20071113 Ver 1_Application_20070626

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DEPAR'T1VIENT OF TRANSPORTATION a'~R~~,
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MICHAEL F. EASLEY
GOVERNOR
June 22, 2007
U. S. Army Corps of Engineers
Regulatory Field Office
Post Office Box 1890
Wilmington, NC 28402-1890
ATTENTION: Mr. Richard Spencer
NCDOT Coordinator
Dear Sir:
LYNDO TIPPETT
SECRETARY
07111$
SUBJECT: Nationwide 14 Permit and Section 401 Water Quality Certification Application
for the Palmer Road Extension from NC 211 at SR 1149 (East Palmer Road) to NC
20 at SR 1403 (Oakdale Gin Road). NCDOT Division 8, State Project No.
8.2530301, WBS No. 34979.1.1, T.I.P. No. U-3816.
Please find the enclosed copies of the permit drawings, half-size roadway designs plans, and Pre-
construction Notification for the subject project.
The North Carolina Department of Transportation (NCDOT) proposes to construct atwo-lane
road on new location referred to as the Palmer Road Extension. The limits of construction are
from the intersection of NC 211 with East Palmer Road to the intersection of NC 20 with
Oakdale Glen Road in Raeford. The new facility will include two lanes, a 12-foot wide travel
lane in each direction, plus 8-foot shoulders, 4-feet of each shoulder will be paved. The
proposed road will utilize a bridge that will span the Rockfish Railroad tracks. The bridge will
include two lanes, 12-foot wide in each direction with a 4 -foot shoulder.
The purpose of this project is to:
1. Improve traffic flow while minimizing sociaUenvironmental disruption in the southern
portion of Raeford by providing a continuous route from NC 211 to NC 20.
2. Provide regional connectivity between US 1 and I-95.
3. Provide local connectivity between other circumferential facilities in Hoke County and the
industries that are coming to the project area.
4. Remove from local street truck and other through traffic accessing US 401 and I-95 via NC
20.
5. Provide access for the development to this area of Raeford, including a city park planned for
the northeastern quadrant of the project and an industrial park planned for the southeastern
quadrant.
6. Maintain the functional integrity of Palmer Road to operate as a major collector and major
thoroughfare.
MAILING ADDRESS: TELEPHONE: [phone] LOCATION:
NC DEPARTMENT OF 71iANSPORTATiON FAX: [phone] CAPTFOL BOULEVARD
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS PARKER LINCOLN BUQ.DPIG, SUITE Z4O
1598 MA-L SERVICE CENTER W6BSrre: R'WW.NCDOT.ORG RALEIGH NC 27699
RALEIGH NC 27699-1598

NEPA Document Status
An Environmental Assessment was approved October 28, 2003. A Finding of No Significant
Impact was approved on March 31, 2005. Existing and projected conditions in the study azea
were described including natural systems and wetlands. Alignments were evaluated with respect
to costs, social and economic impacts, and environmental consequences. The EA and FONSI
have been provided to regulatory review agencies involved in the approval process. Additional
copies will be provided upon request.
The subject project is in compliance with 23 CFR Part 771.111(f) which lists the Federal
Highway Administration (FHWA) characteristics of independent utility of a project:
1. The project connects logical termini and is of sufficient length to address environmental
matters on a broad scope
2. The project is usable and a reasonable expenditure, even if no additional transportation
improvements aze made in the azea
3. The project does not restrict consideration of alternatives for other reasonably foreseeable
transportation improvements.
Indirect and Cumulative Effects
.The proposed project connects two roads neaz the town of Raeford, in Hoke county just south of
Fayetteville, Oakdale Gin road and East Palmer road. This connection will complete a loop
azound the south side of Raeford, bridging over the Rockfish Railroad. The improved road
network will allow travel between NC 20 and NC 211, eliminating much of the truck traffic from
the residential and downtown azeas, improving safety and congestion.
Much of the land within the vicinity of the proposed project is farmland, scattered residential and
some light industrial. The market for development in Raeford is not robust. However, as there
are some lands neazby which are zoned for light industrial and neighborhood business uses, there
will likely be instances of these activities developing along the proposed project. While the
project will provide new access where it does not currently exist, the short length of the project
(0.9 miles) and the limited market for development will not likely provide for widespread
development. Furthermore, as there aze no 303(d) waters, High Quality Waters, Water Supply
Watersheds, prime/unique farmland or other sensitive resources within the immediate vicinity,
the indirect and cumulative effects stemming from the proposed project should be moderate to
minimal.
Impacts to Waters of the United States
The project is located in the Cape Fear River Basin (sub-basin 03-06-OS) in Hoke County. This
area is part of Hydrologic Cataloging Unit 03030004 of the South Atlantic-Gulf Coast Region.
An intermittent unnamed tributary to Peddler's Branch (UT 1) is located within the project azea.
UT1 does not have a separate Best Usage Classification and, therefore, shares the Best Usage
Classification of its receiving waters, Peddlers Branch (DWQ Index # 18-31-16), a Division of
Water Quality Class "B" Waters of the State. There are no impacts to water resources within the
project azea.
No designated Outstanding Resource Waters (ORW), High Quality Waters (HQW), Water
Supply I (WS-I), or Water Supply (WS-II) waters occur within 1.0 mile of the study corridor.
U-3816 Permit Application
Page 2 of 6

