20120934 Ver 1_Application_20121008

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STATE OF NORTH CAROLINA [t,� Q 0(7 8 �
DEPARTMENT OF TRANSPORTATION k>44.O`��'R ?Q ,�
BEVERLY PURDUE P 0 Box 25201 Raleigh NC 27611 5202 EUdN 1d1 J<'
GOVERNOR PHONE [phone] SECRE(P 1
1'Cy
October 2 2012 .
Ms Amy Euhss
NCDENR, Division of Water Quality
Winston-Salem Regional Office 1 Aw
5
' 3 4
85 Waughtown Street
Winston-Salem,NC 27107
Subject 401 Authorization for LIBR project under NWP#3
Replace Bridge#89 on SR 1618
Surry County North Carolina
TIP#BD-5111M
WBS Element Number 453571 13 (DWQ Permit Fee=$240)
Dear Ms Euhss
The North Carohna Department of Transportation is scheduled to replace Bridge#89 on SR 1618
m Surry County with a new bridge at the same location The existmg 91 x 25 bridge is
structurally deficient The proposed structure is a three span bridge @ 130 long No on-site
detour is proposed All impacts associated with this replacement are due to bank armormg The
proposed armoring is mtended to stabihze the banks and maintain existing channel width Stream
impacts are tabulated below
Stream Impacts
Station ' Existing 14.E Proposed IV,- xTempocary , Riprap Total Impacts at
-NNumber Structure Structure4. ,fbeivatenne Impacts(feet) this Station(ft)
Bndge#89 91 x 25 Bndge 130 Bndge 0 75 75
Ipei UT#1 N/A 0 25 25
Total Project Impacts=100 feet
The project impacts are not significant m nature and should not alter the best usage for this
stream Stormwater from the bridge drop inlets will be routed to the buffer zone of Moores Fork
(Class WS-IV) All appropriate BMPs will be used during construction I have attached LIBR
Attachment G plan sheets a marked county map, a marked topography map and photographs
P 0 Box 250 N WnacEsBoRO NC 28659
PHONE [phone] FAx [phone]

Ms Amy Euhss
Bridge#89 on SR 1618
Page 2
October 2 2012
This project is scheduled for let m early November 2012 If further mfonnation is required please
let me know Your early review and consideration will be appreciated
Smcerely,
70e/A14 1.71
Heath Slaughter
Division Environmental Officer
Enclosures
cc Amy Chapman,NCDWQ (3 copies)
Mike Pettyjohn,PE Division Engineer
Janu Guynn, Division Bndge Program Manager
Heath Slaughter, Division Environmental Officer
Neil Tnvette, Roadside Environmental Field Operations Engineer

Attachment G Low/Minimal Impact Bridge Project Data Sheet
1 TIP NO BD-5111L BD-5111M BD-5111N BD-51110 BD-5111P
2 WBS Element No 45357 1 12_45357 1 13 45357 1 14 45357 1 15 45357 1 16
3 County Caldwell Surry Watauga Wilkes Wilkes
4 Bndge Number 316 89 108 11 100
Repalce Replace
Replace Replace Replace
bridge No 11 bridge No
Description
bridge bridge No 89 bridge over N Little 100 over
No 316 over over Moores No 108 over Hunting Purlear
LowerCreek Fork Cove Creek Creek Creek
5
6 Basin Catawba Yadkin ',Watauga Yadkin Yadkin
7 Classification C WS-IV C WS-III WS-IV
8 Stream SIN 11 39(0 5) 12 72 9 5 8-15 12 108 16 6 12 31 1 8(2)
9 Type Perennial Perennial Perennial Perennial Perennial
10 Size 13 X1 16 X2 18 X2 16 X1 15 X1
11 Type 1 span brg 3 span brg 1 span brg 2 span brg 1 span brg
12 Existing Structure Size 41 x 22 91 x 25 46 x 26 41 x 18 41 x 19
13 Suff Rating 25 6 22 5 40 9 20 28 4
14 Type Bridge Bridge Bndge Bridge Bridge
15 Proposed Structure Size 75 130 100 80 100
16 USACE(LF) 7 100 55 22 20
17 Stream NCDWQ Impacts(LF) 7 100 55 22 20
18 USAGE Impacts (AC) 0 0 0 0 0
19 Wetlands Non 404 Impacts(AC) 0 0 0 0 0
20 CAMA Impacts(SF) 0 0 0 0 0
21 NC DWG)Buffers Impacts(SF) 0 0 0 0 0
22 Buffer Applicaton Required(YIN) N N N N N
23 State Stormwater Permit Required(YIN) N N N N N
24 Habitat N N N N N
25 T&E Species Present NONE NONE NONE NONE NONE
26 Bio Conclusion NO EFFECT NO EFFECT NO EFFECT NO EFFECT NO EFFECT
27 Type None None BNT&RBT None None
Moratonum Oct 15 Apr
28 Dates None None 15 None None
29 Native/Hatchery No No Yes No No
30 Trout Species Present No No BNT&RBT No No
31 Trout Waters Trout Conditions(YIN) No No Yes No No
32 _WRC Reviewer McHenry McHenry McHenry McHenry McHenry
33 CAMA AECs No No No No No
34 Essential Fish Habitat No No No No No
35 Nay Opening No No No No No
36 USCG Permit No No No No No
37 Historic Properties No
38 Archaeological Resources No Survey S rvey Rey bred No Survey No Survey No Survey
39 Tnbal Lands No No No No No
40 4(f) Resources No No No No No
41 6(f)[LWCF] Resources No No No No No
42 Wild and Scenic River No No No No No
43 Federal Lands No No No No No
44 NA Area No No 1 Yes No No
45 FEMA Buyout No No No No No
46 FEMA Flood Study Limited Limited Limited Limited No
47 USTs Haz Mats N Observed None Observed N Observed N Observed N Observed
48 Relocatees None None None None None
49 Location LAT 35 94646 36 50967 36 29954 3613645 36 19262
50 LONG 8147457 80 70611 8176791 80 89749 8129405
51 Project Comments _
Completed by Date
Lead Engineer
Date
Division Environmental Officer

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