20061310 Ver 1_Complete File_20060926

OF WATF9P Michael F. Easley, Governor
?0 G William G. Ross Jr., Secretary
? r North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
APPROVAL of 401 Water Quality Certification
Mr. J.M. Mills, P.E.
Division Engineer, Division 7
North Carolina Department of Transportation
1584 Yanceyville Street
Greensboro, North Carolina, 27415
Dear Mr. Mills:
September 25, 2006
Rockingham County
DWQ Project No. 06-1310
Pheasant Rd (SR 2206)
IN,
%Ple
You have our approval, in accordance with the attached conditions and those listed below, to incur the following impacts
in order to replace a bridge with three corrugated metal pipe arches on Pheasant Rd in Rockingham County:
• 90 linear feet of fill impacts to an unnamed tributary of the Mayo River (50 feet piping and 40 feet riprap); and
• Temporary dewatering impacts of approximately 50 square feet.
The project shall be constructed in accordance with your application dated August 11, 2006. After reviewing your
application, we have decided that this fill is covered by General Water Quality Certification Nos. 3404 and 3366,
corresponding to the U.S. Army Corps of Engineers Nationwide Permit Numbers 14 and 33 respectively. 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 federal permit. This condition supercedes condition No. 19 in the General Certification 3404, and
condition No. 12 in General Certification 3366.
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 Division of Water Quality (Division) and submit a new application. If the
property is sold, the new owner must be given a copy of this approval letter and certifications, 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 and any additional conditions listed below.
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.
No°C Caro ina
Neirallly
North Carolina Division of Water Quality 585 Waughtown Street Phone [phone] Customer Service
Internet: www.ncwaterquality.org Winston-Salem, NC 27107 FAX [phone]
An Equal Opportunity/Affirmative Action Employer - 50% Recycledl10% Post Consumer Paper
I
September 25, 2006
DWQ# 06-1310
Page 2
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.
d. The 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 completion of the project.
4. Riparian vegetation must be reestablished within the construction limits of the project by the end of the growing
season following completion of construction.
5. Stormwater should 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 sheet flow.
6. The dimension, pattern and profile of the stream above and below the crossing should not be modified by
widening the stream channel or reducing the depth of the stream.
7. Since multiple pipes are to be installed, they should be designed to mimic natural stream cross section as closely
as possible including pipes or barrels at flood plain elevation and/or sills where appropriate. Widening the stream
channel should be avoided.
8. Disturbed floodplains and streams should be restored to natural geomorphic conditions.
9. Use of rip-rap for bank stabilization is to be minimized; rather, native vegetation is to be planted when practical.
If rip-rap is necessary, it must be limited to the stream bank below the high water mark, and vegetation must be
used for stabilization above high water. Any rip-rap used must not interfere with aquatic life passage during low
flow conditions.
10. If concrete is used, work must be accomplished so the wet concrete does not contact the stream water. This will
lessen the chance of altering the stream's water chemistry and causing a fish kill.
11. Heavy equipment must be operated from the banks rather than in the stream channel in order to minimize
sedimentation and 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. 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.
14. Temporary dewatering sites must be restored to preexisting conditions unless more natural geomorphic conditions
can be provided.
15. All work shall be performed during low flow conditions.
16. 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 upon
completion of the project.
Nlr. Mike Mills, P.E.
September 25, 2006
DWQ# 06-1310
Page 3
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must act
within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition, 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 contact Sue Homewood at 336-771-4964 or at [e-mail].
Sincerely,
,- Alan W. Klimek, P.E.
Attachment
cc: Monte Matthews, USACE Raleigh Field Office
Jerry Parker, Division 7, Division Environmental Officer
DWQ Wetlands/401 Transportation Unit
DWQ Winston Salem Regional Office
DWQ Central Files
mr. ivtme ivinis, r.r..
September 25, 2006
DWQ# 06-1310
Page 4
DWQ Project No.:
County:
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
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, 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, , 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:
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 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:
Engineer's Certification
Date:
Partial Final
I, _ , as a duly registered Professional Engineer 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

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P.O. BOX 25201, RALEIGH, N.C. 27611-5201 LYNDO TIPPETT
GOVERNOR SECRETARY
McLeansville, N.C. 27301
September 12, 2006
F'o *4 ? &.
