20160515 Ver 1_Application_20160520

Att�chment G: Low/Minim�l Ir�p��� �rid�� raj��t �t� h�
1 TIP NO
2 WBS Element No. '�?�P��i �1.F2.1 °15
3 Counfiy Yadkir� Yadkin
4 Bridge Number 9� 92
Descri tion Replace Brg# 91 over Replace Brg.# 92 over Little
5 p Forbush �reek Forbush Creek
6 Basin Yadki� Yadkin
7 Classification C C
8 5trearr� SIN 12-83-(0.3j 12-83-1
9 Type inland Inl�nd
10 S ize 15' 15'
11 Type �RID�E BRIDGE
12 Existing Structure Size 4�' x�.7' 35' x 19'
13 Scaff. Rating 48.19 21.88
14 Proposed Structure Type BRIDGE BRIDGE
15 5 ize 5�' x 27' 4�5' x 27'
1f USACE (LF) 21' (Perm.) 3i' (Temp.} 67' �Temp.)
��, Stream NCDWQ Impacts (LF) N/A N j�,
18 USACE Impacts (AC) N/� �1/�
19 Wetlands Non 4U4 Impacts (AG) NJ/� �I/A
20 CAMA Impacts (SF) N/A N/A
2�. NC DWQ Buf�ers Impacts (Sf) N/� N/,q
22 Buffer Applic�ton Required (Y/N) No i�o
23 State Stormwater Permit Required (Y/N) No �o
24 Nabitat NLE� I�LEB
25 T&E Species Present Non� I�one
26 Bio Conclusion MANLTAA MANLT,4/�
27 �ryoratorium Typ� �� ��
28 Dates N/�4 i�/�
29 Native/Hatchery N/A �I/A
3� Trout Waters Trout Species Present Non� �one
31 Trout Gonditions (YIN) �I f�
32 WRC Reviewer MJ Char�bers �J1J Chambers
33 CAMA AECs N jA N/A
34 Essential Fish Habitat No �Ia
35 Nav. Opening NJ� �l/�
36 USCG Permit No Nca
37 Historic Properties No I�o
38 Archaeologic�l Resources No I�o
39 Tribal Lands No l�o
40 4(f) Resources No No
41 6(f) [LWG�' Resources No �o
42 Wild arad Scenic River No �!o
43 Federal Lands No N�
44 TVA Area No �o
45 FEMA Buyout N f A �/A
46 FEMA Flood Study Limited Detailed Limited Detailed
47 USTs Haz Mats No No
48 Relocatees N o �l o
49 LAT 36.1509 36.1.5135
5� Location LONG -80.5�15 -80.5703
51 f'roject Camments
Completed b}�: Brian N. Elam, PE
Lead Engineer
� C���t� 0 5/2t;/1
vision Environmental C�ff' �

Carpenter, Kristi
From: Slaughter, Johnathan H
Sent: Friday, May 20, 2016 10:12 AM
To: Kichefski, Steven L SAW; Carpenter,Kristi; Wanucha, Dave
Cc: Huff, Christy; Griscom, Jason; Souther, Zachary S; Whitaker, Brandon W; Guynn, Jami C;
Johnson, Mark G
Subject: LIBR Yadkin #91 & #92
Attachments: Attachment G DB year 3 Group 11A-Yadkin_91_92.pdf, SF980091_92_Permit
Drawings.pdf, Yadkin #91 and #92 Topojpg
Steve,
See attached LIBR application for Yadkin bridges #91 and #92. The bridges are very close to each other so we are
submitting this as one application. Impacts include temporary dewatering and bank stabilization. No 401 is needed,
operating under GC. We estimate no more than 0.1 acres of tree clearing. Let me know if you have any questions.
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.

