20040018 Ver 1_Complete File_20040105

091 . Q4pp18
N. C. DEPARTMENT OF TRANSPOR`I ,riON
TRANSMITTAL SLIP DATE I f?
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TO: //
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REF. NO. OR ROOM, BLDG.
FRO REF. NO, OR ROOM, BLDG,

TION
? NOTE AND FILE ? PER OUR CONVERSATION
? NOTE AND RETURN TO ME ? PER YOUR REQUEST
? RETURN WITH MORE DETAILS ? FOR YOUR APPROVAL
? NOTE AND SEE ME ABOUT THIS ? FOR YOUR INFORMATION
? PLEASE ANSWER ? FOR YOUR COMMENTS
? PREPARE REPLY FOR MY SIGNATURE ? SIGNATURE
? TAKE APPROPRIATE ACTION ? INVESTIGATE AND REPORT
COMMENTS:

f 1
WETLANDS/ 401 GROUP
JAN 0 5 M04
STATE of NORTH CAROLINA WATER QUALITY SECTION
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
December 31, 2003
U.S. Anny Corps of Engineers
Raleigh Regulatory Field Office
6508 Falls of the Neuse Road, Suite 120
Raleigh, NC 27609 0 4 0 0 1
Attention: Mr. Eric Alsmeyer, NCDOT Coordinator
Subject: Proposed pipe improvements to structures conveying unnamed tributaries
to Beaver Pond Creek, Island Creek, and Mill Creek on SR 1501
(Townsville Road) in Granville County.
The North Carolina Department of Transportation (NCDOT) proposes to replace pipes
conveying unnamed tributaries to Beaver Pond Creek, Island Creek, and Mill Creek on
SR 1501 (Townsville Road) in Granville County (Figure 1 and Figure 2). Info rtnation
concerning this activity is provided below:
Impacts to Waters of the United States
Site 1: STA 26+56
The project crosses an unnamed perennial tributary to Beaver Pond Creek (NCDENR-
DWQ Index No. 23-3, Best Usage Classification C) (Figure 3) in the Roanoke River
Basin. The existing structure that conveys the creek is a 48 inch metal pipe that is 60 feet
long. Please note that the existing structure is worn and rusted (see reference photographs
1 and 2). The NCDOT proposes to replace the existing structure with a 60 inch pipe that
is 60 feet long. A bore and jack method of installing the replacement pipe will be used.
The new pipe will be installed adjacent to the old pipe, necessitating a minimal amount of
stream relocation to meet the alignment of the new pipe. The relocated channel will have
2:1 slide slopes with rip rap armoring only along the stream banks. The old pipe will be
plugged, capped, and left in place. Permanent impacts at this site include 20 feet of
relocated channel and 21 feet of stream loss.
Site 2: STA 76+70
The project crosses an unnamed intermittent tributary to Beaver Pond Creek (NCDENR-
DWQ Index No. 23-3, Best Usage Classification C) (Figure 4) in the Roanoke River
Basin. The existing structure that conveys the creek is a 30 inch metal pipe that is 49 feet
long. Please note that the existing structure is worn and rusted (see reference photographs
1 and 2). The NCDOT proposes to replace the existing structure with a 42 inch pipe that
is 64 feet long. A bore and jack method of installing the replacement pipe will be used.
Division 5, 2612 N. Duke Street, Durham, NC 27704
Phone: [phone] Fax: [phone]
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The new pipe will be installed adjacent to the old pipe, necessitating a minimal amount of
stream relocation to meet the alignment of the new pipe. The relocated channel will have
2:1 slide slopes with rip rap armoring only along the stream banks. The old pipe will be
plugged, capped, and left in place. Permanent impacts at this site include 20 feet of
relocated channel and 30 feet of stream loss.
Site 3: STA 115+61
The project crosses an unnamed intermittent tributary to Beaver Pond Creek (NCDENR-
DWQ Index No. 23-3, Best Usage Classification C) (Figure 5) in the Roanoke River
Basin. The existing structure that conveys the creek is a 18 inch metal pipe that is 44 feet
long. Please note that the existing structure is worn and rusted (see reference photographs
1 and 2). The NCDOT proposes to replace the existing structure with a 30 inch pipe that
is 48 feet long. A bore and jack method of installing the replacement pipe will be used.
The new pipe will be installed adjacent to the old pipe, necessitating a minimal amount of
stream relocation to meet the alignment of the new pipe. The relocated channel will have
2:1 slide slopes with rip rap armoring only along the stream banks. The old pipe will be
plugged, capped, and left in place. Permanent impacts at this site include 10 feet of
relocated channel and 11 feet of stream loss. In addition to stream impacts, Site 3
includes impacts to wetlands. Rip rap placed at the outlet end of the proposed pipe will
result in wetland fill of less than 0.01 acre.
Site 4: STA 139+74
The project crosses an unnamed perennial tributary to Island Creek (NCDENR-DWQ
Index No. 23-4, Best Usage Classification C) (Figure 6) in the Roanoke River Basin.
The existing structure that conveys the creek is a 42 inch metal pipe that is 60 feet long.
Please note that the existing structure is worn and rusted (see reference photographs
1 and 2). The NCDOT proposes to replace the existing structure with a 54 inch pipe that
is 60 feet long. A bore and jack method of installing the replacement pipe will be used.
The new pipe will be installed adjacent to the old pipe, necessitating a minimal amount of
stream relocation to meet the alignment of the new pipe. The relocated channel will have
2:1 slide slopes with rip rap armoring only along the stream banks. The old pipe will be
plugged, capped, and left in place. Permanent impacts at this site include 20 feet of
relocated channel and 13 feet of stream loss.
Site 5: STA 182+42
The project crosses an unnamed intermittent tributary to Mill Creek (NCDENR-DWQ
Index No. 23-6, Best Usage Classification C) (Figure 7) in the Roanoke River Basin.
The existing structure that conveys the creek is a 30 inch metal pipe that is 57 feet long.
Please note that the existing structure is worn and rusted (see reference photographs
1 and 2). The NCDOT proposes to replace the existing structure with a 42 inch pipe that
is 68 feet long. A bore and jack method of installing the replacement pipe will be used.
The new pipe will be installed adjacent to the old pipe, necessitating a minimal amount of
stream relocation to meet the alignment of the new pipe. The relocated channel will have
2:1 slide slopes with rip rap armoring only along the stream banks. The old pipe will be
plugged, capped, and left in place. Permanent impacts at this site include 20 feet of
relocated channel and 27 feet of stream loss.
3
Riparian Buffer
The construction of the project involves road crossings of streams which are not
subject to any buffer rules since the project is located within the Roanoke River Basin.