MEMORANDUM TO : Sue HomeT?ND FNR 2 d, ` r`
R Representative S?aoS,,"e X06 4"
FROM : Dennis L. Johnson 1jhgRso
NCDOT Division Bridge Maintenance Enginee'
SUBJECT : Replacement of Bridge No. 139 in Rockingham County
- Pheasant Road
This is to request that NCDOT forces be allowed to replace Bridge Number 139,
on Pheasant Road, in Rockingham County with three lines of 120" corrugated metal pipe.
This bridge is in desperate need of replacement. For the last ten years we have passed over
replacing this structure because of the low number of vehicles using it. Although this
bridge is on a dead end road, it still services homeowners.
NCDOT investigated several options to avoid replacement. We discussed
purchasing the property involved but we would still need a vehicular access to utilize it.
The property owner would not likely pursue selling the property without a suitable access
due to the decrease in the value. NCDOT looked at relocating the access to the property.
There are three different locations to potentially access this property. One location would
require crossing Northern and Western Railroad. The railroad companies have certain
restrictions that would prevent access at this location unless a major bridge overpass was
constructed. This is not possible due to other properties would need to provide an
encroachment and construction would require enormous funding. The second location for
an access would be off of US 220. This would not be possible due to the elevation
difference in this roadway and the property. There is only a minimal distance between the
railroad and the creek along US 220 and the difference in elevation is approximately 15 to
20 feet. By sloping an access onto the property, it would require installing a massive
amount of fill material at the location of the property owner's house and buildings. The
third location is the existing access and this seems to be by far the most efficient.
One of the concerns with replacing this bridge is being able to maintain access for
emergency response agencies. We normally try to replace bridges with other structures
that span the creek. If we followed this procedure in this case, we would shut down the
access for several weeks. This would present a significant liability issue. By replacing this
structure with three lines of pipe, we would only prevent access for a couple of days. We
would notify homeowners so that they could plan around this work.
dr?o?
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P.O. BOX 25201, RALEIGH, N.C. 27611-5201 LYNDO TIPPETT
GOVERNOR SECRETARY
By replacing this bridge with pipe, we not only reduce the cost by 50% but we also
reduce the amount of time the access is not available to the landowners and emergency
responders by 90%.
If you have any questions or concerns, please call me at [phone]. Thank
you in advance for your attention to this matter.
Dlj/
Cc: T.J. Dyer, P.E.
J. Parker
\ NA o ?
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
August 30, 2006
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
Mr. J.M. Mills, P.E.
Division Engineer, Division 7
North Carolina Department of Transportation
1584 Yanceyville Street
Greensboro, North Carolina, 27415
Subject: Proposed Bridge Replacement, Pheasant Road (SR 2206). Rockingham County, Project Number 7B.207914.9,
DWQ # 06-1310
Dear Mr. Mills:
The Division of Water Quality has reviewed your submittal for a 401 Water Quality Certification for the aforementioned
project. Review of your application revealed it lacking necessary information required for making an informed permit
decision. The permit application was deficient in the following areas:
• This bridge is being replaced with culverts in order to access one abandoned residential property. Please indicate if other
options for providing access to this property were investigated. Other options may include providing access across the
railroad tracts on the other side of the property, sale of the property to an organization or individual who would not
require access by vehicle such as a conservation easement, or access for the property owner by a pedestrian bridge, and
any other options that would eliminate the need for a vehicular crossing at this location.
Therefore, pursuant to 15A NCAC 2H .0507(a)(5), we will have to place the permit application on hold until we are supplied
the necessary information. You have 21 days to respond in writing with the requested information or notification to this
office that the information is forthcoming. If, at the end of the 21 days, this office has not received this information in
writing, we will assume you are withdrawing your application and it will be returned. Furthermore, until the information is
received by the NC Division of Water Quality, we request (by copy of this letter) that the US Army Corps of Engineers place
the permit application on hold.
If you have any questions or require additional information, please contact Sue Homewood at 336-771-4964.
Sinc rely,
Alan W. Klimek, P.E.
