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HomeMy WebLinkAbout20110670 Ver 1_401 Application_20110711201 10670 July 12, 2011 NC DWQ, 401/Wetlands Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1650 Re: Pre-Construction Notification 5?nzt w i,% j$ot-ta R@190 ER JUG. 1 3 2011 Written Approval - 401 Water Quality Certification Transco - Bank Stabilization and Maintenance of Exposed 36-inch Pipeline in a Tributary to Abernethy Creek Gaston County, Bessemer City, North Carolina Submar Job #SB2999 On behalf of Transco, Submar, Inc. is submitting this request for a Section 401 Water Quality Certification Written Approval to conduct bank stabilization activities and restore cover to natural gas pipelines within waters of the United States. Based on a review of the Corps of Engineers Regulatory Program, it appears that the work proposed herein could meet the criteria established for authorization under Nationwide Permits (NWP) No. 3 - Maintenance and No. 18 - Minor Discharges, as found in the March 12, 2007, Federal Register, Reissuance of Nationwide Permits (72 FR 11180). Please refer to the enclosed Pre-Construction Notification for project specific details. We will comply with the general and regional conditions of the permits during construction. CONTACT INFORMATION Applicant Transco 2800 Post Oak Boulevard Houston, Texas 77056 Attn: Mr. Randall Flowers PROJECT LOCATION & DESCRIPTION Agent Submar, Inc. 805 Dunn Street Houma, Louisiana 70360 Attn: Brandon M. Clark The Transco right-of-way (ROW) crosses a tributary to Abernethy Creek in Gaston County, about 2 miles south of Bessemer City, North Carolina (Figure 1- Vicinity Map). The GPS coordinates for the site are N35.25887° and W81.27697° (Figure 2 - Topographic Map). The stream flows in a southeasterly direction where it crosses the ROW. The site is located in a wooded area between Interstate 85 and US Highway 29 (Kings Mountain Highway). The banks within the ROW are vegetated with a variety of grass and forbs. Outside of the ROW, the banks 805 Dunn Street - Houma, LA 70360 - 985-868-0001 - Fax 985-851-0108 - 800-9-SUBMAR .J W July 12, 2011 Page 2 are also vegetated with brush and trees of varying sizes. The soil in the area is composed of clay, rock, and sand. The banks are 5 feet high and steep. There are three natural gas pipelines in this section of ROW. The upstream line is the 36-inch Line C, followed by the 30-inch Line A. The 36-inch Line B is the downstream pipeline. Headcuts migrating upstream have exposed the top of Line B across the creek. A headcut is currently located between Lines A and C. There is a low-water crossing for local ATV traffic on the downstream end of the ROW. Downstream of the low-water crossing, the creekbed is covered in rocks (Figures 4 and S - Site Photos). Submar proposes to cut back both banks to create gentler, stable slopes and place fill around the exposed Line B. Submar will then armor all three pipelines with a system of articulating concrete revetment mats. The mat system will cover the pipelines in the creekbed and extend up both banks. The tail on the downstream end of the mat system will articulate with the creekbed to prevent the upstream migration of future headcut erosion. Submar's articulating concrete mat system will provide and maintain cover over the pipelines in the matted area (Sheet 3 - Proposed Design). The Submar Revetment Mattress is an articulating concrete mat used primarily for erosion control. The mat is 4.5-inches thick and has a low hydraulic profile when placed in a streambed. Pipeline companies prefer our mat over their pipelines for several reasons. If the stream undergoes significant changes, the mats can be repositioned to compensate for changing flow patterns. The mat has open areas that allow revegetation through the mat. The design for matted areas includes a rapid return to a natural appearance. PURPOSE AND NEED The pipeline