t ilghway North Carolina Department of Transportation
Storni Vater.
Highway Stormwater Program
STORMWATER MANAGEMENT PLAN --
(Version 2.01; Released December 2014) FOR NCDOT PROJECTS
WBS Element: 17BP.11.R.115 TIP No.: SF -980091 County(ies): Yadkin Page 1 of 1
General Project Information
WBS Element: 17BP.11.R.115 ITIP Number: SF -980091 Project Type: Bridge Replacement Date: 7/23/2015
NCDOT Contact: Marc Shown, PE
Contractor / Desi ner:
Sun ate Design Group, PA
Address: Hydraulics Unit
1590 Mail Service Center
Raleigh, NC 27699-1590
Address:
Phone:
Email:
915 Jones Franklin Road
Raleigh, NC 27606
Phone: [phone]
919 859-2243
Email: [e-mail]
belam sun atedesi n.com
Cit gown: Yadkinville
Count ies : Yadkin
River Basin(s): Yadkin -Pee Dee
ICAMA County? I No
Wetlands within Project Limits? No
Project Description
Project Length lin. miles or feet):
450 ft Surrounding Land Use: IRural, Agricultural
Proposed Project
Existing Site
Project Built -Upon Area ac.
0.2 ac.
0.2 ac.
Typical Cross Section Description:
Paved 9' lanes with 3' grassed shoulder section
Paved 9' lanes with 2' grassed shoulder section
Annual Avg Daily Traffic (veh/hr/day):
Design/Future: N/A Year: 2035
Existing: 300 Year: 2011
General Project Narrative:
(Description of Minimization of Water
Quality Impacts)
SF -980091 is a bridge replacement project that involves removing Yadkin County bridge #91, on SR 1599 (Mt. Carmel Church Rd.) over Forbush Creek, and replacing with a
1@47.75, 21" cored slab bridge with vertical sheet pile abutments. The existing bridge is 1 @ 40' steel I-beam with timber deck, timber caps and timber abutments. Deck drains
will not be used on the proposed structure. Measures have been taken to reduce or eliminate impacts to surrounding properties and jurisdictional waters located within the
project limts, including maintaining existing drainage patterns, discharging roadway runnoff as far away from the stream as is practicable and utilizing rip rap to dissicpate energy
from stormwater discharge at ditch and flume outlets.
Waterbody Information
Surface Water Body (1): Forbush Creek NCDWR Stream Index No.: 12-83-(0.3)
NCDWR Surface Water Classification for Water Body Primary Classification: Class C
Supplemental Classification: None
Other Stream Classification: None
Impairments: None
Threatened/Endangered Species? Comments:
NRTR Stream ID:
Buffer Rules in Effect: N/A
Project Includes Bridge Spanning Water Body?
iYes
I Deck Drains Discharge Over Buffer? INo
Dissipator Pads Provided in Buffer? N/A
Deck Drains Discharge Over Water Body?
INo
I (If yes, provide justification in the General Project Narrative)
I
(If yes, describe in the General Project Narrative; if no, justify in the
General Project Narrative)
(If yes, provide justification in the General Project Narrative)