Director
cc: Todd Tugwell, US Army Corps of Engineers, Raleigh Field Office
Jerry Parker, Division 7 Environmental Officer
Travis Wilson, NC Wildlife Resources Commission
DWQ Winston-Salem Regional Office
DWQ 401 Wetlands Transportation Unit
Np
One
r hCaro na
North Carolina Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 Phone [phone] Customer Service
Internet: www.ncwaterquality.org Location: 512 N. Salisbury St. Raleigh, NC 27604 Fax [phone]
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper
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STATE OF NORTH CAROLINA wFr?aho FroR_ `S ZO
wqr 06'
DEPARTMENT OF TRANSPORTATIOi? os,-oR;wu
B
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415 LYNIPPETT
GOVERNOR SECRETARY
August 11, 2006
Ms. Sue Homewood
NC DENR Division of Water Quality
585 Waughtown Street
Winston Salem, NC 27107
Mr. Todd Tugwell
U.S. Army Corps of Engineers
Regulatory Field Office
6508 Falls of the Neuse Road, Suite 105
Raleigh, North Carolina 2761
(Two Copies)
?S ? •3
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SUBJECT: Rockingham County, Bridge Replacement with three 120" X 50' CM Pipe Arch on
Pheasant Road (SR 2206) crossing an unnamed tributary of Mayo River. Project
Number 7B.207914.9
To Whom It May Concern:
The North Carolina Department of Transportation (NCDOT) proposes to replace a bridge on
Pheasant Rd (SR 2206) three 120" X 50' Corrugated Metal (CM) Pipe Arches. The proposed work
is being done in order to reduce future maintenance needs and increase traffic safety. This activity
will result in impacts to an UT of Mayo River. The NCDOT anticipates that the bridge replacement
activity will be authorized under Nationwide Permit (NWP) 14 and 33. This application is intended
as a request for Nationwides 14 and 33 from the US Army Corps of Engineers. This application is
also intended to serve as a courtesy notification to the NC Division of Water Quality as according to
General Water Quality Certification. The following information is being provided to satisfy General
Water Quality Certificate # 3376 and #3404.
Mussel pre-screenings were conducted by permitted biologists and appropriate resource agencies. It
was determined that the site had low probability of supporting mussel fauna and was approved for a
mussel screening carried out by NCDOT personnel. No mussels were observed. The stream has
clean pebble/gravel/sand substrate. Therefore a biological conclusion of "May Affect-Not Likely to
Adversely Affect" was issued for the James spinymussel. Gary Jordanof the US Fish and Wildlife
has been mailed a copy of the survey report and written concurrence is pending his review.
PHONE [phone] FAX[phone]
PROJECT INFORMATION
Road Name SR Number Project Length
(miles) Classification
Pheasant Road SR 2206 N/A Rural
River Basin: DWQ
ID Water Quality
Designation % Impervious Surface
Roanoke 22-30-(9.5) WS -IV; CA N/A
Buffer Rules" Buffer Rule Conditions where applicable)

Protected Species
Presentb Mapped Historic
Pro ertiee CAMA
AEC Essential Fishery
Habitat
No (See attached
letters No No No
'Separate documentation attached as needed: u See the attached Endangered Species Review Sheet for further
information: 'When Applicable - See the attached Historic Review Letter for further information
BRIDGE REPLACEMENT INFORMATION
Site N/A Stream Type Perennial
(Station)
Existing 35 ft Long X 20 ft Wide Proposed 3 @ 120" X 50'CMPA
Bride 35 ft between headwalls Pipe
Construction Pump Around Dewatering ABC Aggregate
Method Device*
Burial Depth One Foot E/C Plan See Attached
Date
Construction As soon as practicable Duration 15 days
Date
Impacts (ft.) 50 lin. ft-enclosure; 40 lin. ft-rip-rap; Approx. 50 sq.ft -temporary
Special
Conditions
Restoration Within 15 working days of the of the pipe replacement the natural stream
Plan contours will be restored and seeded. Temporary silt screens placed along
shoreline will be cleaned and removed following vegetation establishment.
RCP = reinforced concrete pipe; CMP = Corrugated metal pipe; CMPA = Corrugated metal pipe arch; E/C =
Erosion control. *A less intrusive dewatering device may be used in lieu of the one proposed.
-2-
MINIMIZATION INFORMATION
Impacts will be minimized by strict enforcement of Best Management Practices for the protection of
surface waters and wetlands, restrictions against the staging of equipment in or adjacent to waters of
the US, and coordination (including a pre-construction meeting) with the Division Environmental
Officer.
