20040413 Ver 1_Complete File_20040317

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William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Cam' Alan W. Klimek, P.E. Director
> .? Division of Water Quality
{l .? Coleen H. Sullins, Deputy Director
Division of Water Quality
April 27, 2004
Halifax County
DWQ Project No. 040413
APPROVAL of 401 Water Quality Certification
Mr. Anthony W. Roper, P.E., Acting Division Engineer
NCDOT, Division 4
PO Box 3165
Wilson, NC 27895-3165
Dear Mr. Roper:
You have our approval, in accordance with the attached conditions and those listed below, to place fill material in
0.006 acres of jurisdictional wetlands, 28 linear feet of streams, and 9,820 square feet (3700 square feet in Zone 1
and 6120 square feet in Zone 2) of protected Tar-Pamlico River Riparian Buffers for the purpose of widening and
improving SR 1318 in Nash County. The project shall be constructed in accordance with your application dated
received March 17, 2004. After reviewing your application, we have decided that this fill is covered by General
Water Quality Certification Number 3404. This certification corresponds to the Nationwide Permit 14 issued by the
Corps of Engineers. This approval is also valid for the Tar-Pamlico River Buffer Rules (15A NCAC 2B .0259). In
addition, you should acquire any other federal, state or local permits before you proceed with your project including
(but not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This
approval will expire with the accompanying 404 permit, unless otherwise specified in the Water Quality
Certification.
This approval is valid solely for the purpose and design described in your application (unless modified below).
Should your project change, you must notify the DWQ and submit a new application. If the property is sold, the
new owner must be given a copy of this Certification and approval letter, and is thereby responsible for complying
with all the conditions. If total wetland fills for this project (now or in the future) exceed one acre, or of total
impacts to streams (now or in the future) exceed 150 linear feet, compensatory mitigation may be required as
described in 15A NCAC 211.0506 (h) (6) and (7). For this approval to remain valid, you must adhere to the
conditions listed in the attached certification.
1.) Upon completion of the project, the NCDOT shall complete and return the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been completed. The
responsible party shall complete the attached form and return it to the 401/Wetlands Unit of the Division of
Water Quality upon completion of the project.
2.) All stormwater runoff shall be directed to sheetflow through stream buffers at nonerosive velocities, unless
approved otherwise by this certification.
3.) During the construction of the project, no staging of equipment of any kind is permitted in waters of the U.S., or
protected riparian buffers.
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.) 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. Disturbed floodplains and streams should be
restored to natural geomorphic conditions.

N. C. Division of Water Quality 1650 Mail Service Center Raleigh, NC 27699-1650 [phone]
Customer Service: 1 800 623-7748
W ,E1jF Michael F. Easley, Governor
0 RQG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
r Alan W. Klimek, P.E. Director
CO ?
6.) Any riprap used must not interfere with thalweg performance and aquatic life passage during low flow
conditions.
7.) 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.
8.) Discharging hydroseed mixtures and washing out hydroseeders and other equipment in or adjacent to surface
waters is prohibited.
9.) The outside buffer, wetland or water boundary as well as along the construction corridor within these
boundaries approved under this authorization shall be clearly marked by orange fabric fencing for the areas that
have been approved to infringe within the buffer, wetland or water prior to any land disturbing activities.
10.) There shall be no excavation from or waste disposal into jurisdictional wetlands or waters associated with this
permit without appropriate modification of this permit. Should waste or borrow sites be located in wetlands or
stream, compensatory mitigation will be required since it is a direct impact from road construction activities.
11.) Pursuant to NCAC15A 2B.0233(6), sediment and erosion control devices shall not be placed in Zone 1 of any
Neuse Buffer without prior approval by the NCDWQ. At this time, the NCDWQ has approved no sediment and
erosion control devices in Zone 1 anywhere on this project. Moreover, sediment and erosion control devices
shall be allowed in Zone 2 of the buffers provided that Zone 1 is not compromised and that discharge is released
as diffuse flow.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must
act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition that conforms
to Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, P.O. Box 27447,
Raleigh, N.C. 27611-7447. This certification and its conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If you
have any questions, please contact John Hennessy at 919-733-5694.