t ilghway North Carolina Department of Transportation
Storniwater.
Highway Stormwater Program
STORMWATER MANAGEMENT PLAN _-
(Version 2.01; Released December 2014) FOR NCDOT PROJECTS
WBS Element: 17BP.11.R.115 TIP No.: SF -980092 County(ies): Yadkin Page 1 of 1
General Project Information
WBS Element: 17BP.11.R.115 ITIP Number: SF -980092 Project Type: Bridge Replacement Date: 3/5/2015
NCDOT Contact: Marc Shown, PE
Contractor / Desi ner:
Sun ate Design Group, PA
Address: Hydraulics Unit
1590 Mail Service Center
Raleigh, NC 27699-1590
Address:
Phone:
Email:
915 Jones Franklin Road
Raleigh, NC 27606
Phone: [phone]
919 859-2243
Email: [e-mail]
belam sun atedesi n.com
Cit (Town: Yadkinville
Count ies : Yadkin
River Basin(s): Yadkin -Pee Dee
ICAMA County? I No
Wetlands within Project Limits? No
Project Description
Project Length lin. miles or feet):
370 ft Surrounding Land Use: IRural, Agricultural
Proposed Project
Existing Site
Project Built -Upon Area ac.
0.2 ac.
0.2 ac.
Typical Cross Section Description:
Paved 9' lanes with 3' grassed shoulder section
Paved 9' lanes with 2' grassed shoulder section
Annual Avg Daily Traffic (veh/hr/day):
Design/Future: N/A Year: 2035
Existing: 300 Year: 2011
General Project Narrative:
(Description of Minimization of Water
Quality Impacts)
SF -980092 is a bridge replacement project that involves removing Yadkin County bridge #92, on SR 1599 (Mt. Carmel Church Rd.) over Little Forbush Creek, and replacing with
a 1@42.75, 21" cored slab bridge with vertical sheet pile abutments. The existing bridge is 1 @ 35' steel I-beam with timber deck, timber caps and timber abutments. A deck
drain will be used at each end of the bridge, discharging over rip rap bank stabilization at the end bents. Measures have been taken to reduce or eliminate impacts to
surrounding properties and jurisdictional waters located within the project limts, including maintaining existing drainage patterns, discharging roadway runnoffas far away from
the stream as is practicable and utilizing rip rap to dissicpate energy from stormwater discharge at ditch and flume outlets.
Waterbody Information
Surface Water Body (1): Little Forbush Creek NCDWR Stream Index No.: 12-83-1
NCDWR Surface Water Classification for Water Body Primary Classification: Class C
Supplemental Classification: None
Other Stream Classification: None
Impairments: None
Threatened/Endangered Species? Comments:
NRTR Stream ID:
Buffer Rules in Effect: N/A
Project Includes Bridge Spanning Water Body?
Yes
Deck Drains Discharge Over Buffer? INo
Dissipator Pads Provided in Buffer? N/A
Deck Drains Discharge Over Water Body?
INo
(If yes, provide justification in the General Project Narrative)
(If yes, describe in the General Project Narrative; if no, justify in the
General Project Narrative)
(If yes, provide justification in the General Project Narrative)