MITIGATION INFORMATION
Stream mitigation is not anticipated, as the impacts to any individual stream do not exceed 150 feet
Wetland mitigation is not anticipated, as wetland impacts do not exceed 0.10 acres and do not occur
in a unique natural wetland.
APPLICATION INFORMATION
Enclosed please find the Pre-construction Notification Form and supporting documentation for the
above referenced project. If you have any questions or need any additional information, please
contact Dennis Johnson at [phone] or Jerry Parker at [phone]. Your attention to
this matter is greatly appreciated.
Sincerely,
of YN?
. Mills, P.E.
Division Engineer, Division 7
cc: Mr. Jerry Parker, Division Environmental Officer
Mr. Herbert McDowell, District Engineer
Mr. Dennis Johnson, Bridge Maintenance Engineer
Mr. Henry Adkins, County Maintenance Engineer
Mr. Barry Harrington, Area Roadside Field Operations Engineer
NCDENR, 401/Wetlands, Division of Water Quality
Mr. Gary Jordan, US Fish and Wildlife
Mr. Jared Gray, NCDOT PDEA
-3-
Office Use Only: Form Version October 2001
USACE Action ID No. DWQ No.
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
I. Processing
1. Check all of the approval(s) requested for this project:
M Section 404 Permit
? Section 10 Permit
M 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 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
1. Owner/Applicant Information
Name: Mr. J.M. Mills, P.E. Division Engineer - Division 7
Mailing Address: P.O. Box 14996
Greensboro. NC 27415,
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: mmillsadot.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: Jerry Parker
Company Affiliation: NCDOT - Division 7
Mailing Address: 1584 Yanceyyille Street
Greensboro NC 27415
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: iparker&dot.state.nc.us
Page 1 of 9
M. 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: Pheasant Road Bridge Replacement (SR2206) (Bridge #139)
2. T.I.P. Project Number or State Project Number (NCDOT Onlyk.011.207914.9 (non-TIP)
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Rockingham Nearest Town: Stoneville
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From NC 220 N (Battleground
Ave) in Greensboro go approximately 28 miles to Pheasant Road (SR 2206 on the left).
Pheasant Road is approximately 3 miles north of the Dan River crossing on US 220 in
Roc . ,ham County.
5. Site coordinates, if available (UTM or Lat/Long): See the attached USGS M.
(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:
Low density residential. Agriculture and forest.
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): UT to Mayo River
Page 2 of 9
9. River Basin: Roanoke
(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/map s/.)
10. Describe the purpose of the proposed work: To replace a structurally deficient bridge with
Management Practices will be utilized for the removal of the existing bridge
11. List the type of equipment to be used to construct the project: Road construction
equipment (trackh9e grader, backhoe and bulldozer).
12. Describe the land use in the vicinity of this project: Rural low density residential and forest.
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.
N/A
V. Future Project Mans
Are any additional permit requests anticipated for this project in the future? 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
Page 3 of 9
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
1. Wetland 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
feet
Type of Wetland***
N/A

* 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.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.)
List the total acreage (estimated) of existing wetlands on the property: N/A
Total area of wetland impact proposed: N/A
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact Length of Average Width Perennial or
Site Number Type of Impact* Impact Stream Name** of Stream Intermittent?
indicate on ma linear feet Before Im act leasespecify)

Bridge Site Bridge
replacement with
three lines of
CAMP 50 ft(en)
50sf(tmp)
40ft(rp)
UT to Mayo River
10 to 15 feet
Perennial

* 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.cov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.call,
www.makquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: The cumaative impacts
are - 50 linear feet enclosure (en)50 square feet- temporary (tmp). 40 linear feet- rip rap
(ER)
Page 4 of 9
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.
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, 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.): 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.
Bridge replacement activities are necessary to brim the road up _to current safety and
construction standards. Impacts will be minimized by strict enforcement of Best Management
Practices for the protection of wetland and surface waters, restrictions against the staging of
equipment in or adjacent to waters of the US, and coordination with the Division Environmental
Officer. Best Management Practices will also be utilized during the demolition of the old bridge_
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
Page 5 of 9
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/ncwetiands/strmgide,html.
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.
A finding of insignificant boact is anticipated. Cumulative impacts are less than 150 feet.