' Alan W. Klimek, P.E.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
DWQ Raleigh Regional Office
File Copy
Central Files
c:\ncdot\SR 1318\wqc\040413 wqc.doc

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR
SECRETARY
DIVISION 4
n
, 03
1
Mr. Mike Bell
U.S. Army Corps of Engineers
Washington Regulatory Field Office
Post Office Box 1000
Washington, North Carolina 27889-1000
(Copies)
04041:3
WETLkon GRO! P
Mr. John Hennessy
Wetlands/401 Unit
NC DENR Division of Water Quality
1650 Mail Service Center
MAR 1 7 2004
e'iifis,F1i79 i bjwy aS??°?
Raleigh, NC 27699
(Seven Copies)
SUBJECT: Nash County, Upgrade of Hayes Road (SR 1318) from an unpaved
secondary road to a paved secondary road.
State Project Number: 4C.064015 M-PL000 rer)"ti, Fee: $2oo
Dear Sirs:
The North Carolina Department of Transportation (NCDOT) proposes to improve Hayes
Road (SR 1318) from an unpaved to a paved secondary road to reduce future maintenance
needs and increase traffic safety. This activity will result in impacts to wetlands and
a stream due to the replacement of a crossline pipe. The following information is being
provided to satisfy the Nationwide Permit Condition for Notification (Federal Register
January 15, 2002) and reporting conditions of the corresponding General Water Quality
Certification. The NCDOT anticipates that the pipe replacement activity will be
authorized under Nationwide Permit (NWP) 14 and, if needed, the dewatering operation
will be authorized under NWP 33. This application is also intended as request for written
401 and/or Buffer authorization from the NC Division of Water Quality, as needed, to
replace the pipe under a General Water Quality Certification and/or the Buffer Rules.
r 4 S
iPost Office Box 3165, Wilson, North Carolina 27895-3165
Phone [phone] Fax [phone]
APPLICATION INFORMATION
Enclosed please find the Pre-construction Notification (PCN) Form and supporting
documentation for the above referenced project.
In accordance with North Carolina General Statute 143-215.3D(e) the following
information is being provided to facilitate payment of fees associated with the appropriate
Water Quality Certificate:
• Certificates being requested: #3404 (NWP14) and #3366 (NWP33)
• State Project Number : 4C.064015
• Amount of fee: $200
PROJECT INFORMATION
Road Name SR Number Project Length
(miles) Classification
Hayes Road 1318 1.0 Rural
River Basin: DWQ
ID Water Quality
Designation % New Impervious
Surface
Tar-Pamlico 28-33-1.5 QNSW 0
Buffer Rules Buffer Use Designation
Tar-Pamlico Allowable
Protected Species Mapped Historic
Present* Properties"
No No
* As listed on the Natural Heritage Program database.
** As listed on the National Register Information System (NRIS) database.
PIPE REPLACEMENT INFORMATION
Site (Station) 23+90 Map Status Shown on topo and ssurvey
Existing Proposed
Diameter (in) 72" Diameter 137"x87"
Length (ft) 52' Length 60'
Construction Dewatering
Method pump around Device*** sheet pile
Burial Depth 1' substrate clay/silt
Construction
Date ASAP Duration One month
Impacts (ft.) 8'-piped; 0-rip-rap protection ;20'-temporary
Comments Rip rap will be placed on banks, not in stream bottom. Coffer-dams if needed.
Restoration Within 15 working days of the of the pipe replacement all cofferdams will be
Plan*** entirely removed and natural stream contours will be restored and seeded.
Temporary silt screens placed in intermittent channels will be cleaned and removed
following vegetation establishment.
RCP = reinforced concrete pipe; CMP = Corrugated metal pipe; CMPA = Corrugated metal pipe arch;
*** If needed.
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 impacts and mitigation are not anticipated, as surfacing can be accomplished
within the existing roadway footprint.
If you have any questions or need any additional information, please contact Terry Ellis at
[phone] or Jamie Shern at [phone]. Your time and effort are appreciated.