There are no streams listed on the Fina12004 303(d) List of Impaired Waters within 1-mile of the
project area.
There are two riverine wetlands located within the project area. U.S. Army Corps of Engineers
(USAGE) representative Richard Spencer verified the wetlands on January 11, 2001. NCDOT
biologists Erica McLamb, Greg Price, and Ashley Cox reviewed the wetlands during a site visit
on January 9, 2007 and determined that there have been no changes to the jurisdictional
wetlands.
Permanent Impacts
Site 1 is located at station 38+20 -L-; a total of 0.21 acre of riverine wetlands will be
permanently impacted in this area. Construction of the new road and 66 inch reinforced concrete
pipe will result in 0.17 acre of permanent fill into the wetland located at Site 1. Mechanized
clearing to allow for construction access will result- in the remaining 0.04 acre of permanent
impact.
Temporary Impacts
Site 2 is located from station 49+30 to 50+28-L-. There will be 0.08 acre of temporary impacts
to riverine wetlands resulting from the placement of temporary fill necessary for the temporary
work mats and the temporary work pad. The temporary work mats will allow a crane access to
the temporary work pad for a work crane. The temporary work pad will be used to support a
crane during construction of the bridge.
Hand .Clearing
There will be 0.36 acre of impacts to riverine wetlands resulting from hand clearing at Site 2 to
allow for construction access.
Utility Impacts
There will be no impacts to jurisdictional wetlands resulting from the removal or relocation of
utilities impacted by this project.
Federally Protected Species
Plants and animals with federal classifications of Endangered (E), Threatened (T), Proposed
Endangered (PE), Proposed Threatened (PT), are protected under provisions of Section 7 and
Section 9 of the Endangered Species Act of 1973, as amended. As of January 29, 2007, the
United States Fish and Wildlife Service lists six federally protected species for Hoke County.
Table 1 list the species and their federal status.
U-3816 Permit Application
Page 3 of 6

Table 1. Federally Protected Species in Hoke County. NC
Common Name Scientific Name Federal Status Biological Conclusion Habitat
Present
Neonympha
St. Francis satyr mitchellii E No Effect No
rancisci
red-cockaded

wood ecker picoides borealis E No Effect No
rough-leaved Lysimachia

loosestrife
a erulae olia E No Effect No
American chaffseed Schwalbea E No Effect No
americana
Alligator
American alligator mississippiensis T(S/A) N/A No
Michaux's sumac Rhus michauxii E No Effect Yes
The project area was evaluated on June 5, 2002 and August 17, 2005 for potential habitat for
federally listed species in Hoke County. Suitable habitat is not present within the project azea for
the red-cockaded woodpecker, St. Francis satyr, rough-leaved loosestrife, American chaffseed, or
the American alligator. Biological Conclusions of "No Effect" were given in the EA.
Suitable habitat is present for Michaux's sumac. All areas containing suitable habitat were
surveyed for Michaux's sumac on June S, 2002 and August 17, 2005, no specimens were
observed. A biological conclusion of "no effect" was given in the EA. Based on comments
received from USFWS in a letter dated December 31, 2003, the biological conclusion was
changed to "may affect, not likely to adversely affect." However, due to changes in terminology
and protocol the biological conclusion was changed back to "no effect."
A review of the North Carolina Natural Heritage Program database on March 16, 2007 revealed
no occurrences of Michaux's sumac, St. Francis satyr, rough-leaved loosestrife, American
chaffseed, or the American alligator within 1.0 mile of the project azea. There is a NCNHP
elemental occurrence of the red-cockaded woodpecker located approximately 0.9 mile from the
project, however, according to NCNHP records the cluster was destroyed and all the nesting trees
were cut. Therefore, biological conclusions of "No Effect" remain valid for all federally
protected species in Hoke County.
Avoidance, Minimization, and Compensatory Mitigation
Avoidance, Minimization, and Mitigation: The NCDOT is committed to incorporating all
reasonable and practicable design features to avoid and minimize jurisdictional impacts, and to
provide full compensatory mitigation of all remaining, unavoidable jurisdictional impacts.
Avoidance measures were taken during the planning and NEPA compliance stages; minimization
measures were incorporated as part of the project design.
According to the Clean Water Act (CWA) §404(b)(1) guidelines, NCDOT must avoid, minimize,
and mitigate, in sequential order, impacts to Waters of the US. The following is a list of the
project's jurisdictional stream avoidance/minimization activities proposed or completed by
NCDOT:
U-3816 Permit Application
Page 4 of 6

