20070074 Ver 1_Application_20070112

~~~~~
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415
GOVERNOR
January 8, 2007
Ms. Sue Homewood
NC DENR Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
(One Color Copy)
Mr. Monte Matthews
U.S. Army Corps of Engineers
Regulatory Field Office
6508 Falls of the Neuse Road, Suite 105
Raleigh, North Carolina. 2761
(Two Copies)
`"~
LYNDO TIPPETT
SECRETARY
0'~~fl ~
SUBJECT: Alamance County, Repair of culvert on Gilbreath Street (SR 2100) crossing an
unnamed tributary of Haw River State Project Number: 7B.200111
To Whom It May Concern:
The North Carolina Department of Transportation (NCDOT) proposes to repair rusted out culverts
on Gilbreath Street (SR 2100) near Graham in Alamance County. The existing culverts are failing
due to bottoms of pipes rusting out. Repair is necessary in order to maintain traffic safety. It will
consist of pouring concrete in the bottom of the corrugated metal pipes during a dewatered state.
NCDOT believes that the pipe repair activity will be authorized under Nationwide Permit (NWP) 3
and 33. This application is intended as a request for Nationwides 3 and 33 from the US Army Corps
of Engineers. We are also providing a courtesy notification to NC Division of Water Quality to
repair the pipes under General Water Quality Certificate # 3494 (NWP 3) and notification under
#3366 (NWP 33). The following information is being provided to satisfy Condition 1 of General
Water Quality Certificate # 3494 and #3366.
PHONE [phone] FAX [phone]
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PROJECT INFORMATION
Road Name SR Number Project Length
(miles) Classification
Gilbreath Street SR 2100 N/A Suburban
River Basin: DWQ
ID Water Quality
Desi nation % Impervious Surface
Cape Fear 16-(1) C; NSW N/A
Buffer Rulesa Buffer Rule Conditions (where a licable)
No Not A licable
Protected Species
Presentb Mapped Historic
Pro erties` CAMA
AEC Essential Fishery
Habitat
No No No No
a Separate documentation attached as needed: ° See the attached Endangered Species Review Sheet for further
information: ° When Applicable -See the attached Historic Review Letter for further information
PIPE REPAIR INFORMATION
Site N/A Stream Type Perennial
Station
Existing Pipe 80' long X 75"high X 112" wide Proposed Repair of existing pipe
Work
Construction Pump Around Dewatering ABC Aggregate
Method Device*
Burial Depth N/A E/C Plan See Attached
Date
Construction As soon as practicable Duration 15 days
Date
Im acts ft. Olin. ft-enclosure; A rox. 100 s . $ -tem or im acts durin dewaterin
Special
Conditions
Restoration Within 15 working days of the of the pipe replacement the natural stream
Flan contours will be restored and seeded. Temporary silt screens placed along
shoreline will be cleaned and removed followin ve etation establishment.
RCP =reinforced concrete pipe; CMP =Corrugated metal pipe; CMPA =Corrugated metal pipe arch; E/C =
Erosion control. *A less intrusive dewatering device may be used in lieu of the one proposed.
-2-

MINIMIZATION INFORMATION
Impacts will be minimised by strict enforcement of Best Management Practices for the protection of
surface waters and wetlands, restrictions against the staging of equipment in or adjacent to waters of
the US, and coordination (including apre-construction meeting) with the Division Environmental
Officer.
MITIGATION INFORMATION
Stream mitigation is not anticipated, as the impacts to any individual stream do not exceed 150 feet
Wetland mitigation is not anticipated, as wetland impacts do not exceed 0.10 acres and do not occur
in a unique natural wetland.
APPLICATION INFORMATION
Enclosed please find the Pre-construction Notification Form and supporting documentation for the
above referenced project. If you have any questions or need any additional information, please
contact Dennis Johnson at [phone] or Jerry Parker at [phone]. Your time and effort
are appreciated.
Sincerely,
~1
. Mills, P.E.
Division Engineer, Division 7
cc: Mr. Jerry Parker, Division Environmental Officer
Mr. Chuck Edwards, District Engineer
Mr. Dennis Johnson, Bridge Maintenance Engineer
Mr. Mike Venable, County Maintenance Engineer
Mr. Barry Harrington, Area Roadside Field Operations Engineer
Wetlands/401 Unit NCDENR DWQ Raleigh
-3-

Office Use Only' Form Version October 2001
20070074
USACE Action ID No. DWQ No.
If any particulaz item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
I. Processing
1. Check all of the approval(s) requested for this project:
_ Section 404 Permit
^ Section 10 Permit
® 401 Water Quality Certification
^ Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 3 & 33
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here X
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII -Mitigation), check here: X
II. Applicant Information
1. Owner/Applicant Information
Name; Mr J M Mills P E Division Engineer -Division 7
Mailing Address: P O Box 14996
Greensboro NC 27415
Telephone Number:,~33~ 334-3192 Fax Number: X336) 334-3673
E-mail Address: mmills~a dat state nc us
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: Jerry Parker --
Company Affiliation: NCDOT -Division 7
Mailing Address: 1584 Yance_yville Street
Greensboro NC 27415
Telephone Number: (336256-2063 Fax Number:~33~ 334-4149
E-mail Address: jpazker~a dot state ne us
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 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: Gilbreath Street (SR 21001
2. T.I.P. Project Number or State Project Number (NCDOT Only:#7B.200111(non-TIPL_
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Alamance Nearest Town: Graham.
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From I-85/40 take Exit 148 near
Graham in Alamance County and head south on NC 54 for approximately one mile to Ivey
Street Turn right on Ivey Street and continue approximately 0 5 miles to Gilbreath Street.
Turn left on Gilbreath Street and continue approximately one mile to the site
5. Site coordinates, if available (LTTM or Lat/Long):_ See the attached USGS map.
(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 Forest and agricuturall with few residences.
7. Property size (acres):
8. Nearest body of water (stream/river/sound/ocean/lake): UT to Haw River
9. River Basin: Cade Fear
Page 2 of 9

(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/.)
10. Describe the purpose of the proposed work: To repair culverts to increase traffic safety
11. List the type of equipment to be used to construct the project: Road construction
~uipmen~trackhoe Grader backhoe and bulldozer)
12. Describe the land use in the vicinity of this project: Suburban.
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:
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 3 of 9

1. No~ermanent stream impacts are anticipated Temporary stream impacts will result from the
dewatering activities.
2. 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***
N/A

r„
* List each impact separately and identify temporary impacts. Impacts include, but are not limtteo to: mecnantzea cieanng, graamg, nu,
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 httU://www.fema.~ov.
*** 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
3. 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 Im act Perennial or
Intermittent?
(leases eci

Gilbreath Street
Culvert repair 0 ft(en)
100sf(tmp)
Ot r )
UT to Haw River
4 to 8 ft
Perennial

* List each impact separately and identify temporary impacts. Impacts include, but are not timnea to: cuiver[s ana associates np-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
~~~v uscs.~,ov. Several Internet sites also allow direct download and printing of USGS maps (e.g., wtivw.topozone.com,
www.uiaygllest.com, etc.).
*Cumulative impacts (linear distance in feet) to all streams on site: Project should involve 0
linear feet of stream impacts -enclosure (en) 0 ft
tem~porarX (tmp, sandbags and rock silt dams in streams---approximately 100 sf ,
riprap (rol permanent placement of riprap at each end of pipe ---approximately O if total
Page 4 of 9

4. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water ofthe 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,
ba ,ocean, etc.
N/A

* List each impact separately and identify temporary impacts. Impacts mcluae, but are not iimitea to: nu, excavai~on, oreagmg,
flooding, drainage, bulkheads, etc.
5. 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.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
VII. Impact Justification (t~voidance and Minimization)
VIII. 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
Culvert repair activities are necessary to maintain traffic safety. Impacts will be minimized by
strict enforcement of Best Management Practices for the protection of wetland and surface
waters restrictions against the staging of equipment in or adjacent to waters of the US, and
coordination (including a Qre-construction meeting) with the Division Environmental Officer.
~. 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
Page 5 of 9

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 far Stream Work in North Carolina, available at
htt~//h2o.enr.state nc.us/ncwetlands/strmgide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
A fmdin og f insignificant impact is anticipated• therefore a mitigation plan is not provided.
Cumulative impacts are less than 150 feet. The maximum amount of permanent impacts to a
single stream is approximately 0 linear feet. No Outstanding, Resource Waters, federally
protected species or their habitats or essential fisher habitats occur in the project area. This
project is not located in a High Quality Water area.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at http://1~2o.ei~r.state.nc.us/wrp/indea.htm. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Page 6 of 9

Amourrt of stream mitigation requested (linear feet): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount ofNon-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
X. 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 ^
XI. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify N/A )?
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. ~f buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Page 7 of 9