Sincerel ,
Mr. Lynn R. Ward, P.E.
District 2 Engineer, Division 4, NCDOT
cc: Mr. James F. Shern, Division Environmental Officer
Mr. Lynn Ward, District 2 Engineer
Mr. Bryant Bunn, P. E., NCDOT Division Maintenance Engineer
Mr. Bobby Lewis, County Maintenance Engineer, Nash
Mr. B+Hcr Area Roadside Field Operations Engineer
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Office Use Only: ,p Form Version October 2001
USACE Action ID No. DWQ No.®4 ®4 1 3
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
1. Processing
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: ?
II. Applicant Information
Owner/Applicant Information
Name: Mr. Anthony W. Roper, P.E., Acting Division Engineer
Mailing Address: North Carolina Department of Transportation/Division 4
P.O. Box 3165
Wilson, NC 27895-3165
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
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: Mr. James Shern
Company Affiliation: Division Environmental Officer
Mailing Address: North Carolina Department of Transportation/Division 4
P.O. Box 3165
Wilson NC 27895-3165
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
Page 5 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: SR 1318, Hayes Road
2. T.I.P. Project Number or State Project Number (NCDOT Only): 4C.064015
3. Property Identification Number (Tax PIN): NA
4. Location
County: Nash Nearest Town: Springhope
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): Take SR 1002 west of
Springhope, turn left on SR 1318
5. Site coordinates, if available (UTM or Lat/Long):Bunn East Quad Map: Lat Long 35.9512N,
78.1592W
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Describe the existing land use or condition of the site at the time of this application: Rural,
timber/farmland
7. Property size (acres)
NA
8. Nearest body of water (stream/river/sound/ocean/lake): Coker Creek 28-33-1.5 QNSW
9. River Basin: Tar-Pamlico
(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/adm.in/maps/.)
Page 6 of 12
10. Describe the purpose of the proposed work: Road grading, drainage, base, paving and
erosion control to bring existing gravel road in compliance with standard safety design
specifications.
11. List the type of equipment to be used to construct the project: Construction equipment
(backhoe, excavator, dump truck, bulldozer, grader)
12. Describe the land use in the vicinity of this project: Rural timber & farmland
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
NA
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application:
NA
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
1. Wetland Impacts
Page 7 of 12
Wetland Impact Area of Located within Distance to
Site Number Type of Impact* Impact 100-year Floodplain** Nearest Stream Type of Wetland***
(indicate on map) (acres) (yes/no) (linear feet)
23+90 Clear and grade 0.06 Yes 0 Beaver pond
* 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.gov.
** 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: 0.06
Total area of wetland impact proposed: 0.06
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)
23+90 -L- 137"x87" CMP 8 Coker Creek 6 feet Perennial
23+90 -L- Dewatering 20 Coker Creek 6 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.usgs.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 28'
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
Open Water Impact Area of Name of Waterbody Type of Waterbody
Site Number Type of Impact* Impact (if applicable) (lake, pond, estuary, sound,
(indicate on ma) (acres) bay, ocean, etc.)
N/A
List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
Page 8 of 12
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.): NA
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
Work will be performed within the existing road footprint. Wherever feasible, road drainage
is designed to be turned out of the ditch to sheet flow through the buffer to reduce impacts. Strict
enforcement of sedimentation and erosion control Best Management Practices for the protection
of wetlands and surface waters will be enforced during project construction.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
Page 9 of 12
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
N/A
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at ht!p:Hh2o.enr.state.ne.us/nM/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):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ® Meets Minimum Criteria
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If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify Tar-Pamlico )?
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 3700 3 N/A
2 6120 1.5 N/A
Total 9820
* "Lone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
Existing use is a road crossing. Allowable under the buffer rules with notification.
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XI.
XII.
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.
All appropriate best management practices for sediment and erosion control will be implemented
during pipe replacement.
Sewage Disposal (DWQ Only)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
N/A
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 211.0500) 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).
lam(, LftG4 t 1?
ApplicandAgent's Sig ature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12