The maximum amount of permanent impact to a the stream is 50 linear feet. No
Outstanding Resource Waters federally protected species or their habitats or essential
fisheahabitats occur in the project area. The project is not located in a High Quality Water.
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://li2o.enr.state.nc.us/=/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): 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
Page 6 of 9
Amount of Coastal wetland mitigation requested (acres): N/A
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 ?
X.
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 ?
Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify N/A )?
Yes 0 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. act Zone* s cape feet Multiplier Mitt uired

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.
Page 7 of 9
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
XL Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
In accordance with the February 25. 1991 delegation agreement one copy of the sediment and
erosion control plan will be submitted to DENR - Division of Land Resources and NCDOT
Roadside Environmental Prior to construction. .
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.
XM. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 211,0500) or any Buffer Rules?
Yes ? No X
Is this an after-the-fact permit application?
Yes ? No X
Page 8 of 9
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).
-23-6
Applicantlf+nfs Signature Date
(Agent's si nature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9
County Rockingham
Bridge 139 Fever Basin
SR- 2206 Pheasant Rd
Discription: Remove existing bridge and replace with 3@ 120" x 50' CAMP
Project No 78.207914.9
Description : Removal of exsiting bridge and replace with 3 @ 120 X 50' with inlet headwall
NOTE : All erosion control devises & proper installation plus maintenance of erosion control will
be done by using NCDOT Best management Practices Manual.
1 Dam both ends of stream with ABC aggregate ( underlain and wrapped with filter frabic) or less
intrusive device to allow dewatering of work area.
2 Pump water around excavation area.
3 Excavate stream channel and place ABC stone for base.
4 Pump water from excavated area into silt bag.
5 Install silt fence as needed.
6 Set 3 @ 120 X 50' aluminum pipe buried one foot below streambed.
7 Divert stream into one pipe using ABC stone underlain with filter frabic cofferdam.
8 Backfill pipelines and shoulder areas.
9 Place filter frabic and rip rap as needed.
10 Seed and mulch exposed areas after backfilling is complete.
11 Remove temperary erosion control devices after vegetation is established.
Approx. starting date 8/07 6
Prepared by -u.;,)- TS-111 date 1/11/06
Approx. starting date 8/07/06
Approval divison bridge engineer date
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Name: MAYODAN Location: 036° 26'07.3" N 079° 56'04.4" W
Date: 8/11/2006 Caption: Pheasant Rd (SR 2206)
Scale: 1 inch equals 2000 feet Rockingham County
I
MSWiok? / ??V
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06
STATE OF NORTH CAROLINA S?asTO??jQq F e
DEPARTMENT OF TRANSPORTATION NCH
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415 LYNDO TIPPETT
GOVERNOR SECRETARY
August 11, 2006
Ms. Sue Homewood
NC DENR Division of Water Quality
585 Waughtown Street
Winston Salem, NC 27107
Mr. Todd Tugwell
U.S. Army Corps of Engineers
Regulatory Field Office
6508 Falls of the Neuse Road, Suite 105
Raleigh, North Carolina 2761
(Two Copies)
-°' SUBJECT: Rockingham County, Bridge Replacement with three 120" X 50' CM Pipe Arch on
Pheasant Road (SR 2206) crossing an unnamed tributary of Mayo River. Project
-- Number 7B.207914.9
To Whom It May Concern:
t?
The North Carolina Department of Transportation (NCDOT) proposes to replace a bridge on
Pheasant Rd (SR 2206) three 120" X 50' Corrugated Metal (CM) Pipe Arches. The proposed work
is being done in order to reduce future maintenance needs and increase traffic safety. This activity
will result in impacts to an UT of Mayo River. The NCDOT anticipates that the bridge replacement
activity will be authorized under Nationwide Permit (NWP) 14 and 33. This application is intended
as a request for Nationwides 14 and 33 from the US Army Corps of Engineers. This application is
also intended to serve as a courtesy notification to the NC Division of Water Quality as according to
General Water Quality Certification. The following information is being provided to satisfy General
Water Quality Certificate # 3-376 and #3404.
