20071640 Ver 1_Application_20070927

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STATE of NORTH CAROLINA ~R~~~C
DEPARTMENT OF TRANSPORTATION '~
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
DIVISION 4
September 11, 2007
Mr. William Wescott
U.S. Army Corps of Engineers
Washington Regulatory Field Office
Post Office Box 1000
Washington, North Carolina 27889-1000
(Two Copies)
Mr. Robert Ridings
Wetlands/401 Unit
NC DENR Division of Water Quality
2321 Crabtree Blvd
Raleigh, NC 27604
(Seven Copies)
071640
SUBJECT: Halifax County, Improvement of SR 1815 (Whites Fork Road)
WBS Element: ~ C , ~ ~ 205
Dear Sirs:
The North Carolina Department of Transportation (NCDOT) proposes to pave SR 1815
to bring the road into compliance with standard safety design specifications. This activity
will result in impact to an UT to Deep Creek due to the replacement and extension of a
crossline to facilitate travel lane and shoulder widening. The NCDOT anticipates that the
pipe replacement activity will be authorized under Nationwide Permit (NWP) 14 as well
as a Nationwide Permit (NWP) 33 due to dewatering needs. This application is also
intended as request for written authorization from the NC Division of Water Quality to
replace the pipe under General Water Quality Certificate # 3404 (NWP 14). The
following information is being provided to satisfy Nationwide Permit Condition 13
(Federal Register January 15, 2002) and Condition 1 of General Water Quality
Certificate # 3404.
Post Office Box 3165, Wilson, North Carolina 27895-3165
Phone [phone] Fax [phone]

APPLICATION INFORMATION
Enclosed please find the Pre-construction Notification (PCN) Form and supporting
documentation for the above referenced project.
In accordance with North Carolina General Statute 143-215.3D(e) the following
information is being provided to facilitate payment of fees associated with the appropriate
Water Quality Certificate:
• Certificates being requested: #3404 (NWP 14) and #3366 (NWP 33)
• WBS Element: 46$9- ~ L . ~ ~f 20,5'
• Amount of fee: $200
PROJECT INFORMATION
Road Name

hues Fork Road SR Number

SR 1815 Project Length
(miles
0.93
Classification
Rural
River Basin: DIWDQ Water Quality Designation % New Impervious Surface
Tar-Pamlico 28-79-32-(0.5)
NSW C
Buffer Rules Buffer Use Designation
Tar-Pamlico Exempt

Protected Species Present Mapped Historic Properties
No No
PIPE REPLACEMENT INFORMATION
Site (Station) 39+25 -L- Map Status Shown on topo and ssurvey
Existing RCP Proposed CMP
Diameter (in) I g
Diameter
q2
Length (ft) 28 Length 60
Construction
Method
Pomp around
Dewatering
*

sheet pile
Device
Bwial Depth 9 Inches Substrate Sandy loam
Construction Date ASAP Duration One week
Impacts (ft.) 20-piped; -rip-rap protection ; -temporary
Comments

Restoration Pl Within l5 working days of the of the pipe replacement all cofferdams will be entirely removed and natural stream
an contours will be restored and seeded. Temporary silt screens placed in intermittent channels will be cleaned and
removed following vegetation establishment.
rc~r = remtorced concrete pipe; CMP =Corrugated metal pipe; CMPA =Corrugated metal pipe arch; * If needed.

FEDERALLY-PROTECTED SPECIES AND CULTURAL RESOURCES
The Fish and Wildlife Service (FWS) currently list three federally protected species for
Halifax County (Table 1).
Table 1-Federally Protected Species of Halifax County
Federal Habitat Biological
Common Name Scientific Name Status Present Conclusion
Ked-cockaded Picoides borealis E N No Effect
woodpecker
Dwarf wedge mussel Alasmidonta heterodon E N No Effect
Tar spiny mussel Elliptio steinstansana E N No Effect
No element occurrences are listed on the NHP database within one mile of the project
area. During the onsite visit, it was determined that there were no pine trees suitable for
RCW foraging or nesting are in, or adjacent to, the project area. There was also no habitat
suitable for the Dwarf wedge mussel or Tar spiny mussel. This project is not likely to
jeopardize the continued existence of any of the federally protected species listed in
Halifax County.
No sites eligible for listing on the National Register occur within the area of potential
effect. This project will not affect listed or eligible historic properties.
MINIMIZATION INFORMATION
Impacts will be minimized 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.
If you have any questions or need any additional information, please contact Jamie
Guerrero at [phone] or Chad Goggins at [phone]. Your time and effort are
appreciated.
Respectfully yours,
R. E. ne, Jr., PE
Division Engineer, Division 4
cc: Mr. Jamie Guerrero, Division Environmental Officer
Mr. Franz Enders, P.E., Assistant District 1 Engineer

Office Use Only: Form Version March OS
USACE Action ID No. DWQ No. 2 ~~ 7 1 6 4 0
/TC .. .t_
~-- »••, y.•==~»_,++ .~.,.,. ~~ av~ a~~iioaoic ~o tms project, ptease 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: 14 and 33
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
I. Owner/Applicant Information
Name: R.E._ Greene, Jr. P.E. Division Engineer
Mailing Address: North Carolina Department ofTransportation/Division 4
P.O. Box 3165
Wilson NC 27895-3165
Telephone Number: [phone]x3501 Fax Number: [phone]
E-mail Address: r~reene(a,dot.state.nc us
2. AgentlConsultant 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: Jamie Guerrero
Company Affiliation: Division Environmental Officer
Mailing Address: Division 4 - NCDOT
P.O. Box 3165
Wilson NC 27895-3165
Telephone Number: [phone]x3530 Fax Number: [phone]
E-mail Address: i~uen'ero(a~dot.state nc us
Updated 11/1/2005
Page 5 of 13

