20060118 Ver 1_COMPLETE FILE_20060123

O?O? W AT ?9QG
0 'C
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
March 27, 2006
DWQ Project # 06-0118
Bertie County
Town of Powellsville
P.O. Box 219
Powellsville, NC 28513
Subject Property:
Town of Powellsville Sanitary Sewer
Ut to White Oak Swamp [030210, 24-2-4, C, SW]
Approval of 401 Water Quality Certification with Additional Conditions - REVISED
Dear Sir or Madam:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 4 linear feet of perennial stream as described in your application dated January
3, 2006, and received by-the Division of Water Quality (DWQ) on January 23, 2006 for the purpose of
installation of a sewer force main at the site. After reviewing your application, we have decided that the
impacts are covered by General Water Quality Certification Number(s) 3374 (GC3374). The
Certification(s) allows you to use Nationwide Permit(s) NW 12 when issued by the US Army Corps of
Engineers (USACE). This Certification replaces the Certification issued on March 14, 2006. In addition,
you should obtain or otherwise comply with any other required federal, state or local permits before you
go ahead with your project including (but not limited to) Erosion and Sediment Control, and Non-
discharge regulations. Also, this approval to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application shall expire upon expiration of the 404 or CA IA
Permit.
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for,
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 2H.0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.
The Additional Conditions of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:
Amount Approved nits Plan Location or Reference
Stream 4 linear feet PCN attachment
401 Oversight/Express Review Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: http://h2o.enr,stite.nc.us/ncwctlands
Nort hCarolina
Naturallif
An Equal Opportunity/Affirmative Action Employer- 50% Recycled/10% Post Consumer Paper
Tomi of Powellsville
Page 2 of 5
March 27, 2006
2. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre-Construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
3. Erosion and sediment control practices must be in full compliance with all specifications governing
the proper design, installation and operation and maintenance of such Best Management Practices in
order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor-owned or leased borrow pits associated with the project.
c. Sufficient materials required for stabilization and/or repair of erosion control measures and
stormwater routing and treatment shall be on site at all times.
4. Sediment and Erosion Control Measures
Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that
the Division of Land Resources has released the project;
5. Protective Fencing
The outside buffer, wetland or water boundary and along the construction corridor within these
boundaries approved under this authorization shall be clearly marked with orange warning fencing
(or similar high visibility material) for the areas that have been approved to infringe within the
buffer, wetland or water prior to any land disturbing activities to ensure compliance with 15A
NCAC 213.0233 and GC 3404;
6. 'Sewer Systems
The project shall comply with 15A NCAC 2H .0219(i)(2)(G) and all other State, Federal and local
sewer system regulations.
7. Construction Stormwater Permit NCGO 10000
Upon the approval of an Erosion and Sedimentation Control Plan issued by the Division of Land
Resources (DLR) or a DLR delegated local erosion and sedimentation control program, an
NPDES General stormwater permit (NCGO10000) administered by DWQ is automatically issued
to the project. This General Permit allows stormwater to be discharged during land disturbing
construction activities as stipulated by conditions in the permit. If your project is covered by this
Town of Powellsville
Page 3 of 5
March 27, 2006
permit [applicable to construction projects that disturb one (1) or more acres], full compliance
with permit conditions including the sedimentation control plan, self-monitoring, record keeping
and reporting requirements are required. A copy of this permit and monitoring report forms may
be found at http://l12o.enr.state.nc.us/su/Forms Docunients.htni.;
8. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable
Buffer Rules, and any subsequent modifications, the applicant is required to return the attached
certificate of completion to the 401 Oversight/Express Review Permitting Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650.
Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification, shall expire upon
expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or
stream impacts), you may ask for an adjudicatory hearing. You must act within 60 days. of the date that
you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of
the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a
hearing.
Any disputes over determinations regarding this Authorization Certificate (associated with the approved
buffer impacts) shall be referred in writing to the Director for a decision. The Director's decision is
subject to review as provided in Articles 3 and 4 of G.S. 150B.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act and the Neuse riparian buffer protection rule as described within 15A NCAC 2B .0233. If you have
any questions, please telephone Cyndi Karoly or Ian McMillan at 919-733-1786.
Sincerely,
Alan W. Klimek, P.E.
