20040309 Ver 1_Complete File_20040301

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DWQ Project No.: OV4.5 0 County:
Applicant: N C iDo -I- D--,r/ i u L /?c r
Project Name: ,Sly 212Y l tfu / A S 120,,
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, 1650 Mail Service Center, Raleigh, NC,
27699-1650. 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, a ai , hereby state that, to the best of my abilities, due care
and diligence, was used. in the ob ervation,of the construction such that the construction was observed to
be built v?ithin substantial compliance and intent of the 401 Water Quality Certification and Buffer
Rules, the ap r d d.s V,4?,OtD and other supporting materials.
Signature' Date: /c7 Dc'-f ZVZ)J
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: Date:
If this project was designed by a Certified Professional
I, , as a duly registered Professional (i.e.,
Engineer, Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized
to observe (periodically, weekly, full time) the construction of the project, for the Permitee 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
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

North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetlands/
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March 3, 2004
Union County
DWQ Project No. 040309
Secondary road improvements to SR 2128 (Mullis Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. Benton G. Payne, P.E., Division Engineer
NCDOT Division 10
716 West Main Street
Albemarle, North Carolina 28001
Dear Mr. Payne:
You have our approval, in accordance with the attached conditions and those listed below, to incur 36
linear feet of permanent and 40 linear feet of temporary impacts to two unnamed tributaries of Gum Log
Branch in order to improve SR 2128 (Mullis Road) in Union County. The project shall be constructed in
accordance with your application dated February 26, 2004 (received March 1, 2004). After reviewing
your application, we have decided that this fill is covered by General Water Quality Certification No.
3404 corresponding to the U.S. Army Corps of Engineers Nationwide Permit Number 14. 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 only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us in writing, and you may be required to
send us a new application. If the property is sold, the new owner must be given a copy of this
Certification and approval letter and is thereby responsible for complying with all conditions. If total
wetland fills for this project (now or in the future) exceed one acre, or if stream impacts exceed 150 linear
feet, compensatory mitigation may be required as described in 15A NCAC 2H.0506 (h) (6) and (7). For
this approval to be valid, you must follow the conditions listed in the attached certification and any
additional conditions listed below.
Construction shall be performed so that no violations of state water quality standards, statutes, or
rules occur.
¦ 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 water quality standards.
¦ The erosion and sediment control measures for this project must equal or exceed the proper
design, installation, operation and maintenance outlined in the most recent version of the
North Carolina Sediment and Erosion Control Planning and Design Manual. These 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 projects included under
this Certification.
¦ If this project requires borrow pit sites, the erosion and sediment control measures must equal
or exceed the proper design, installation, operation and maintenance outlined in the most
recent version of the North Carolina Surface Mining Manual.
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
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), hftp://h2o.enr.state.nc.us/ncwetlands/
Mr. Benton Payne, P.E.
DWQ 040309
March 3, 2004
¦ Any reclamation measures and implementation must comply with the reclamation in
accordance with the requirements of the Sedimentation Pollution Control Act.
2. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters
is unavoidable, they shall be removed and the natural grade restored within 30 days after the
Division of Land Resources has released the project.
NCDOT and its contractors and/or agents shall not excavate, fill, or perform mechanized land
clearing at any time in the construction or maintenance of this project within waters and/or
wetlands, except as authorized by this Certification, or any modification to this Certification (e.g.,
no work shall occur outside of the footprint of the plans provided). In addition, there shall be no
excavation from or waste disposal into jurisdictional wetlands or waters associated with this
Certification without appropriate modification. If this occurs, compensatory mitigation may be
required since it is a direct impact from road construction activities.
4. This Certification does not authorize the discharge of waste rock and dirt into the stream or
riparian zone except for permitted areas associated with culvert conditions.
5. Stormwater runoff shall be treated by the use of grass swales, pre-formed scours holes or other
means that are compatible with the project site's topography, prior to reaching the stream.
6. The structures required for this project shall be installed in such a manner that the original stream
profiles are not altered (i.e. the depth of the channel must not be reduced by a widening of the
streambed). Existing stream dimensions (including the pattern and profile) are to be maintained
above and below locations of each pipe. The structure shall be designed and installed to allow.for
fish and other wildlife movement as well as prevent headcutting of the streams.
7. The presence of equipment in the channels must be minimized. Under no circumstances must
rock, sand or other materials be dredged from the stream channel under authorization of this
Certification, except in the immediate vicinity of the culverts. Instream dredging has catastrophic
effects on aquatic life and disturbance of the natural form of the stream channel will likely cause
downstream erosion problems, possibly affecting other landowners.
8. Heavy equipment should be operated from the bank rather than in the stream channel rather than
in the stream channel in order to minimize sedimentation and reduce the likelihood of introducing
other pollutants into the stream.
9. All mechanized equipment operated near surface waters should be inspected and maintained
regularly to prevent contamination of stream waters from fuels, lubricants, hydraulic fluids or
other toxic substances.
10. Discharging hydroseed mixtures and washing out hydroseeders and other equipment in or
adjacent to surface waters is strictly prohibited.
11. Upon completion of the project, the NCDOT and/or its authorized agents shall complete and
return the enclosed "Certificate of Completion" form to the 401/Wetlands Unit of the NC
Division of Water Quality upon completion of the project. Please include photographs upstream
and downstream of each structure to document correct installation.
Mr. Benton Payne, P.E.
DWQ 040309
March 3, 2004
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.
You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written
petition that conforms to Chapter 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its
conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please telephone Ms. Cynthia Van Der Wiele at 919.733.5715 or Mr.
Michael Parker of the Mooresville Regional Office at 704.663.1699.
Sincerely,
Attachment
Pc: Wilmington District Corps of Engineers
Steve Lund, USACE Asheville Field Office
NCDWQ Mooresville Regional Office
Central Files
File Copy
. Klimek, P.E.