III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: SR 1815
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County:_Halifax USGS Hobgood Nearest Town: Roseneath
Subdivision name (include phase/lot number):
Directions to-site. (include road numbers/names, landmarks, etc.):
Take 258 north fromTarboro turn on right on SR 1816 then the first road to the ri twill be
SR 1815
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35.0529 °N 77.4501 °W
6. Property size (acres):,
7. Name of nearest receiving body of wtter:_ UT to Deep Creek (DWO ID•NSW C 28-79-32
0.5
8. River Basin: Tar-Pamlico
(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/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Rural wooded
Updated I 1 / 1 /2005
Page 6 of 13

10. Describe the overall project in detail, including the type of equipment to be used:
Road adin draina a base avin and erosion control as well as r lacin 1 line of 28' X
18" RCP with one line of 60'X42" CMP
Heavy construction equipment (backhoe excavator dump truck bulldozer grader will be
used
11. Explain the purpose of the proposed work:_ to brine dirt road into compliance with standard
safety desi>~n specifications.
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.
1. Provide a written description of the proposed impacts: we are ~ osing to replace and
upsize one wipe which will have a total stream impact of 32 linear feet (0 002 acres ~_
Updated 11/1/2005
Page 7 of 13

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 lmnactS due to hnth ctn,~t,,,-P a„rl fl~~rl;.,R

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)

Total Wetland Impact (acres)
3. List the total acreage (estimated) of all existing wetlands on the property:
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 a included: -To calculate acrea e, multi I len h X width, then divide b 43 560.
Stream Impact
Number

(indicate on ma)
St.39 + 25
Stream Name

UT to Dee Cneek
P
T e of Im act
~ p

Pi e U
p pgrade
Perennial or
Intermittent?

Intermittent Average

Stream Width
Before Im act
3 Impact

Length
linear feet)

32
St.39 + 25 UT to Deep Crreek Temp. Sheetpile
for dewaterin Intermittent 3 0

Total Stream Impact (by length and acreage)
5.
Area of
Impact
002
0.002
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, drainage, bulkheads, etc.
Updated 11 /1 /2005
Page 8 of 13

on
~ Total Open Water Impact (acres)
6. List the cumulative impact to all Waters of the U_S_ recultinu from the,,,-n;eer•
Stream Impact (acres): ,002 v
Wetland Im act (acres): 0
O en Water Im act (acres): 0
Total Impact to Waters of the U.S. (acres) .002
Total Stream Im act (linear feet): 32
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. Phis 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
Current land use in the vicinity of the pond: N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
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. Equipment staging and work
will be performed within the existing road footprint Strict enforcement of Best Mana ement
Practices for sedimentation and erosion control the protection of wetlands and surface waters
will be enforced.
Updated I 1 / 1 /2005
Page 9 of 13

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 aze 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 Cazolina (see DWQ website for most current
version.).
1._ Provide_a brief descripton_of_the~roposed-mitigation plan. -The description shoulclprovi~e -
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/lineaz 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.
2. Mitigation may also be made by payment into the North Cazolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applcant'_s_ responsibility to contact -the- NCEEP at
(919) '~15-0476 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://www nceep net/pa~es/inlieurenlace htm. If use of the NCEEP is proposed,
please check the appropriate box on page five and provide the following information:
Updated 11/1/2005
Page 10 of 13

Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount ofNon-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
IX. 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 ^
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
-- -
justif cation for these_impacts in_Sectian-ulI above.- All proposed impacts-must be fisted 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
(Meuse), 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 Meuse )? 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.
Updated 11/1/2005
Page 11 of 13

Zone* Impact
s uare feet) Multiplier Required
Miti ation
1 2563 3 (2 for Catawba)
2 1614 1.5
Total 4177
• c.une i extenas out su feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone I .
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.
All appropriate best mana>;ement practices for sediment and erosion control will be
implemented.
ewage isposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
N/A
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:
Updated I 1 / I /2005
Page 12 of 13

This nroiect is apart of the statewide secondary road paving_program
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).
hYNna:auu~geni•s Cigna
(Agent's signature is valid only if
- ~~~~ ~
Date
letter from the applicant is provided.)
updated t vii2oos
Page 13 of 13

I MI-'AC; I MAP
COUNTY Ha I i f ax S I TES SR 1815 -L - 39+30
SCA~E~ l " = 50' Franz Enders 9/ 1 1 / 07

- iopo~one - U~(r~ Hobgoad (NC) Topo Map Page 1 of 1
y u.i v.z 4.3 0.4 0.5 kie '~'
0 0.09 0.18 0.27 0.36 0.45 mi
36.0529°N, 77,4501°W (NAD27)
USGS Hobgood (NC) Quadrangle M=-9.761
Projection is UTM Zone 18 NAD83 Datum G=-1.443
http://www.topozone. com/print. asp?Iat=36.05285&lon=-77.45012&s=24&size=l&u=5&la... 9/11/2007