Avoidance/Minimization:
• The bridge over the railroad at Site 2 was lengthened to span the wetlands.
• The fill slopes were steepened to 1.75:1 at station 45+50 -L- lt. to 49+00 -L- to avoid the
wetlands.
• Temporary work mats will be used in wetlands at Site 2.
• Preformed scour hole located at Site 1 will be used dissipate energy of stormwater discharge
prior to entering wetland.
• The 66-inch reinforced concrete pipe will be buried one foot at Site 1.
Based on the above considerations, it is determined that there is no practicable alternative to the
proposed construction in jurisdictional Waters of the U.S. and that the proposed action includes
all practicable methods to avoid and/or minimize jurisdictional wetland impacts that may result
from such use.
Compensatory Miti ation:
The NCDOT has avoided and minimized impacts to jurisdictional resources to the greatest extent
possible as described above. The unavoidable permanent impacts to 0.21 acre of riverine
wetland will be offset by mitigation credit currently available within Hydrologic Cataloging Unit
03030004 from the Little River Bridge Mitigation Site.
The Little River Bridge Mitigation Site was constructed as onsite mitigation for T.I.P R-0210A
US 1 bypass in Moore County. The 14.8-acre site is located in Moore County, 0.75 miles
southeast of the town of Vass and crosses over the Little River. Access to the site is via US 1
South Business on the northeastern boundary. The 14.8-acre site includes 6.4 acres of restoration
and 8.4 acres of preservation of bottomland hardwood forest. The site was monitored in 2006 and
met prescribed hydrologic and vegetative success criteria.
The site was originally debited for R-0210A in July 2002. To offset 0.21 acres of unavoidable
impacts to riverine wetlands due to TIP U-3816, the Site will be debited 0.42 acres of riverine
wetland restoration based on a 2:1 mitigation ratio. These debits are reflected in the debit ledger
below.
Table 2. Onsite Mitigation Debit Ledger w/ Residual Assets
Site name HUC Mitigation Type Original(acres) Available Debit Debit
Little River 3030004
R-0210A U-3816
Riverine Preservation 8.4 0 8.4
Riverine Restoration 6.4 1.18 4.8 0.42
Schedule
At this time the project is scheduled to let December 18, 2007 (review date of November 6,
2007) with a date of availability of January 9, 2008. It is expected that the contractor will choose
to start construction in January.
U-3816 Permit Application
Page 5 of 6

Regulatory Approvals
Section 404 Permit: Application is hereby made for the Department of Army Section 404
Nationwide Permit 14 authorizing the above-described activities.
Section 401 Permit: The NCDOT will adhere to all conditions of the General Water Quality
Certifications (WQC) 3627. Written concurrence from the NCDWQ is required. In accordance
with 15A NCAC 2H 0.0501(a) and 15A NCAC 2B 0.200 we are providing five copies of this
application to the North Carolina Department of Environment and Natural Resources, Division
of Water Quality, for their review and approval.
A copy of this permit application will be posted on the NCDOT website at:
http://www.ncdot.org/doh/preconstruct/pe/. If you have any questions or need additional
information, please call Erica McLamb at 715-1521.
Sincerely
~.
~{J~ Gregory Thorpe, Ph.D
Environmental Management Director, PDEA
w/attachment
Mr. John Hennessy, NCDWQ (5 Copies)
Mr. Travis Wilson, NCWRC
Mr. Gary Jordan, USFWS
Dr. David Chang, P.E., Hydraulics
Mr. Mark Staley, Roadside Environmental
Mr. Greg Perfetti, P.E., Structure Design
Mr. Victor Barbour, P.E., Project Services Unit
Mr. Tim Johnson, P.E., Division 8 Engineer
Mr. Art King, Division 8 Environmental Officer
w/o attachment
Mr. Jay Bennett, P.E., Roadway Design
Mr. Majed Alghandour, P. E., Programming and TIP
Mr. Art McMillan, P.E., Highway Design
Mr. Scott McLendon, USACE, Wilmington
Ms. Jennifer Fuller, PDEA
Mr. Randy Griffin, P.E ,Mitigation Implementation Team
Ms. Lelani Paugh, ICUOn-Site Mitigation Group
Mr. Robert Deaton, Public Involvement and Community Studies
U-3816 Permit Application
Page 6 of 6