is exposed, so a repair to restore cover is required. Headcuts migrating upstream have exposed the top of Line B across the creek. A headcut is currently located between Lines A and C. There is a low-water crossing for local ATV traffic on the downstream end of the ROW. At some point, this Line B exposure may likely suffer structural damage. This unfortunate event could cause environmental damage and endanger the public. DIRECT AND INDIRECT ENVIRONMENTAL IMPACTS The proposed project involves the installation of 21 articulating concrete mats over the exposed pipeline to restore cover. Of the 21 total mats proposed, 6 (approximately 9 cubic yards) will be installed below the ordinary high water mark. About 4 cubic yards of clean uncontaminated fill will also be placed below the ordinary high water mark. It appears that the project may permanently impact about 0.02 acre of other waters of the United States. It is anticipated that no wetlands will be impacted. We expect temporary impacts (approximately 0.07 acre) during construction; however, anticipate no long-term adverse impacts to the project area. 805 Dunn Street • Houma, LA 70360 • 985-868-0001 • Fax 985-851-0108 - 800-9-SUBMAR It I T July 12, 2011 ADDITIONAL PERMITS TO BE REQUESTED Page 3 No other state or federal environmental permits are required for the subject work. NWP-3 and NWP-18 are certified Nationwide Permits under the North Carolina Department of Environment and Natural Resources Division of Water Quality (DWQ) Program; therefore, an individual WQC will not be required. However, written approval is being requested from DWQ. Your prompt attention and approval of this permit request will be appreciated. If you have any questions, or if I may be of further service, please call me at (800) 978-2627. Thank you in advance for your assistance in this matter. Sincerely, SUBMAR Brandon M. Clark Regulatory and Compliance Manager Enclosures cc: Mr. Randall Flowers, Transco 2800 Post Oak Boulevard, Houston, Texas 77056 805 Dunn Street • Houma, LA 70360 • 985-868-0001 • Fax 985-851-0108 • 800-9-SUBMAR _0O W A rF9°G y O Y 2 0 1 1 0 6 7 0 Office Use Only: Corps action ID no. DWQ project no. Form Version 1.3 Dec 10 2008 Pre-Construction Notification PCN Form A. Applicant Information 1. Processing 1a. Type(s) of approval sought from the Corps: Section 404 Permit El Section 10 Permit FZ 1 b. Specify Nationwide Permit (NWP) number: 3 and 18 or General Permit (GP) number: 1c. Has the NWP or GP number been verified by the Corps? ® Yes ? No 1 d. Type(s) of approval sought from the DWQ (check all that apply): ® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit ? 401 Water Quality Certification - Express ? Riparian Buffer Authorization 1 e. Is this notification solely for the record because written approval is not required? For the record only for DWQ 401 Certification: ? Yes ® No For the record only for Corps Permit: ? Yes ® No 1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu fee program. ? Yes ® No 1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h below. ? Yes ® No 1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No 2. Project Information 2a. Name of project: Bank Stabilization and Maintenance of Exposed 36" Pipeline in Tributary to Abernethy Creek 2b. County: Gaston 2c. Nearest municipality / town: Bessemer City 2d. Subdivision name: Kings Mountain Highway 2e. NCDOT only, T.I.P. or state project no: N/A 3. Owner Information 3a. Name(s) on Recorded Deed: 185 Highway 29/74 LLC; Christa A. Overcash; Transcontinental Gas Pipe Line Corporation as recorded in 1949 3b. Deed Book and Page No. 3901 and 0491; 3901 and 0497; Right-of-Way Agreement: Book 554 and Page No. 453 3c. Responsible Party (for LLC if applicable): Transco, Attn: Mr. Randall Flowers 3d. Street address: 2800 Post Oak Boulevard 3e. City, state, zip: Houston, Texas 77056 3f. Telephone no.: 713-215-3427 3g. Fax no.: 713-215-5442 3h. Email