AWK/ijm
Enclosures: GC 3374
Certificate of Completion
cc: Bradley Gillam, McDavid Associates, Inc., P.O. Box Drawer 49, Farmville, NC 27828
USACE Washington Regulatory Field Office
Kyle Barnes, DWQ Washington Regional Office
DLR Washington Regional Office
File Copy
Central Files
Filename: 060118TOPowellsvilleS anitaryS ewcr(B ertie)401 _edited

WAT ?9PG
co
WG
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
March 14, 2006
DWQ Project # 06-0118
Bertie County
Town of Powellsville
P.O. Box 219
Ayden, NC 28513
Subject Property:
Town of Powellsville Sanitary Sewer
Ut to White Oak Swamp [030210, 24-2-4, C, SW]
Approval of 401 Water Quality Certification with Additional Conditions
Dear Sir or Madam:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 4 linear feet of perennial stream as described in your application dated January
3, 2006, and received by the Division of Water Quality (DWQ) on January 23, 2006 for the purpose of
installation of a sewer force main at the site. After reviewing your application, we have decided that the
impacts are covered by General Water Quality Certification Number(s) 3374 (GC3374). The
Certification(s) allows you to use Nationwide Permit(s) NW 12 when issued by the US Army Corps of
Engineers (USACE). In addition, you should obtain or otherwise comply with any other required federal,
state or local permits before you go ahead with your project including (but not limited to) Erosion and
Sediment Control, and Non-discharge regulations. Also, this approval to proceed with your proposed
impacts or to conduct impacts to waters as depicted in your application shall expire upon
expiration of the 404 or CAMA Permit.
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 2H .0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.
The Additional Conditions of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:
Amount Approved (Units) Plan Location or Reference
Stream 4 (linear feet) PCN attachment
401 Oversight/Express Review Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Interact: http://h2o.enr.suile.ne.us/ncwctlands
No `hCarolina
Naturally
An Equal Opportunity/Affinnative Action Employer- 50% Recycled/10% Post Consumer Paper

Town of Powellsville
Page 2 of 5
March 14, 2006
2. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre-Construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
3. Erosion and sediment control practices must be in full compliance with all specifications governing
the proper design, installation and operation and maintenance of such Best Management Practices in
order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor-owned or leased borrow pits associated with the project.
c. Sufficient materials required for stabilization and/or repair of erosion control measures and
stormwater routing and treatment shall be on site at all times.
4. Sediment and Erosion Control Measures
Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that
the Division of Land Resources has released the project;
5. Protective Fencing
The outside buffer, wetland or water boundary and along the construction corridor within these
boundaries approved under this authorization shall be clearly marked with orange warning fencing
(or similar high visibility material) for the areas that have been approved to infringe within the
buffer, wetland or water prior to any land disturbing activities to ensure compliance with 15A
NCAC 213.0233 and GC 3404;
6. 'Sewer Systems
The project shall comply with 15A NCAC 2H .0219(i)(2)(G) and all other State, Federal and local
sewer system regulations.
7. Construction Stormwater Permit NCGO10000
Upon the approval of an Erosion and Sedimentation Control Plan issued by the Division of Land
Resources (DLR) or a DLR delegated local erosion and sedimentation control program, an
NPDES General stormwater permit (NCGO10000) administered by DWQ is automatically issued
to the project. This General Permit allows stormwater to be discharged during land disturbing
construction activities as stipulated by conditions in the permit. If your project is covered by this
permit [applicable to construction projects that disturb one (1) or more acres], full compliance
Town of Powellsville
Page 3 of 5
March 14, 2006
with permit conditions including the sedimentation control plan, self-monitoring, record keeping
and reporting requirements are required. A copy of this permit and monitoring report forms may
be found at http://h2o.enr.state. nc.uslyulFornis Doctanents.htm.;
8. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable
Buffer Rules, and any subsequent modifications, the applicant is required to return the attached
certificate of completion to the 401 Oversight/Express Review Permitting Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650.
Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification, shall expire upon
expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or
stream impacts), you may ask for an adjudicatory hearing. You must act within 60 days of the date that
you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of
the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a
hearing.