Office Use Only: Form Version March OS
2 C ~ -, ~ 1 3
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ^ Riparian or Watershed Buffer Rules
^ Section 10 Permit ^ Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ^ Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NW 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 Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ^
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ^
II. Applicant Information
1. Owner/Applicant Information
Name: Gregory J. Thorpe, Ph.D., Environmental Management Director
Mailing Address: 1598 Mail Service Center
Raleigh, NC 27699-1548
Telephone Number: [phone] Fax Number: (9191733-9794
E-mail Address:
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: N/A
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page 1 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 lazger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Proposed construction of Raeford-Palmer Extension on new location from
NC 211 at SR 1149 (East Palmer Rd.l to NC 20 at SR 1403 (Oakdale Gin Rd.)
2. T.I.P. Project Number or State Project Number (NCDOT Only): U-3816
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Hoke Nearest Town: Raeford
Subdivision name (include phase/lot number):
Directions to site (include road numbers/names, landmarks, etc.): see mad in permit
drawings
5. Site coordinates (For lineaz projects, such as a road or utility line, attach a sheet that
sepazately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 34.9664 °N 79.2236 °W
6. Property size (acres): N/A
7. Name of nearest receiving body of water: UT to Peddlers Branch Creek
8. River Basin: Cane Feaz
(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/maQs/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: The project area is primarily farmland with some business
developments and forested areas.
Page 2 of 9

10. Describe the overall project in detail, including the type of equipment to be used:
The Palmer Rd. Extension will be constructed on new location. Heavy duty excavation
eauipment will be used such as trucks dozers cranes and other various equipment necessary
for roadway construction.
11. Explain the purpose of the proposed work: To improve traffic flow through the southern
portion of Raeford provide connectivity between US 1 and I-p5, provide connectivity
between facilities in Hoke County and future industries, remove trucks and through traffic
from local streets, provide access for development, and to maintain the functional integrity of
Palmer Road to operate as a major collector and thoroughfare.
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. N/A
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.
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. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should 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.
Page 3 of 9

1. Provide a written description of the proposed impacts: Please refer to attached cover letter.
2. Individually list wetland impacts. Types of 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.
Wetland Impact
Site Number
(indicate on map)
Type of Impact Type of Wetland
(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Floodplain
( es/no) Distance to
Nearest
Stream
(linear feet) Area of
Impact
(acres)
1 Permanent Fill Riverine Yes 110 0.17
1 Mechanized Clearing Riverine Yes 100 0.04
2 Temporary Fill Riverine Yes 100 0.08

Total Wetland Impact (acres) 0.29
3. List the total acreage (estimated) of all existing wetlands on the property: 0.88 acre
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, 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. To calculate acreage, multi ly len X width, then divide by 43,560.
Stream Impact
Number
(indicate on ma)
Stream Name
Type of Impact
Perennial or
Intermittent? Average
Stream Width
Before Im act Impact
Length
linear feet Area of
Impact
(acres)

Total Stream Impact (by length and acreage) 0 0
Page 4 of 9

5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dredging, flooding, draina e, bulkheads, etc.
Open Water Impact

Site Number
(indicate on ma)
Name of Waterbody
(if applicable)

Type of Impact Type of Waterbody

(lake, pond, estuary, sound, bay,
ocean, etc.) Area of

Impact
(acres)

Total Open Water Impact (acres) 0
6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): 0
Wetland Impact (acres): 0.29
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) 0
Total Stream Impact (linear feet): 0
7. Isolated Waters
Do any isolated waters exist on the property? ^ Yes ®No
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
8. 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.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond: Expected pond surface area:
Page 5 of 9

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. Please refer to the attached
cover letter
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 January 15, 2002, 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 NCEEP 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.
Page 6 of 9

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.
Mitigation is required for the proposed permanent impacts to riverine wetlands resulting from
mechanized clearing and the placement of permanent fill within portions of the wetlands
Wetland impacts will be offset by mitigation credit currently available within Hydrologic
Cataloging Unit 03030004 from the Little River Brid a Mitigation Site
2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet): .0
Amount of buffer mitigation requested (square feetj: 0.
Amount of Riparian wetland mitigation requested (acres): 0
Amount ofNon-riparian wetland mitigation requested (acres): 0
Amount of Coastal wetland mitigation requested (acres): 0
lX. Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ® No ^
2. 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 ^
3. 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 ^
Page 7 of 9

X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes ^ No
2. If "yes", 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.
* I Impact I I Required
Zone ,~~,.~_~ c ~~, Multiplier ,,,~,,:__~,__
1 3 (2 for Catawba)
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration /Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (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. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level. N/A
XII. Sewage Disposal (required by DWQ)
Page 8 of 9

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.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ^ No
Is this an after-the-fact permit application? Yes ^ No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ® No ^
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description:
XV. 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).
None
~•~ ;, 5 ~_ty•u
Applicl[nt/A~nt's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9

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