address: I. Randall. Flowers@williams.com Page I of 12 PCN Form - Version 1.3 December 10, 2008 Version W t 4. Applicant Information (if different from owner) 4a. Applicant is: ? Agent ? Other, specify: 4b. Name: 4c. Business name (if applicable): 4d. Street address: 4e. City, state, zip: 4f. Telephone no.: 4g. Fax no.: 4h. Email address: 5. Agent/Consultant Information (if applicable) 5a. Name: Brandon M. Clark 5b. Business name (if applicable): Submar, Inc. 5c. Street address: 805 Dunn Street 5d. City, state, zip: Houma, Louisiana 70360 5e. Telephone no.: 1-800-978-2627 5f. Fax no.: 985-851-0108 5g. Email address: bclark@submar.com Page 2 of 12 PCN Form - Version 1.3 December 10, 2008 Version I J -.t B. Project Information and Prior Project History 1. Property Identification 1a. Property identification no. (tax PIN or parcel ID): PIN 3525-26-5713 and PID 205044 1b. Site coordinates (in decimal degrees): Latitude: 35.25887 Longitude: - 81.27697 (DD.DDDDDD) (-DD.DDDDDD) 1 c. Property size: N/A acres 2. Surface Waters 2a. Name of nearest body of water (stream, river, etc.) to Tributary to Abernethy Creek proposed project: 2b. Water Quality Classification of nearest receiving water: C 2c. River basin: Catawba 3. Project Description 3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application: The site is currently being maintained as a right-of-way for existing natural gas pipelines. Current land cover is (311) Managed Herbaceous Cover and (321) Managed Shrublands while land use is categorized as (1.06.02.02) Gas Storage and Transmission. 3b. List the total estimated acreage of all existing wetlands on the property: Unknown 3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: Stream is approximately 150 linear feet at limits of maintained right-of-way crossing. 3d. Explain the purpose of the proposed project: Project purpose is to conduct erosion control activities within a tributary to Abernethy Creek to restore protective cover to Line B, an exposed natural gas pipeline and to protect two other lines, Line A and Line C, from future exposure. 3e. Describe the overall project in detail, including the type of equipment to be used: Submar proposes to cut back the right bank to create a gentler, more stable slope (2:1) and place fill around the exposed Line B. We will then armor all three pipelines with a system of articulating concrete revetment mats. Proposed project involves the installation of 21 articulating concrete mats over the exposed pipeline to restore cover. Of the 21 total mats proposed, 6 (approximately 9 cubic yards) will be installed below the ordinary high water mark. About 4 cubic yards of clean uncontaminated fill will also be placed below the ordinary high water mark. It appears that the project may permanently impact about 0.02 acre of other waters of the United States. The mat system will cover the pipelines in the creekbed and extend up both banks. The tail on the downstream end of the mat system will articulate with the creekbed to prevent the upstream migration of future headcut erosion. Submar's articulating concrete mat system will provide and maintain cover over the pipelines in the matted area. A track excavator and track loader will be used. 4. Jurisdictional Determinations 4a. Have jurisdictional wetland or stream determinations by the Corps or State been requested or obtained for this property / ? Yes ? No Unknown project (including all prior phases) in the past? Comments: Corps permit likely issued when pipeline installed 4b. If the Corps made the jurisdictional determination, what type ? Preliminary ? Final of determination was made? 4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: Name (if known): Other: 4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation. Page 3 of 12 PCN Form - Version 1.3 December 10, 2008 Version I t 5. Project History 5a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past? ? Yes ? No ® Unknown 5b. If yes, explain in detail according to "help file" instructions. 