Ll
STATE OF NORTH CAROLINA PERMIT DRAWING sTw� TwTe PRae T ReFRREN E No.
DIVISION OF HIGHWAYS SHEET 1 OF 6 17BP.11.R.11
PROI. NO. . w. PROD. NO.
17 BP.11. R.115
17 BP.11. R.115
17BP.1l.R.115
YADKIN COUNTY
LOCATION: BRIDGES #980091 AND #980092 OVER
FORB USH CREEK & LITTLE FORB USH CREEK
ON SR 1599 (MOUNT CARMEL CHURCH ROAD)
TYPE OF WORK: GRADING, PAVING, DRAINAGE, & STRUCTURE
WETLAND AND SURFACE WATER IMPACTS PERMIT
END CONSTRUCTION
THIS PROJECT IS NOT WITHIN A MUNICIPAL BOUNDARY. APPROX.250'FROM END PROJECT
CLEARING ON THIS PROJECT SHALL BE PERFORMED TO TIE PAVEMENT MARKINGS TO EXISTING
THE LIMITS ESTABLISHED BY METHOD III.
soot
�� SMITH—ROWS, LLC
STV En
900 gineers, Iuc.
ll V West Trade St, Suite
Ea7q� Charlotte, NC 28202
NC License Number F-0991
GRAPHIC SCALES
DESIGN DATA
PROJECT LENGTH
s
�Ce
o�
u11-1
N
��Oii
tea.
1oLN
1J/' O� I
7 $9 L tis
oU
END PROJECT oma°
900 West Trade St., Ste. 715, Charlotte NC, 28202
NC License Number F-0991
Mohr
M Chir 15R9 N
MChurcharmel
SR
5g9
SR 1
9
ADT 2035 = N/A
V (980091) = 20 MPH
LENGTH OF STRUCTURE PROJECT 17BP.II.R.l15 = 0.018 MILES
PE
BEGIN PROJECT
\Pilo
PLANS
CgaUsy
Ch Urch V.
Rd
V (980092) = 25 MPH
T = b%*
TOTAL LENGTH OF PROJECT 17BP.II.R.115 = 0.155 MILES
S °c�
p o°
$R 151 p
a
�p �a
®r 8waw�
SIGNATURE:
O
Q -a
tibb�
�
v
D
SIO 4
sR 21 Rd
e�
4 2 0 4 8
* TTST=3%, DUALS=3%
160S
STATE OF NORTH CAROLINA PERMIT DRAWING sTw� TwTe PRae T ReFRREN E No.
DIVISION OF HIGHWAYS SHEET 1 OF 6 17BP.11.R.11
PROI. NO. . w. PROD. NO.
17 BP.11. R.115
17 BP.11. R.115
17BP.1l.R.115
YADKIN COUNTY
LOCATION: BRIDGES #980091 AND #980092 OVER
FORB USH CREEK & LITTLE FORB USH CREEK
ON SR 1599 (MOUNT CARMEL CHURCH ROAD)
TYPE OF WORK: GRADING, PAVING, DRAINAGE, & STRUCTURE
WETLAND AND SURFACE WATER IMPACTS PERMIT
END CONSTRUCTION
THIS PROJECT IS NOT WITHIN A MUNICIPAL BOUNDARY. APPROX.250'FROM END PROJECT
CLEARING ON THIS PROJECT SHALL BE PERFORMED TO TIE PAVEMENT MARKINGS TO EXISTING
THE LIMITS ESTABLISHED BY METHOD III.
soot
�� SMITH—ROWS, LLC
STV En
900 gineers, Iuc.
ll V West Trade St, Suite
Ea7q� Charlotte, NC 28202
NC License Number F-0991
GRAPHIC SCALES
DESIGN DATA
PROJECT LENGTH
PLANS PREPARED FOR THE NCDOT BY:
HYDRAULICS
STV/RALPH WHITEHEAD ASSOCIATES, INC.
ENGINEER
20 10 0 20 40
ADT 2011 = 300
900 West Trade St., Ste. 715, Charlotte NC, 28202
NC License Number F-0991
Mohr
LENGTH OF ROADWAY PROJECT 17BP.II.R.115 = 0.137 MILES
®t �
2012 STANDARD SPECIFICATIONS
ADT 2035 = N/A
V (980091) = 20 MPH
LENGTH OF STRUCTURE PROJECT 17BP.II.R.l15 = 0.018 MILES
PE
PLANS
20 10 0 20 40
V (980092) = 25 MPH
T = b%*
TOTAL LENGTH OF PROJECT 17BP.II.R.115 = 0.155 MILES
RIGHT OF WAY DATE:
APRIL 15, 2014
BRIAN K. LUSK, PE
a
�p �a
®r 8waw�
SIGNATURE:
ROADWAY
DESIGN
ENGINEER
PROJECT ENGINEER
PROFILE (HORIZONTAL)
4 2 0 4 8
* TTST=3%, DUALS=3%
NCDOT CONTACT: VIRGINIA MABRY
LETTING DATE.
PATRICK A. LIVINGSTON, EI
PROJECT DESIGNER
FUNC. CLASSIFICATION:
APRIL 15, 2014
fflfflffl
RURAL LOCAL
Priority Projects Unit
PROFILE (VERTICAL)
PE
SIGNATURE:

IMPERVIOUS
DIKE

WETLAND PERMIT IMPACT SUMMARY
WETLAND IMPACTS SURFACE WATER IMPACTS
Site
No.
Station Structure
(From/To) Size / Type
Permanent
Fill In
Wetlands
(ac)
Temp.
Fill In
Wetlands
(ac)
Excavation
in
Wetlands
(ac)
Mechanized
Clearing
in Wetlands
(ac)
Hand
Clearing
in
Wetlands
(ac)
Permanent
SW
impacts
(ac)
Temp.
SW
impacts
(ac)
Existing
Channel
Impacts
Permanent
(ft)
Existing
Channel
Impacts
Temp.
(ft)
Natural
Stream
Design
(ft)
13+67 / 13+95 -L- Dewatered Area / Imp. Dike
< 0.01
37
1
13+65 / 13+95 -L- LT Rip Rap at Embankment
< 0.01
21
2
18+14 / 18+58 -L- Dewatered Area / Imp. Dike
< 0.01
67
TOTALS*:
< 0.01
0.02
21
104
0
*Rounded totals are sum of actual impacts
NOTES:
2013 1024