Any disputes over determinations regarding this Authorization Certificate (associated with the approved
buffer impacts) shall be referred in writing to the Director for a decision. The Director's decision is
subject to review as provided in Articles 3 and 4 of G.S. 150B.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act and the Neuse riparian buffer protection rule as described within 15A NCAC 2B .0233. If you have
any questions, please telephone Cyndi Karoly or Ian McMillan at 919-733-1786.
AWK/ijm
Enclosures: GC 3374
Certificate of Completion
Sincerely,
//-Ill Alan W. Klimek, P.E.
cc: Bradley Gillam, McDavid Associates, Inc., P.O. Box Drawer 49, Farmville, NC 27828
USACE Washington Regulatory Field Office
Kyle Barnes, DWQ Washington Regional Office
DLR Washington Regional Office
File Copy
Central Files
Filename: 060118TOPowcllsvilleSanitarySewer(Benie)401
WQC #3374
UTILITY LINE BACKFILL AND BEDDING CERTIFICATION
GENERAL CERTIFICATION FOR PROJECTS ELIGIBLE
FOR CORPS OF ENGINEERS NATIONWIDE PERMIT NUMBER 12 OR
REGIONAL PERMIT 198100049 (UTILITY LINE BACKFILL AND BEDDING)
AND RIPARIAN AREA PROTECTION RULES (BUFFER RULES)
This General Certification is issued in conformity with the requirements of Section 401,
Public Laws 92-500 and 95-217 of the United States and subject to the North Carolina Division of
Water Quality (DWQ) Regulations in 15A NCAC 2H, Section .0500 and 15A NCAC 2B .0200 for
the discharge of fill material to waters and wetland areas as described in 33 CFR 330 Appendix A
(B) (12) and General Permit No. 198100049 of the Corps of Engineers regulations (i.e., including
any fill activity for utility line backfill and bedding) and for the Riparian Area Protection Rules
(Buffer Rules) in 15A NCAC 2B .0200. This certification replaces Water Quality Certification
(WQC) Number 2664 issued on January 21, 1992, Water Quality Certification Number 3022
issued on September 6, 1995, Water Quality Certification (WQC) Number 3101 issued on
February 11, 1997 and Water Quality Certification Number 3288 issued on June 1, 2000. This
WQC is rescinded when the Corps of Engineers reauthorize Nationwide 12 or Regional Permit
198100049 or when deemed appropriate by the Director of the Division of Water Quality.
The State of North Carolina certifies that the specified category of activity will not violate
applicable portions of Sections 301, 302, 303, 306 and 307 of the Public Laws 92-500 and 95-217
if conducted in accordance with the conditions hereinafter set forth.
Conditions of Certification:
1. Activities covered by this General Certification do not require written concurrence from the
Division of Water Quality as long as they comply with all conditions of this General
Certification and the conditions of Nationwide 12 or Regional Permit 198100049 as
appropriate. If any condition in this Certification cannot be met, application to and written
concurrence from DWQ are required. Also, Condition No. 6 is applicable to all streams in
basins with riparian area protection rules;
2. In accordance with North Carolina General Statute Section 143-215.3D(e), any request
for written concurrence for a 401 Water Quality Certification must include the appropriate
fee. If a project also requires a CAMA Permit, one payment to both agencies shall be
submitted and will be the higher of the two fees;
In accordance with 15A NCAC 2H .0506 (h) compensatory mitigation may be required for
stream and/or wetland impacts. Streamside buffer mitigation may be required for any
project with Buffer Rules in effect at the time of application for buffer impacts resulting
from activities classified as "allowable with mitigation" within the "Table of Uses" section of
the Buffer Rules or require a variance under the Buffer Rules. A determination of buffer,
wetland and stream mitigation requirements shall be made by DWQ for any Certification
involving written concurrences including those for relevant Buffer Rules;
4. The edge of the construction corridor shall not be installed parallel to and closer than 10
feet (3 meters) to a stream and 25 feet in waters classified as HQW. Utility lines shall not
cross a stream channel at other than a near-perpendicular direction (i.e., stream channel
crossings shall not be at an angle of less than 75 degrees or more than 105 degrees to
the stream bank);
WQC #3374
5. Any wastewater line that crosses any stream shown on the most recent version of the
1:24,000 USGS topographic map or NRCS (SCS) County Soil Survey as permanent or
intermittent shall be installed with no joints connected within the footprint of a stream
channel or within 2 feet of the stream banks. Otherwise, written concurrence from DWQ
is required;
6. Impacts to any stream length in the Neuse, Tar-Pamlico, Randleman and Catawba River
Basins (or any other river basins with Buffer Rules in effect at the time of application)
requires written concurrence from DWQ in accordance with 15A NCAC 2B.0233,.0259,
.0250 and .0243. Activities listed as "exempt" from these rules do not need to apply for
written concurrence under this Certification. New development activities located in the
protected 50-foot wide riparian areas (whether jurisdictional wetlands or not) within the
Neuse, Tar-Pamlico and Randleman River Basins shall be limited to "uses" identified
within and constructed in accordance with 15A NCAC 2B .0233-0259-0250 and .0243.