6. Future Project Plans 6a. Is this a phased project? ? Yes ® No 6b. If yes, explain. Page 4 of 12 PCN Form - Version 1.3 December 10, 2008 Version T 1 If C. Proposed Impacts Inventory 1. Impacts Summary 1 a. Which sections were completed below for your project (check all that apply): ? Wetlands ® Streams - tributaries ? Buffers ? Open Waters ? Pond Construction 2. Wetland Impacts If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted. 2a. 2b. 2c. 2d. 2e. 2f. Wetland impact Type of jurisdiction number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact Permanent (P) or (if known) DWQ - non-404, other) (acres) Temporary T W1 ? P M T ? Yes ? Corps ? No ? DWQ W2 ? P ? T ? Yes ? Corps ? No ? DWQ W3 ? P ? T ? Yes ? Corps ? No ? DWQ W4 ? P ? T ? Yes ? Corps ? No ? DWQ W5 ? P ? T ? Yes ? Corps ? No ? DWQ W6 ? P ? T ? Yes ? Corps ? No ? DWQ 2g. Total wetland impacts 2h. Comments: No known wetlands on site 3. Stream Impacts If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this question for all stream sites impacted. 3a. 3b. 3c. 3d. 3e. 3f. 3g. Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact number - (PER) or (Corps - 404, 10 stream length Permanent (P) or intermittent DWQ - non-404, width (linear Temporary (T) (INT)? other) (feet) feet) S1 ®P ? T Excavation Tributary to ® PER ® Corps 10 140 Abernethy Creek ? INT ® DWQ S2 ® P ? T Fill Tributary to ® PER ® Corps 10 105 Abernethy Creek ? INT ® DWQ S3 ? P ? T ? PER ? Corps ? INT ? DWQ S4 ? P ? T ? PER ? Corps ? INT ? DWQ S5 ? P ? T ? PER ? Corps ? INT ? DWQ S6 ? P ? T ? PER ? Corps ? INT ? DWQ 3h. Total stream and tributary impacts 3i. Comments: Impacts associated with excavation of the banks to create more gentle 2:1 slopes will be approximately 140 linear feet. Approximately 105 linear feet of impacts will be a result of fill associated with the installation of the pre-formed concrete mattresses. Page 5 of 12 PCN Form - Version 1.3 December 10, 2008 Version t v Y 4. Open Water Impacts If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of the U.S. then individually list all open water impacts below. 4a. 4b. 4c. 4d. 4e. Open water Name of waterbody impact number - (if applicable) Type of impact Waterbody type Area of impact (acres) Permanent (P) or Temporary T 01 ?P?T 02 ?P?T 03 ?P?T 04 ?P?T 4f. Total open water impacts 4g. Comments: N/A 5. Pond or Lake Construction If and or lake construction proposed, then complete the chart below. 5a. 5b. 5c. 5d. 5e. Wetland Impacts (acres) Stream Impacts (feet) Upland Pond ID Proposed use or purpose (acres) number of pond Flooded Filled Excavated Flooded Filled Excavated Flooded P1 P2 5f. Total 5g. Comments: N/A 5h. Is a dam high hazard permit required? ? Yes ? No If yes, permit ID no: 5i. Expected pond surface area (acres): 5j. Size of pond watershed (acres): 5k. Method of construction: 6. Buffer Impacts (for DWQ) If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts below. If an impacts require mitigation, then you MUST fill out Section D of this form. 6a. ? Neuse ?Tar-Pamlico ? Other: Project is in which protected basin? ? Catawba ? Randleman 6b. 6c. 6d. 6e. 6f. 6g. Buffer impact number - Reason Buffer Zone 1 impact Zone 2 impact Permanent (P) or for Stream name mitigation (square feet) (square feet) Temporary T impact required? 