401 MUM
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DIVISION OF HIGHWAYS W. LYNDo TIPPETT
GOVERNOR SECRETARY
FILE COPY 26 2004
February ,
VVETLf rQoup
U. S. Army Corps of Engineers
Asheville Regulatory Field Office MAF" 41111
Attention: Mr. Steve Lund, MS, PWS
151 Patton Avenue, Room 208 ()40309 WATER 00,%L1 I'f SECTION
Asheville, NC 28801-5006
Subject: Secondary Road Improvements to SR 2128 (Mullis Road), Union County. State
Work Order No. 10C. 090030 (DWQ Minor Permit Fee $200.00).
Dear Mr. Lund:
The North Carolina Department of Transportation (NCDOT) proposes to upgrade SR 2128
(Mullis Road), in Union County. SR 2128 is an unpaved roadway that will be upgraded to a
paved roadway. The total project length is 1.27miles.
Transportation and highway laws of North Carolina (G.S. 136-44.6, 136-44.7, 136-44.7A, 136-
44.8 and 136-44.9) require the NCDOT to develop annual work programs for construction and
maintenance of secondary roads. These general statutes specifically set forth requirements for
annual construction and paving of existing unpaved roads. Paving of these roads is performed in
priority order as established by the NCDOT for each unpaved road within a given county. This
number is based on characteristics of each road, including number of homes, schools, churches,
businesses, industries, recreational facilities, traffic counts, presence of school bus routes, and
value as a thoroughfare. SR 2128 is scheduled for paving in the 2004-2005 Secondary Roads
Construction Program.
Protected Species
The subject project has been reviewed for the presence of listed threatened and endangered
species. It has been determined that the construction of this project will have no effect on any
listed plant or animal species.
a
716 West Main Street, Albemarle, NC 28001 • [phone] • Fax [phone]
Impacts to Waters of the United States
This project cannot be completed without impacts to waters of the United States. The project lies
in the Yadkin River Basin (Hydrologic Unit # 03040105), affecting the drainage of unnamed
tributaries to Gum Log Branch. There will be approximately 36 linear feet of permanent impacts
to the existing stream channels as a result of the proposed construction.
Wetland Impacts
There are no wetland impacts that will result from the construction of this project. Potential
impacts would be avoided by the proposed new location.
Stream Impacts
There are a total of two impacts to intermittent streams. Table 1 includes information related to
site number, stream name, existing pipe length (ft), existing pipe width (in), proposed replacement
or extended pipe length (ft) and width (in).
Table 1. Impacts to Streams from improvements to SR 2128 (Mullis Road)
Site - Existing
, Existing Proposed '
' Proposed
No. A' Stream Name Length 3
" Width Lengthy '
? "' Width"
i A",
feet a
inches
feet
inches
35+70 UT Gum Lo Branch 30' 18" 50' 30"
64+25 UT Gum Lo Branch 28' 18" 44' 30"
Note: "UT" refers to unnamed tributary.
Avoidance/Minimization
Any wetlands or 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 or near wetlands or surface waters.
The side slopes have been steepened to the extent possible and the proposed roadway adjusted to
lessen the impacts to jurisdictional sites. 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 between maintenance forces and the Division
Environmental Officer during construction in an effort to minimize impacts to jurisdictional sites.
Compensatory Mitigation
At this time, the NCDOT does not anticipate the need for compensatory mitigation based upon
the limited impacts associated with the construction of this project.
. Summary
The purpose of this letter is to request authorization to construct the proposed project under
Section 404 Nationwide Permit (NWP) 14. Application is also made to the North Carolina
Division of Water Quality (NCDWQ) for the Section 401 Water Quality Certificate (WQC) No.
GC3404 that is required in order to construct this project.
If you have any questions or need any additional information concerning this project, please feel
free to contact Mr. Larry Thompson, Division Environmental Officer, at [phone].
Sincerely,
Benton G. Payne, P. E.
Division Engineer
BGP/LBT
cc: Mr. John Dorney, NCDWQ
Ms. Marella Buncick, USFWS
Ms. Marla Chambers, NCWRC
Mr. Mike Walden, NCDOT
Mr. David Gillette, NCDOT
Mr. Larry Thompson, NCDOT
Area Field Operations Unit
Office Use Only' Form Version April 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.
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: Nationwide 14
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here:
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ?
II. Applicant Information
1. Owner/Applicant Information
Name: N. C. Department of Transportation
Mailing Address: 716 West Main Street
Albemarle NC 28001
Telephone Number: [phone]
E-mail Address:
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: Benton G. Payne, P. E.
Company Affiliation: Division Engineer
Mailing Address: 716 W. Main Street
Albemarle NC 28001
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
Fax Number: [phone]
Pagel 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: SR 2128 (Mullis Road)
2. T.I.P. Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Union County Nearest Town: Monroe
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From Monroe, travel south on
NC 207, bearing left on SR 2115 (Stack Road). SR 2128 (Mullis Road) is located on the left
approximated 5.4 miles ahead
5. Site coordinates, if available (UTM or Lat/Long): 34° 53' 21.90"N / 80° 29' 29.35"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. Describe the existing land use or condition of the site at the time of this application:
Rural residential setting with pastures located at each jurisdictional crossing.
7. Property size (acres):
8. Nearest body of water (stream/river/sound/ocean/lake): Gum Log Branch
9. River Basin: Yadkin-Pee Dee (,Hydrologic Unit 03040105)
(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/maps/.)
Page 2 of 9
10. Describe the purpose of the proposed work: Upgrade existing gravel road to a paved road.
Project will necessitate pipe upgrades at two jurisdictional crossings.
11. List the type of equipment to be used to construct the project: Heavy construction equipment
(backhoe trackhoe excavator, grader, boom truck, dump trucks etc.).
12. Describe the land use in the vicinity of this project: Rural residential - pastures located at
each jurisdictional crossing ----
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.
V. Future Project Plans
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
linear feet
Type of Wetland***