Portions of the most recent version of the Clarksville South & Tungsten (USGS,
1968/1981) topographic quadrangle (Figure 1) and the Soil Survey of Granville County
(USDA-NRCS, 1997) (Figure 2) are included as site maps within this application.
Waters of the U.S. Mitigation
Avoidance: All wetlands and surface waters not affected by the project will be protected
from unnecessary encroachment. No staging of construction equipment or storage of
construction supplies will be allowed in wetlands or near surface waters.
Minimization: The side slopes have been steepened to the extent possible at jurisdictional
sites. Strict enforcement of sedimentation and erosion control Best Management Practices
for the protection of wetlands and surface waters will be enforced during project
construction. Continued coordination will occur with maintenance forces and the
Environmental Officer during construction to minimize impacts to these sites.
Compensatory 7att, ion: Construction of the project will result in only minimal impacts
to waters of the United States. Impacts have been avoided and minimized to the
maximum extent possible during the design process. Due to minimal impacts,
compensatory mitigation for stream and wetland impacts will not be provided for this
project.
Protected Species
Plants and animals with federal classifications of Endangered, Threatened, Proposed
Endangered, and Proposed Threatened are protected under provisions of Section 7 and
Section 9 of the Endangered Species Act. As of January 29, 2003 the bald eagle
(Haliaeetus leucocephalus), dwarf wedgemussel (Alasmidonta heterodon), smooth
coneflower (Echinacea laevigata), and harperella (Ptilimnium nodosum) are listed as
protected species in Granville County. Biological Conclusions of No Effect have been
rendered for each species
Summary
The NCDOT proposes to replace the existing structures at five sites. Cumulative impacts
include 90 feet of relocated channel, 102 feet of stream lost, and less than 0.01 acre of fill
in wetlands.
Application is hereby made for a Department of the Army Section 404 Nationwide
Permit (NWP) 3. Additionally, this application provides notification to the NCDWQ as
Section 401 Water Quality Certification (WQC) No. 3376 will be utilized for
construction of this project. The NCDOT will comply with all applicable NWP and WQC
conditions. A pre-construction notification is attached with this request. If you have any
questions or need additional information, please contact Ms. Heather Montague at (919)
560-6081.
Sincerely,
Christopher A. Murray, P.W.S.
Environmental Officer
cc: John Dorney, NCDWQ
Battle Whitley, NCDOT
Mike Harris, NCDOT
Jeremy Goodwin, NCDOT
Office Use On1v: Form VCI'SIUIt May 20112
USACE Action ID No. DWQ No.
(it 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 (WQC 3376 does not require written concurrence).
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 3
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: ?
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: ?
IL Applicant Information
Owner/Applicant Information
Name: NCDOT Division 5, Christopher A. Murray
Mailing Address: 2612 N. Duke St. Durham NC 27704
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: cmurray(a dot. state. nc.us
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:_
Telephone Number:_
E-mail Address:
III. Project Information
Fax Number:
Pagel o178
Ill. 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: Proposed replacements of a structures conveying unnamed tributaries to
Beaver Pond Creek Island Creek and Mill Creek on SR 1501 (Townsville Road) in
Granville County.
2. T.I.P. Project Number or State Project Number (NCDOT Only): Non-TIP and Non-Work
Order Number
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Granville Nearest Town: Oxford
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From Oxford travel north on
Hwy 15 Travel beyond the communities of Stovall and Bullock, make a right onto
Townsville Road (SR 1501). Project station numbering begins at Hwy 15 with 00+00.
5. Site coordinates, if available (UTM or Lat/Long): Site 1: 36.5293°N, 78.5268°W
Site 2: 36.5284°N, 78.5087°W
Site 3: 36.5298°N, 78.4981°W
_ Site 4: 36.5308°N, 78.4886°W
Site 5: 36.5342°N, 78.4749°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): approximately 0.3 acre combined (- 0.06 acre at each site)
Page 2 of 8
Site 1: Unnamed Tributary to Beaver Pond Creek
Site 2: Unnamed Tributary to Beaver Pond Creek
Site 3: Unnamed Tributary to Beaver Pond Creek
Site 4: Unnamed Tributary to Island Creek
Site 5: Unnamed Tributary to Mill Creek
8. 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/a(imin/inaps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Site is surrounded by wooded and agriculture areas and
gravel driveways.
10. Describe the overall project in detail, including the type of equipment to be used: The
NCDOT will use a bore and lack method of installing the replacement pipes The new pipes
will be installed adjacent to the old pipes necessitating a minimal amount of stream
relocation at each site to meet the alignment of the new pipes. The relocated channels will
have 2:1 slide slopes with rip rap armoring only along the stream banks The old pipes will
be plugged, capped, and left in place. Equipment may include excavator, backhoe bulldozer,
w, ader, crane, and equipment use to bore and jack.
11. Explain the purpose of the proposed work: The existing structures are worn and rusted out.
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 pen-nits,
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.
None that are known for NCDOT activities.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
No
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
Page 3 of 8
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 The proiect proposes to replace the
existing structures.
9 Individually list wetland impacts below:
Wetland Impact Area of Located within Distance to
Site Number Type of Impact* Impact 100-year Floodplain** Nearest Stream Type of Wetland***
(indicate on ma) (acres) es/no (linear feet
Site 3 fill < 0.01 No adjacent emergent
" List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized cicarmg, grading, "!I,
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.feinit.Rov.
*** 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 (detennination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: 0.01 acre
Total area of wetland impact proposed: < 0.01 acre
3. Individually list all intermittent and perennial stream impacts below:
- - ----- - --
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 (please secif