All new development shall be located, designed, constructed, and maintained to have
minimal disturbance to protect water quality to the maximum extent practicable through
the use of best management practices;
7. Measures shall be taken to prevent live or fresh concrete from coming into contact with
waters of the state until the concrete has hardened;
8. Herbicides can be applied in wetlands or other waters only when applied by a certified
applicator, and in strict accordance with product labeling;
9. Placement of rip rap is restricted to the stream bottom and banks directly impacted by the
placement of the utility line. Rip rap may only be used below the normal high water level.
The stream cross section must be restored to its original grade and elevation. Placement
of rip rap or other materials shall not result in de-stabilization of the stream bed or banks
upstream of downstream of the crossing;
10. That appropriate sediment and erosion control practices which equal or exceed those
outlined in the most recent version of the "North Carolina Sediment and Erosion Control
Planning and Design Manual" or the "North Carolina Surface Mining Manual" whichever is
more appropriate (available from the Division of Land Resources (DLR) in the DENR
Regional or Central Offices) shall be in full compliance with all specifications governing
the proper design, installation and operation and maintenance of such Best Management
Practices in order to assure compliance with the appropriate turbidity water quality
standard;
11. All sediment and erosion control measures placed in wetlands or waters shall be
removed and the original grade restored within two months after the Division of Land
Resources has released the project;
12. Annual native species suitable for wet locations shall be planted and established within
jurisdictional wetlands for soil and erosion control. Perennials such as fescue are
prohibited;
13. No fertilizer shall be applied within 10 feet (3 meters) of streams. Any fertilizer application
must comply with all other Federal, State and Local regulations;
14. The construction corridor (including access roads and stockpiling of materials) is limited to
40 feet (12.2 meters) in width in wetlands and across stream channels and must be
minimized to the maximum extent practicable;
WQC #3374
15. Permanent, maintained access corridors shall be restricted to the minimum width
practicable and shall not exceed 10 feet (3 meters) in width except at manhole locations.
A 10 feet (3 meters) by 10 feet (3 meters) perpendicular vehicle turnaround must be
spaced at least 500 feet (152.4 meters) apart. Written concurrence is required if the
maintenance corridor is greater than 10 feet (3 meters) wide except that a maintenance
corridor larger than ten feet is acceptable for gas pipelines as long as mitigation is
provided for additional wetland fills to the maintenance corridor beyond those widths
specified in this General Certification;
16. An anti-seep collar shall be placed at the downstream (utility line gradient) wetland
boundary and every 150 feet (45.7 meters) up the gradient until the utility exits the
wetland for buried utility lines. Anti-seep collars may be constructed with class B
concrete, compacted clay, PVC pipe, or metal collars. Wetland crossings that are
directionally drilled, and perpendicular wetland crossings that are open cut and less than
150 feet (45.7 meters) long do not require anti-seep collars. The compacted clay shall
have a specific discharge of 1 X 10- 5 cm/sec or less. A section and plan view diagram is
attached for the anti-seep collars;
The following specifications shall apply to class B concrete:
a) Minimum cement content, sacks per cubic yard with rounded course aggregate 5.0
b) Minimum cement content, sacks per cubic yard with angular course aggregate 5.5
c) Maximum water-cement ratio gallons per sack 6.8
d) Slump range 2" to 4"
e) Minimum strength - 28 day psi 2,500
17. This General Certification does not authorize any permanent changes in pre-construction
elevation contours in waters or wetlands or stream dimension, pattern or profile. The
permittee will have a specific plan for restoring wetland contours. Any excess material
will be removed to a high ground disposal area;
18. If an environmental document is required, this Certification is not valid until a Finding of
No Significant Impact (FONSI) or Record of Decision (ROD) is issued by the State
Clearinghouse;
19. Stormwater management will not be required for this Certification as long as all other