61 ?P?T ?Yes ? No B2 ? P ? T ? Yes ? No B3 ?P?T ?Yes ? No 6h. Total buffer impacts 6i. Comments: Although located within the Catawba River Basin, proposed project is not located within protected buffer. Page 6of12 PCN Form - Version 1.3 December 10, 2008 Version + 4 -W D. Impact Justification and Mitigation 1. Avoidance and Minimization 1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project. Project is designed to minimize the amount of material to be placed within the stream, but maximize the protection of the currently exposed line and additional lines within the section of right-of-way. 1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques. Measures to control sediment and erosion will be implemented prior to any ground disturbance and will be maintained throughout project construction. Permanent grass will be planted to help control erosion immediately following any fianl ground disturbing activity. Native annual small grains and herbs appropriate for the season will be planted. Fescue based mixtures will be avoided. Also, fertilizers and pesticides will not be used near streams. Additionally, construction best management practices, using pre-formed concrete mats, working in the dry, clean uncontaminated fills, and permanent soil stabilization measures. 2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State 2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State? ? Yes ®No 2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps 2c. If yes, which mitigation option will be used for this project? ? Mitigation bank El Payment to in-lieu fee program ? Permittee Responsible Mitigation 3. Complete if Using a Mitigation Bank 3a. Name of Mitigation Bank: 3b. Credits Purchased (attach receipt and letter) Type Quantity 3c. Comments: 4. Complete if Making a Payment to In-lieu Fee Program 4a. Approval letter from in-lieu fee program is attached. ? Yes 4b. Stream mitigation requested: linear feet 4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold 4d. Buffer mitigation requested (DWQ only): square feet 4e. Riparian wetland mitigation requested: acres 4f. Non-riparian wetland mitigation requested: acres 4g. Coastal (tidal) wetland mitigation requested: acres 4h. Comments: 5. Complete if Using a Permittee Responsible Mitigation Plan 5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan. Page 7 of 12 PCN Form - Version 1.3 December 10, 2008 Version 1 6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ 6a. Will the project result in an impact within a protected riparian buffer that requires ? Yes ® No buffer mitigation? 6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the amount of mitigation required. 6c. 6d. 6e. Zone Reason for impact Total impact Multiplier Required mitigation (square feet) (square feet) Zone 1 3 (2 for Catawba) Zone 2 1.5 6f. Total buffer mitigation required: 6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank, permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund). 6h. Comments: Project is located within the Catawba River Basin; however, it is located outside of the protected riaprian buffer zones of the Catawba River mainstem. Page 8 of 12 PCN Form - Version 1.3 December 10, 2008 Version E. Stormwater Management and Diffuse Flow Plan (required by DWQ) 1. Diffuse Flow Plan 1 a. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No within one of the NC Riparian Buffer Protection Rules? 1 b. If yes, then is a diffuse flow plan included? If no, explain why. ? Yes ? No Comments: 2. Stormwater Management Plan 2a. What is the overall percent imperviousness of this project? 0% 2b. Does this project require a Stormwater Management Plan? ? Yes ® No 2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Total project imapcts (temporary and permanent) are less than 1 acre. 2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan: ? Certified Local Government 2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program ? DWQ 401 Unit 3. Certified Local Government Stormwater Review 3a. In which local government's jurisdiction is this project? Gaston ? Phase II 3b. Which of the following locally-implemented stormwater management programs ? NSW ? USMP apply (check all that apply): ? Water Supply Watershed ? Other: 3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No attached? 4. DWQ Stormwater Program Review ? Coastal counties ? HQW 4a. Which of the following state-implemented stormwater management programs apply ? ORW (check all that apply): ? Session Law 2006-246 ? Other: 4b. Has the approved Stormwater Management Plan with proof of approval been attached? ? Yes ? No 5. DWQ 401 Unit Stormwater Review 5a. Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No 5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No Page 9 of 12 PCN Form - Version 1.3 December 10, 2008 Version S U Or F. Supplementary Information 1. Environmental Documentation (DWQ Requirement) 1 a. Does the project involve an expenditure of public (federal/state/local) funds or the ? Yes ® No use of public (federal/state) land? 1 b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the requirements of the National or State ? Yes ? No (North Carolina) Environmental Policy Act (NEPA/SEPA)? 1 c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval ? Yes ? No letter.) Comments: 2. Violations (DWQ Requirement) 2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No or Riparian Buffer Rules (15A NCAC 2B.0200)? 2b. Is this an after-the-fact permit application? ? Yes ® No 2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s): 3. Cumulative Impacts (DWQ Requirement) 3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No additional development, which could impact nearby downstream water quality? 3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the most recent DWQ policy. If you answered "no," provide a short narrative description. 4. Sewage Disposal (DWQ Requirement) 4a. 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. No wastewater is anticipated to be generated from the propsed project. Any sewage generated will be contained within a porta-potty and hauled off site by an authorized waste disposal company at the completion of the project. Page 10 of 12 PCN Form -Version 1.3 December 10, 2008 Version u i 5. Endangered Species and Designated Critical Habitat (Corps Requirement) 5a. Will this project occur in or near an area with federally protected species or ? Yes ® No habitat? 5b. Have you checked with the USFWS concerning Endangered Species Act ® Yes ? No impacts? E:1 Raleigh 5c. If yes, indicate the USFWS Field Office you have contacted. ® Asheville 5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat? USFWS Threatened and Endangered Species list for Gaston County and USFWS sent a letter to Submar and Asheville Regulatory Field Office on June 29 indicating the propsed project would have "no effect" on Endangerd Species or Designated Critical Habitat. 6. Essential Fish Habitat (Corps Requirement) 6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No 6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat? http://ocean.floridamarine.org/efh_coral/ims/viewer.htm and EFH layer on Google Earth 7. Historic or Prehistoric Cultural Resources (Corps Requirement) 7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation ? Yes ® No status (e.g., National Historic Trust designation or properties significant in North Carolina history and archaeology)? 7b. What data sources did you use to determine whether your site would impact historic or archeological resources? Electronic resources at http://www.hpo.dcr.state.nc.us and National Register of Historic Places layer on Google Earth and concurrence letter sent to the State Historic Preservation Office on June 9, 2011. 8. Flood Zone Designation (Corps Requirement) 8a. Will this project occur in a FEMA-designated 100-year floodplain? ® Yes ? No 8b. If yes, explain how project meets FEMA requirements: Project packet sent to Gaston County floodplain administrator for review and permit determination. 