Zone* Impact
s uare feet Multiplier Required
Miti ation
1 3
2 l .5
Total
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Gone 1 extends an
additiona120 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration /Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
N/A
XII. Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
In accordance with the February 25 1991 delegation agreement one copy of the sediment and
erosion control plan will be submitted to DENR -Division of Land Resources and NCDOT
Roadside Environmental Prior to construction
XIII. 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.
XIV. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ^ No X
Isthis anafter-the-fact permit application?
Yes - No X
Page 8 of 9

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).
m
~-~'-~~
s Signature
Date
is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9

N.C. D.O.T.
BRIDGE MAINT. DEPT.
EROSION CONTROL SEQUENCE
COUNTY Alamance
S.R. No. SR 2100 1:~~ 1 ~ ~ ' .f c~ ~ ~ ~~
BRIDGE No. 363
PROJECT No. 78.200111
DESCRIPTION: POUR CONCRETE IN BOTTOM OF CM PIPE THAT HAS RUSTED OUT
FOR PROMPT ACTION REPAIR WRITTEN BY BRIDGE INSPECTORS DURING
A ROUTINE INSPECTION.
Note:
Ail Erosion Control devices $ proper installation plus maintenance of erosion control will be pertormed
~Iby using - NCDOT Best Management Practices for Construction and Maintenance Activites Manual
1. CONSTRUCT TEMPORARY DIVERSION DAM WITH SANDBAGS TO FORCE STREAM
INTO PIPE NO. 1
2, BUILD S~ PLACE PLYWOOD FORMS IN FRONT OF PIPE 2
3. PLACE LARGE WOODEN PADS ON BACKSIDE OF PIPE 2 -PADS WILL BE PLACED
TEMPORARY TO MOVE CONCRETE BUGGY IN & OUT OF CULVERT WHILE POURING
CONCRETE. PADS WILL BE COVERED WITH FILTER FABRIC TO KEEP ANY FRESH
CONCRETE FROM ENTERING STREAM.
5. POUR CONCRETE IN PIPE 2
6. AFTER CONCRETE HAS CURED
7. REMOVE FORMS
8. DIVERT STREAM INTO PIPE 2 WITH SANDBAGS
9. BUILD FORMS FOR PIPE 1
10.PLACE LARGE WOODEN PADS ON UPSTREAM SIDE OF PIPE 1
FOR CONCRETE BUGGY TO ENTER PIPE
COVER WITH FILTER FABRIC SO NO CONCRETE WILL ENTER STREAM
11. POUR CONCRETE in PIPE No. 1
12. LET CONCRETE CURED
13. REMOVE FORMS
17. APPROXIMATE PROJECT START DATE N/A
PREPARED BY ~ ~ T NSPORTATION SUPV. DATE
APPROVAL DIV. BRIDGE ENG. DATE
11122/2006
II-22-D4
jcomell

COUNTY Alamance SEQUENCE 1
S.R. No. SR 2100
BRIDGE No. 363
1 DIVERT STREAM INTO PIPE 1 WITH SANDBAGS
2 BUILD FORMS FOR PIPE 2
3 PLACE LARGE WOODEN PADS ON DOWNSTREAM SIDE OF PIPE 2
FOR CONCRETE BUGGY TO ENTER PIPE
4 COVER WITH FILTER FABRIC SO NO CONCRETE WILL ENTER STREAM
5 POUR CONCRETE in PIPE No. 2
6 AFTER CONCRETE HAS CURED
N
jcornell

COUNTY Alamance SEQUENCE 2
S.R. No. SR 2100
BRIDGE No. 363
8 DIVERT STREAM INTO PIPE 2 WITH SANDBAGS
9 BUILD FORMS FOR PIPE 1
10 PLACE LARGE WOODEN PADS ON UPSTREAM SIDE OF PIPE 1
FOR CONCRETE BUGGY TO ENTER PIPE
COVER WITH FILTER FABRIC SO NO GONCRETE WILL ENTER STREAM
11 POUR CONCRETE in PIPE No. 1
12 LET CONCRETE CURED
jcornell

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Gilbreath Street (SR 2100) -View of inlet pipes from upstream side.

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Name: MEBANE Location: 036° 02' 46.4" N 079° 22' 19.6" W
Date: 1/8/2007 Caption: Gilbreath Street (SR 2100)
Scale: 1 inch equals 2000 feet Alamance County
Copyright (C) 1997, Maptech, Inc