Conditions are met. However, in the twenty coastal counties, the appropriate DWQ
Regional Office must be contacted to determine if Coastal Stormwater Regulations still
apply;
20. Compensatory mitigation (i.e., restoration, creation or preservation) for wetland losses will
not be required for this Certification if written concurrence is not needed;
21. Payment of a dollar per acre figure into the Wetland Restoration Program for these
impacts is acceptable when compensatory mitigation is required as long as the Wetlands
Restoration Program agrees in writing to accept this payment. Other mitigation plans
must receive written DWQ concurrence;
22. This Certification does not relieve the applicant of the responsibility to obtain all other
required Federal, State or local approvals;
23. Additional site-specific conditions may be added to projects for which written concurrence
is required or requested under this Certification in order to ensure compliance with all
applicable water quality and effluent standards;
WQC #3374
24. Concurrence from DWQ that this Certification applies to an individual project shall expire
three years from the date of the cover letter from DWQ or on the same day as the
expiration date of the corresponding Nationwide Permit 12 or Regional Permit 198100049
whichever is sooner;
25. When written concurrence is required, the applicant is required to use the most recent
version of the Certification of Completion form to notify DWQ when all work included in the
401 Certification has been completed.
Non-compliance with or violation of the conditions herein set forth by a specific fill project
may result in revocation of this Certification for the project and may also result in criminal and/or
civil penalties.
The Director of the North Carolina Division of Water Quality may require submission of a
formal application for individual certification for any project in this category of activity that requires
written concurrence under this certification, if it is determined that the project is likely to have a
significant adverse effect upon water quality or degrade the waters so that existing uses of the
wetland or downstream waters are precluded.
Public hearings may be held for specific applications or group of applications prior to a
certification decision if deemed in the public's best interest by the Director of the North Carolina
Division of Water Quality.
Effective date: 18 March 2002
DIVISION OF WATER QUALITY
By
Gregory J. Thorpe, Ph.D.
Acting Director
WQC # 3374
WQC #3374
ANTI -SEEP COLLAR
? 18
I inches - ?-
? Utliity'Line
j i ?Qiameter Varies}
1 !
? foot I Class B Concret?1
,? i ?-`-' or Compacted CEay
_ i _I
E?
.?
n inChas rvncE? V?lctth 6 inClieS
blot to exceed 40 feet
SECTION
Class B Concrete
or Compacted Clay
12
Inches
6 Inches ?,u.,q_ ..?,.?.'?nches
PLAN
5
WQC #3374
Certification of Completion
DWQ Project No.:
Applicant:
Project Name:
Date of Issuance of Isolated Wetland Permit:
County:
Certificate of Completion
Upon completion of allwork approved within the 401 Water Quality .Certification and Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form may be returned to DWQ by
the applicant, the applicant's authorized agent, or the project engineer. It is not necessary to send certificates from all of
these.
Applicant's Certification
I, ; hereby state that, to the, best of my abilities, due care and diligence was
used in the observation of the construction such that the, construction 'was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer. Rules, the approved plans and specifications,.
and other supporting materials.
Signature: Date-_
Agent's Certification
I, , hereby state that, to the best of my abilities, due care and diligence was
used in the observation of the 'construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications,
and other supporting materials.
Signature:
Date:
If this project was designed by a Certified Professional
I, as a. duly registered Professional (i:e.; Engineer,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized io.observe (periodically,
weekly, full time) the construction of the project, for the Permittee hereby state that, to the best of my abilities, due care
and diligence was.used in the observation of the construction such that the construction was observed to be built within
substantial compliance and intent of the 401. Water Quality Certification and Buffer Rules, the approved plans and
specifications,.and other supporting materials.
Signature: Registration No. Date.
NC DENR DIVISION OF WATER QUALITY ?- _ --?-
WETLANDS/401 UNIT r?