• List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mecnanizea clearing, grading, uu.
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.tema.9ov.
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
Site Number
indicate on ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream Before
Impact Perennial or
Intermittent?
leases eci fy)
35+70 30" x 50' RCP 20' UT Gum Log Branch Approx. 1.5' Intermittent
64+25 30" x 44' RCP 16' UT Gum Log Branch Approx. 1.5' Intermittent

* 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.sov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapquest.com, etc.).
Page 4 of 9
Cumulative impacts (linear distance in feet) to all streams on site: 36 feet permanent impacts
and 40 feet of temporary impacts
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.

* 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.):
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.
Any wetlands or surface waters not impacted by this project will be protected from unnecessary
encroachment No staging of construction equipment will be allowed in or near wetlands or
waters of the United States Strict enforcement of sedimentation and erosion Best Management
Practices for the protection of wetlands and surface waters will be enforced during all phases of
project construction
Page 5 of 9
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http:/ih2o.enr.state.nc.us/ncwetiands/strmp,ide.htmi.
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.
No mitigation is proposed for this project.
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
Page 6 of 9
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wro/index.htm. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
IX. Environmental Documentation (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 ?
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 213 .0233
(Meuse), 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.
Page 7 of 9
Zone* Impact
(square feet Multiplier Required
Mitigation
I 3
2 1.5
Total
• Zone I extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone I.
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.
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.
Existing gravel base road is 20 feet in width, proposed paved road section will be 20 feet in
width There will not be an increase in impervious area as a result of this project being
constructed.
Temporary dewatering_ if required) and all appropriate Best Management Practices for sediment
and erosion control will be implemented during pipe rep lacement/extension activities.
XII. 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
Page 8 of 9
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (I 5A 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).
Applicant/Agent's Sighatu
(Agent's signature is valid
if an authorization letter from the applicant is provided.)
1171
-
Date'
Page 9 of 9
SR 2128 (Mullis Road) - Union County
N
A
Legend
Q permit site

Prepared by:
North Carolina
Department d'I'runsporlallon
CnIlroumental Unit, Dlvhdon 10
Dale: February 26, 2004
This map Is Intended for Internal DOT use only.
ror all other uses, no warranties of any sort,
Including accuracy, fitness, or merchantability
accompany this product.
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