Mussel pre-screenings were conducted by permitted biologists and appropriate resource agencies. It
was determined that the site had low probability of supporting mussel fauna and was approved for a
mussel screening carried out by NCDOT personnel. No mussels were observed. The stream has
clean pebble/gravel/sand substrate. Therefore a biological conclusion of "May Affect-Not Likely to
Adversely Affect" was issued for the James spinymussel. Gary Jordan of the US Fish and Wildlife
has been mailed a copy of the survey report and written concurrence is pending his review.
PHONE [phone] FAX [phone]
PROJECT INFORMATION
Road Name SR Number Project Length
(miles) Classification
Pheasant Road SR 2206 N/A Rural
River Basin: DWQ
ID Water Quality
Designation % Impervious Surface
Roanoke 22-30-(9.5) WS -IV; CA N/A
Buffer Rules' Buffer Rule Conditions (where applicable)

Protected Species
Presentb Mapped Historic
Pro erti& CAMA
AEC Essential Fishery
Habitat
No (See attached
letters No No No
° Separate documentation attached as needed: b See the attached Endangered Species Review Sheet for further
information: `When Applicable - See the attached Historic Review Letter for further information
BRIDGE REPLACEMENT INFORMATION
Site N/A Stream Type Perennial
(Station)
Existing 35 ft Long X 20 ft Wide Proposed 3 @ 120" X 50'CMPA
Bride 35 ft between headwalls Pipe
Construction Pump Around Dewatering ABC Aggregate
Method Device*
Burial Depth One Foot E/C Plan See Attached
Date
Construction As soon as practicable Duration 15 days
Date
Impacts (ft.) 50 fn. ft-enclosure; 40 lin. ft-rip-rap; Approx. 50 sq.ft -temporary
Special
Conditions
Restoration Within 15 working days of the of the pipe replacement the natural stream
Plan contours will be restored and seeded. Temporary silt screens placed along
I shoreline will be cleaned and removed following vegetation establishment.
RCP = reinforced concrete pipe; CMP = Corrugated metal pipe; CMPA = Corrugated metal pipe arch; E/C =
Erosion control. *A less intrusive dewatering device may be used in lieu of the one proposed.
-2-
MINIMIZATION INFORMATION
Impacts will be minimized by strict enforcement of Best Management Practices for the protection of
surface waters and wetlands, restrictions against the staging of equipment in or adjacent to waters of
the US, and coordination (including a pre-construction meeting) with the Division Environmental
Officer.
MITIGATION INFORMATION
Stream mitigation is not anticipated, as the impacts to any individual stream do not exceed 150 feet
Wetland mitigation is not anticipated, as wetland impacts do not exceed 0.10 acres and do not occur
in a unique natural wetland.
APPLICATION INFORMATION
Enclosed please find the Pre-construction Notification Form and supporting documentation for the
above referenced project. If you have any questions or need any additional information, please
contact Dennis Johnson at [phone] or Jerry Parker at [phone]. Your attention to
this matter is greatly appreciated.
Sincerely,
Mr. J.M. Mills, P.E.
Division Engineer, Division 7
cc: Mr. Jerry Parker, Division Environmental Officer
Mr. Herbert McDowell, District Engineer
Mr. Dennis Johnson, Bridge Maintenance Engineer
Mr. Henry Adkins, County Maintenance Engineer
Mr. Barry Harrington, Area Roadside Field Operations Engineer
NCDENR, 401/Wetlands, Division of Water Quality
Mr. Gary Jordan, US Fish and Wildlife
Mr. Jared Gray, NCDOT PDEA
-3-
Office Use Only: Form Version October 2001
USACE Action ID No. DWQ No. 2 0 0 6 1 3 1 0
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
I. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 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
1. Owner/Applicant Information
Name: Mr. J.M. Mills, RE, Division Engineer - Division 7
Mailing Address: P.O. Box 14996
Greensboro NC 27415
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: mmills(-Mot. 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: Jerry Parker
Company Affiliation: NCDOT - Division 7
Mailing Address: 1584 Yanceyyille Street
Greensboro NC 27415
Telephone Number: [phone] Fax Number: [phone]
E-mail Address:^[e-mail]
Page 1 of 9
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: Pheasant Road Bridge Replacement SR2206) (Bridge _ #139)
2. T.I.P. Project Number or State Project Number (NCDOT Only):#7B.207914.9 (non-TIP)
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Rockingham Nearest Town: Stoneville
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From NC 220 N (Battleground
Ave) in Greensboro go approximately 28 miles to Pheasant Road (SR 2206 on the left).