1650 MAIL SERVICE CENTER ZI
RALEIGH, NC 27699-1650 Zp
C?
v
A ? INSUFFICIENT ADDRESS
C ? AT
TEMPTED NOT KNOWN [/?! O
uTHER
? 140 SUCH NUMBER/ STREET Pf J -
S ? NOT DELIVERABLE AS ADDRESSED
UNABLE TO FORWARD i?a ?
o?O? wAr?RQ?
r
O Ni?? "C
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
March 14, 2006
DWQ Project # 06-0118
Bertie County
Town of Powellsville
P.O. Box 219
Ayden, NC 28513
Subject Property:
Town of Powellsville Sanitary Sewer
Ut to White Oak Swamp [030210,24-2-4, C, SW]
Approval of 401 Water Quality Certification with Additional Conditions
Dear Sir or Madam:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 4 linear feet of perennial stream as described in your application dated January
3, 2006, and received by-the Division of Water Quality (DWQ) on January 23, 2006 for the purpose of
installation of a sewer force main at the site. After reviewing your application, we have decided that the
impacts are covered by General Water Quality Certification Number(s) 3374 (GC3374). The
Certification(s) allows you to use Nationwide Permit(s) NW 12 when issued by the US Army Corps of
Engineers (USACE). In addition, you should obtain or otherwise comply with any other required federal,
state or local permits before you go ahead with your project including (but not limited to) Erosion and
Sediment Control, and Non-discharge regulations. Also, this approval to proceed with your proposed
impacts or to conduct impacts to waters as depicted in your application shall expire upon
expiration of the 404 or CAMA Permit.
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 2H.0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.
The Additional Conditions of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:
Amount Approved nits Plan Location or Reference
Stream 4 linear feet PCN attachment
401 Oversight/Express Review Pemritting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: http://h2o,enr.stite.no.tis/ncwctlinds
None Caro ina
Ytur2
An Equal Opportunity/Affirmative Action Employer- 50% Recycled/10% Post Consumer Paper
Town of Powellsville
Page 2 of 5
March 14, 2006
2. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre-Construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
3. Erosion and sediment control practices must be in full compliance with all specifications governing
the proper design, installation and operation and maintenance of such Best Management Practices in
order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor-owned or leased borrow pits associated with the project.
c. Sufficient materials required for stabilization and/or repair of erosion control measures and
stormwater routing and treatment shall be on site at all times.
4. Sediment and Erosion Control Measures
Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that
the Division of Land Resources has released the project;
5. Protective Fencing
The outside buffer, wetland or water boundary and along the construction corridor within these
boundaries approved under this authorization shall be clearly marked with orange warning fencing
(or similar high visibility material) for the areas that have been approved to infringe within the
buffer, wetland or water prior to any land disturbing activities to ensure compliance with 15A
NCAC 213.0233 and GC 3404;
6. 'Sewer Systems
The project shall comply with 15A NCAC 2H.0219(i)(2)(G) and all other State, Federal and local
sewer system regulations.
7. Construction Stormwater Permit NCGO 10000
Upon the approval of an Erosion and Sedimentation Control Plan issued by the Division of Land
Resources (DLR) or a DLR delegated local erosion and sedimentation control program, an
NPDES General stormwater permit (NCGO10000) administered by DWQ is automatically issued
to the project. This General Permit allows stormwater to be discharged during land disturbing
construction activities as stipulated by conditions in the permit. If your project is covered by this
permit [applicable to construction projects that disturb one (1) or more acres], full compliance
Town of Powellsville
Page 3 of 5
March 14, 2006
with permit conditions including the sedimentation control plan, self-monitoring, record keeping
and reporting requirements are required. A copy of this permit and monitoring report forms may
be found at http://l`12o.enr.state.nc.uslstilFornis Documents.htni.;
8. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable
Buffer Rules, and any subsequent modifications, the applicant is required to return the attached
certificate of completion to the 401 Oversight/Express Review Permitting Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650.
Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification, shall expire upon
expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or
stream impacts), you may ask for an adjudicatory hearing. You must act within 60 days of the date that
you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of
the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certificatioh and its conditions are final and binding unless you ask for a
hearing.