I -Relocated channel 20 ft UT Beaver Pond Creek 2 ft Perennial
-Stream loss 21 ft
2 -Relocated channel 20 ft UT Beaver Pond Creek 2 ft Intermittent
-Stream loss 30 ft
3 -Relocated channel 10 ft UT Beaver Pond Creek 2 ft Intermittent
-Stream loss 11 ft
4 -Relocated channel 20 ft UT Island Creek 3 ft Perennial
-Stream loss 13 ft
5 -Relocated channel 20 ft UT to Mill Creek 2 ft Intermittent
-Stream loss 27 ft
* List each impact separately and identity temporary impacts. Impacts include, but are not limned to: curverns anu assvc.atcu ..N-. uF,,
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., wnvw tonozone•com,
www.mapquest.Coin, etc.).
Page 4 of 8
Cumulative impacts (linear distance in feet) to all streams on site: 90 feet of relocated
channel and 102 feet of stream loss.
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
(indicate on ma)
Type of Impact* Area of
Impact
(acres)
(if Name applicable) Wat) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.)
N/A

* List each impact separately and identity temporary impacts. Impacts include, but are not limited to: till, excavation, dredging,
flooding, drainage, bulkheads, etc.
5. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on 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.
All wetlands and surface waters not affected by construction will be protected from
unnecessary encroachment during construction. Strict enforcement of Best Management
Practices for the protection of wetlands and surface waters will be enforced during construction.
Only the smallest amount of till necessary to complete the project will be placed in waters of the
United States or protected riparian buffers.
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.
Page 5 of 8
USAGE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Pen-nits, 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/stnugide.html.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
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/wrp/index.litm. 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
Amount of Coastal wetland mitigation requested (acres): N/A
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes ® No ?
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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
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
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
*
Zone Impact
(square feet)
Multiplier Required
Mitigation
I N/A 3 N/A
2 N/A 1.5 N/A
Total N/A N/A
* Zone I 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 2B .0242 or.0260.
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X1. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreagd'on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
There is 0.02 acre of existing impervious surface area with no increase proposed within the
0.3 acre total project size. Erosion and sediment control devices along the proiect are comprised
of temporary silt fence.
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.
The project will not generate wastewater.
X111. 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
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).
0-0 ?!? IZ(?l/o3
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
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