Pheasant Road is approximately 3 miles north of the Dan River crossing on US 220 in
Rockingham County.
5. Site coordinates, if available (UTM or Lat/Long): See the attached USGS map.
(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:
Low density residential. Agriculture and forest.
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): UT to Mayo River
Page 2 of 9
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
1. Wetland 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***
N/A
I --A

* 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:/hvvvw. fema. cov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, ctc.)
List the total acreage (estimated) of existing wetlands on the property: N/A
Total area of wetland impact proposed: N/A
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact Length of Average Width Perennial or
Site Number Type of Impact* Impact Stream Name** of Stream Intermittent?
indicate on ma linear feet Before Impact leasespecify)
Bridge 50 ft(en)
Bridge Site replacement with
three lines of 50sRtmp) UT to Mayo River 10 to 15 feet Perennial
CAMP 40ft(rp)

* 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, ctc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.usss.?ov. Several intemet sites also allow direct download and printing of USGS maps (e.g., wwxv.topozone.com,
w\vvv.maj)qucst.cont, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: The cumaative impacts
are - 50 linear feet enclosure (en), 50 square feet- temporary (tmp), 40 linear feet- rip rap
Page 4 of 9
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.
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, 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.): 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.
Bridge replacement activities are necessary to brinu the road up to current safetv and
construction standards. Impacts will be minimized by strict enforcement of Best Management
Practices for the protection of wetland and surface waters, restrictions against the staging o
equipment in or adjacent to waters of the US, and coordination with the Division Environmental
Officer. Best Management Practices will also be utilized during the demolition of the old bridge._
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
Page 5 of 9
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/newetlands/strmgide.litml.
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.
A finding of insignificant impact is anticipated. Cumulative impacts are less than 150 feet.
The maximum amount of permanent impact to a the stream is 50 linear feet. No
Outstanding Resource Waters, federally protected species or their habitats, or essential
fishery habitats occur in the project area. The project is not located in a High Quality Water.
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 1ittp://h2o.cnr.stite.nc.us/Nvn)/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): 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
Page 6 of 9
Amount of Coastal wetland mitigation requested (acres): N/A
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 ?
X.
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 ?
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 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify N/A )?
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.
Page 7 of 9
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.
In accordance with the February 25, 1991 delegation agreement one copy of the sediment and
erosion control plan will be submitted to DENR - Division of Land Resources and NCDOT
Roadside Environmental Prior to construction.
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.
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No X
Is this an after-the-fact permit application?
Yes ? No X
Page 8 of 9
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 9 of 9
County Rockingham //
[-, -'cIA:,k
Bridge 139 q&dg *uG v Basin
SR- 2206 Pheasant Rd
Discription: Remove existing bridge and replace with 3@ 120" x 50' CAMP
Project No 7B.207914.9
Description : Removal of exsiting bridge and replace with 3 @ 120 X 50' with inlet headwall
NOTE : All erosion control devises & proper installation plus maintenance of erosion control will
be done by using NCDOT Best management Practices Manual.
1 Dam both ends of stream with ABC aggregate ( underlain and wrapped with filter frabic) or less
intrusive device to allow dewatering of work area.
2 Pump water around excavation area.
3 Excavate stream channel and place ABC stone for base.
4 Pump water from excavated area into silt bag.
5 Install silt fence as needed.
6 Set 3 @ 120 X 50' aluminum pipe buried one foot below streambed.
7 Divert stream into one pipe using ABC stone underlain with filter frabic cofferdam.
8 Backfill pipelines and shoulder areas.
9 Place filter frabic and rip rap as needed.
10 Seed and mulch exposed areas after backfilling is complete.
11 Remove temperary erosion control devices after vegetation is established.
Approx. starting date 8/071Q6
Prepared by 'ui,? TS-111 date 1/11/06
Approx. starting date 8/07/06
Approval divison bridge engir?oer l ?V'?`?4'V!v date
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Name: MAYODAN Location: 036° 26'07.3" N 079° 56'04.4" W
Date: 8/11/2006 Caption: Pheasant Rd (SR 2206)
Scale: 1 inch equals 2000 feet Rockingham County
Copyright (C) 1997, Maptech, Inc.

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