Any disputes over determinations regarding this Authorization Certificate (associated with the approved
buffer impacts) shall be referred in writing to the Director for a decision. The Director's decision is
subject to review as provided in Articles 3 and 4 of G.S. 150B.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act and the Neuse riparian buffer protection rule as described within 15A NCAC 2B .0233. If you have
any questions, please telephone Cyndi Karoly or Ian McMillan at 919-733-1786.
Sincerely,
4-111r,A _eo
Alan W. Klimek, P.E.
AWK/ijnl
Enclosures: GC 3374
Certificate of Completion
cc: Bradley Gillam, McDavid Associates, Inc., P.O. Box Drawer 49, Farmville, NC 27828
USACE Washington Regulatory Field Office
Kyle Barnes, DWQ Washington Regional Office
DLR Washington Regional Office
File Copy
Central Files
Filename: 060118TOPowellsvi IIeS anitaryS ewer(Bertie)101
Triage Check List
Date.
Project Name:
To: ? - ARO Kevin Barnett
? FRO Ken Averitte
? MRO Alan Johnson
? RRO Mike Horan
From: I
County:
Ar?r
I I?gWaRO Tom Steffens and Kyle Barnes
? WiRO Noelle Lutheran
? WSRO Daryl Lamb
Telephone : (919) J ? 5 " ?J I
The file attached. is being forwardedio.p our for your evaluation.
Please call if you need\as'stance.
? Stream length impacted.
? Stream determination
? Wetland determination and distance to blue-line surface'waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules (Meuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
? Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings? -
? Cumulative impact concern
Comments:
= McDAVID AsSOCUTES, INC.
INC. Engineers - Planners - Land Surveyors
CORPORATE OFFICE GOLDSBORO OFFICE
[phone]-Fax[phone] [phone]-Fax[phone]
E-mail: [e-mail] E-mail: maigoldgmcdavid-inc.com
3714 N. Main Street - P.O. Drawer 49 109 E. Walnut Street - P.O. Box 1776
Farmville, NC 27828 Goldsboro, NC 27533
January 18, 2006
T
US Army Corps of Engineers
Washington Regulatory Field Office
943 Washington Square Mall 2 () 0 6 0 1 1 8
Washington, NC 27889
ATTN: Tracey Wheeler
SUBJECT: CE 404 Permit Request
Contract No. 1 - Sanitary Sewer, Pump
Station and Force Main
1999 Sanitary Sewer Improvements
Town of Powellsville
Dear Ms. Wheeler:
In reference to the subject project, please find enclosed the following:
1. One (1) set of the following plan excerpts:
A. Index map Nos. 2 and 3 of 86 and creek crossing plan drawings from Sheet
Nos. 36, 37, 42, 44, 45, 47, 51 and 52 of 86 (MAI P-775 Orange) from the
subject contract.
B. Standard Drawings SD 70030 and SD 70040 which show a typical Creek
Crossing, plan and section views.
2. Two (2) copies of the signed permit forms.
Request nationwide permit or permit waiver at your earliest convenience. Please advise if we
may further assist.
Sincerely,
McDAVID ASSOCIATES, INC.
Bradley C. Gillam, PE
Farmville Office
BCG:lcm
Enclosures
cc: Thomas Asbell, Mayor, Town of Powellsville
D405B0006
POWELLSVILLE-99-CN 1-SSI-CE404-PM-REQ.LTR:2
?D
'Aft 2 3 2006
V, DENR - WATE
Ar1p RQUAUrv
Zaki? Sr0??Ml",?ATE/? BRANCH
4:13pm
060117
o ?c??ad? D
-.; ., JAN ,2 3 2006
DENR • WATER QUALITY
11( UNDS AND STOR AWATER BRANCH
a?
4
.'0aG0118
?G
C
Pre-Construction Notification (PCN) Application Form
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
This form is to be used for projects qualifying for any of the U.S. Army Corps of Engineers' (USACE)
Nationwide, Regional or General Permits as required by Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act, and for the North Carolina Division of Water Quality's
(DWQ) associated General 401 Water Quality Certifications. This form is also to be used for any
project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water
Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401
Water Quality Certification. The USACE Individual Permit application form is available online at
www.saw.usace.army.mil/wetiands/Permits.html.