8c. What source(s) did you use to make the floodplain determination? The National Flood Hazard Layer (NFHL) for Google Earth developed by the Federal Emergency Management Agency (FEMA), its mapping partners, and America's communities. Viewed data from the National Flood Hazard Layer as an overlay in Google Earth. Additionally, map was viewed at www.gastongov.com and hftp://www.ncfloodmaps.com. G" ry). U"lC- 1 rla/t ?m C? .,k Applicant/Agent's Printed Name Applicant/Agent's Signature Date (Agent's signature is valid only if an authorization letter from the applicant is provided.) Page 11 of 12 PCN Form - Version 1.3 December 10, 2008 Version u ? SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO. A PLAN NO. N?A PARCEL ID: `a U504? STREET ADDRESS: _NlA •- iiLynSco &A 4 - 9 - j? ( ?• ???? " el. P1 b91) W -j ess e r C •?, -N C (SZ A999) Please print: Property Owner: Tran S W - Add r+ : Mr, RQM A l l Property Owner: The undersigned, registered property owners of the above noted property, do hereby authorize random N. Cork , of ?ubr•ar}Irc. (Contractor / Agent) (Name of consulting firm) to act on my behalf and take all actions necessary for the processing, Issuance and acceptance of this permit or certification and any and all standard and special conditions attached. Property Owner's Address (if different than property above): a'WW b4- Oe-k ?3c:? to «r,nl r Hoc's 6n 'Ty -1-10510 Telephone: 1 13 ° a 15 - N X? We hereby certify the above Information submitted In this application Is true and accurate to the best of our knowledge. A ed SI Authorized Signature Date: A j /2-40 11 Date: r?N W T /VNESSEEA E TENNESEEAVE y BOSTON q CORD tnx = C'P?SOP ??? ';;, 32 = ° BESS pAVF cF2J , ' Uw2 RHYNE ST _ R a q cc y E CLEVELq E T ENryESSE E lNDlANA AVE o'p tn; H tix NO AVE AVE 3 O0 w ?PV CAS WELL AVE N EAST GASTON RD as D lZ?~ O 1 a P H V i w S w ? O 1? 3 ti n p m J PQ '' 3 13 ?4) P may: 0 A (35.25887,-81.27697) m N m X w' 2 ?? Gt m -?• t p ?C?`?y m z m 1341 29 VICTOaY lN- '!b 250' `-" p ° Z Q? g t yly? 29 " ?r9 108 A I MOUNTAIN VILLAGE CIR C q- 108 ?A( ?OJ ap0. 0Z419 Q? c ;r0 i % 3 r? z9 N 'P° o <? 0 'a 'R' r y Alm 2 IINWOOD RE) F Q2 On 3 J' Mountain View `? O z j O ARCH! O o S ti E WHITES 0 IDES R w ft z 0 800 600 Zoom 400 1 3200 4000 Data eRENnt poo c! S 805 Dunn Street PROJECT TITLE: Houma, LA 70360 36-inch Line B Exposure Repair in Phone: 985-868-0001 Fax: 965-851-0106 _ Tributary to Abernethy Creek Willia Gas Pipelines Email. submar@submarcom Gaston County i6Z? Transco Website. www.submar.com ,>..A Bessemer City, North Carolina SOURCE: DeLorme Street Atlas USA 2009 DRAWING NO.: SB2999 DATE: 06/09/2011 SHEET TITLE., Vicinity Map SHEET: Figure 1 ?OGp? `ry$ tix N 9r2? Bessemer City W PENNSYLVANIA AVE ?x ay 42 _ 2 ate, 2 ?P? 9L<1 SR 1307 27? E VIRGINIA AVE ?? o y y PENNSyLV ]\ . - j x ANlA N :, ^ SR 13A 0 VE .' uO x n P k HARTFORD AVE W BpST0N AVE h 9Jy? n W !Np OSA E h 2 Z I ,_y w n ? r, f4 Z ?.U-,(-- IN k '", o t ti _f 2 r u. -74 „ E S •sr 06 1 ? 805 Dunn Street PROJECT TITLE: Houma, LA 70360 36-inch Line B Exposure Repair in .? Phone: 985-868-0001 Fax: 985-851-0108 Tributary to Abernethy Creek W illiams Gas Pipelines Email: submar@submarcom Gaston County Website: www.submar.com Transco 5L7-.,j..r>:Bessemer City, North Carolina SOURCE: USGS 7.5 Minute Topo, "Bessemer City, NC". DRAWING NO.: SB2999 DATE: 06/09/2011 SHEET TITLE: Too Ma SHEET: Fi ure 2 Map dated 2003. P P 9 • I 1P ¦ 1= 805 Dunn Street Houma, LA 70360 Phone 985-868-0001 Fax: 985-851-0108 Email: submar@submarcom Website: www.submar.com rrl..yt..aC lt.G..- SOURCE: Google Earth, 2011 Imagery M PROJECT TITLE: 36-inch Line B Exposure Repair in Tributary to Abernethy Creek Gaston County Bessemer City, North Carolina DRAWING NO.: SB2999 DATE: 06/09/2011 V a Gas Pipelines 46 Transco SHEET TITLE: Aerial Map I SHEET: Figure 3 V a Looking Upstream 4 ?u arA? y ?x+ r ? writ C` 3' k G r ''x:41 w? w 805 Dunn Street Houma, LA 70360 Phone: 985-868-0001 Fax 985-851-0108` _ Email: submar@submar com Website: www.submar.com SOURCE: Site Visit March 31. 2009 Looking Upstream PROJECT TITLE: 36-inch Line B Exposure Repair in Tributary to Abernethy Creek Gaston County Bessemer City, North Carolina DRAWING NO.: SB2999 DATE: 06/09/2011 Willi" Gas Pipelines ? 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