1 Pipe increase 4 feet (Lake Wylie below 1-2 ft Intermittent
elev 570), NC portion
1 Rock ladder 5 feet "
I Temporary 20 feet "
Cofferdams
* 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.usgs.gov. Several internet sites also allow direct download and printing of USGS maps (e.g.,
www.topozone.com, www.mapguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: Permanent Impacts = 10
feet, Temporary Impacts = 20 feet.
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below: 0
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 ma acres bay, ocean, etc.

• List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation,
dredging, flooding, drainage, bulkheads, etc.
Page 4 of 8
5. Pond Creation: NO POND IMPACTS
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:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
The existing pipe will be extended four feet to provide an adequate road shoulder width. The
existing pipe grade will set the grade of the pipe extension. The newly extended pipe will be
perched; therefore, a rock ladder will be constructed at the pipe outlet to facilitate some aquatic
passage.
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.
Page 5 of 8
I . 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.
MITIGATION NOT ANTICIPATED
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
[phone] 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.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):
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
[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 (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
Page 6 of 8
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 213 .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
* 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 213 .0242 or .0260.
NA
XI. Stormwater (required by DWQ)
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.
No additional impervious surface is proposed.
XII. Sewage Disposal (required by DWQ)
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
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No
Page 7 of 8
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).
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8
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Name: BELMONT Location: 035° 11'56.981, N 081 ° 01 10.66" W
Date: 11/20/2006 Caption: Pipe Ext., SR 2741 (Allison Street); UT to Catawba River (Lake
Scale: 1 inch equals 1000 feet Wylie below elev. 570) NC; WS-VB, Catawba Basin
Downstream-
Outlet
wv 1 r -L-
STATiE OF NORTH CAROLINA SUBJECT < 2?¢l --A L/-15-L) gQ PROJECT U?2
)EPARTMENT OF TRANSPORTATION GrL.05 Sr ???? PI A OL -2t>0 GA S:?`Dt) COUNTY
DIVISION OF HIGHWAYS -
HIGHWAY BUILDING PREPARED BY M-1 R DATE///? -0/ STATION
P. O. BOX 25201
RALEIGH. NORTH CAROLINA 27611 CHECKED BY DATE STR NO SHEET_ OF

tz /'7/Toow V'
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SD-01
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: 1 ? County:Gsctnn Project ID:
River Basin: Catawba Bridge No: Pipe Extension
Route: SR 2741, Allison Street
&B Watershed
Stream: UT to Catawba River, WS-V
Water Quality Criteria:
Yes No
Stream Crossing Blue Line On USGS F r
ORW F P1
WSI r r
WS II,III OR IV, Crossing Within 0.5mi of W.S. Critical Area r r
Roadway Criteria:
Route Designation-
Yes No
Arterial Urban r r;r
Arterial Rural F W
Additional Site Information:
Yes No
Is a Hazardous Spill Basin Required? r W
Criteria Based Upon NCDOT "Best Management Practices for the
.Protection of Surface Waters" (March, 1997).