The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide,
Regional or General permits, and to determine which permit applies to, your project, please go to the
USACE website at www.saw.usace.army.mil/wetlands/index.htmi, or contact one of the field offices
listed on page 3 of this application. The website also lists the responsible project manager for each
county in North Carolina and provides additional information regarding the identification and regulation
of wetlands and waters of the U.S.
The DWQ issues- a corresponding Certification (General or Individual), and cannot tell the applicant
which 401 Certification will apply until the 404 Permit type has been determined by the USACE.
Applicants are encouraged to visit DWQ's 401/Wetlands Unit website at
http://h2o.enr.state.nc.us/ncwetlands to read about current requirements for the 401 Water Quality.
Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The
applicant is also advised to read the full text of the General Certification (GC) matching the specific 404
Permit requested. In some cases, written approval for General Certifications is not required, provided
that the applicant adheres to all conditions of the GC. Applicants lacking access to the internet should
contact DWQ's Central Office in Raleigh at [phone].
Trout Waters Coordination - Special coordination with the North Carolina Wildlife Resources
Commission (NCWRC) is required for projects occurring in any of North Carolina's twenty-five
counties that contain trout waters. In such cases, the applicant should contact the appropriate NCWRC
regional coordinator (listed by county on page 4 of this application) prior to submittal of the application.
Page 1 of 12
Coastal Area Management Act (CAMA) Coordination - If the project occurs in any of North Carolina's
twenty coastal counties (listed on page 4) the applicant should contact the North Carolina Division of
Coastal Management (DCM). DCM will determine whether or not the project is within a designated
Area of Environmental Concern, in which case DCM will act as the lead permitting agency. In such
cases, DCM will require a CAMA Permit and will coordinate the 404/401 Permits.
The applicant may also choose to coordinate with the United States Fish and Wildlife Service to ensure
that the proposed project will have no impact upon any endangered or threatened species or critical
habitat as regulated by the Endangered Species Act, and the State Historic Preservation Office, North
Carolina Department of Cultural Resources to ensure that the proposed project will have no impact upon
any properties listed or eligible for listing on the National Register of Historic Places. Compliance with
these regulations is required to be eligible for any Department of the Army permit. The addresses for
both agencies are listed on page 3 of this application.
USACE Permits - Submit one copy of this form, along with supporting narratives, maps, data forms,
photos, etc. to the applicable USACE Regulatory Field Office. Upon receipt of an application; the
USACE will determine if the application is complete as soon as possible, not to exceed 30 days. This
PCN form is designed for the convenience of the applicant to address information needs for all USACE
Nationwide, Regional or General permits, as well as information required for State authorizations,
certifications, and coordination. Fully providing the information requested on this form will result in a
complete application for any of the USACE Nationwide, Regional or General permits. To review the
minimum amount of information that must be provided for a complete PCN for each USACE
Nationwide permit, see Condition 13, 67 Fed. Reg. 2090 (Jan. 15, 2002), available at
http://www.usace.army.mil/inet/functions/cw/ceewo/reg/2002nwps.12df. Processing times vary by
permit and begin once the application has been determined to be complete. Please contact the
appropriate regulatory field office for specific answers to permit processing periods.
401 Water Quality Certification or Buffer Rules - All information is required unless otherwise stated
as optional. Incomplete applications will be returned. Submit seven collated copies of all USACE
Permit materials to the Division of Water Quality, 401/Wetlands Unit, 1650 Mail Service Center,
Raleigh, NC, 27699-1650. If written approval is required or specifically requested for a 401
Certification, then a non-refundable application fee is required. In brief, if project impacts include less
than one acre of cumulative wetland/water impacts and less than 150 feet cumulative impacts to
streams, then a fee of $200 is required. If either of these thresholds is exceeded, then a fee of $475 is
required. A check made out to the North Carolina Division of Water Quality, with the specific name of
the project or applicant identified, should be stapled to the front of the application package. For more
information, see the DWQ website at httR://h2o.ehnr.state.ne.us/ncwetiands/fees.htm1. The fee must be
attached with the application unless the applicant is a federal agency in which case the check may be
issued from a separate office. In such cases, the project must be identifiable on the U.S. Treasury check
so that it can be credited to the appropriate project. If written approval is sought solely for Buffer Rules,
the application fee does not apply, and the applicant should clearly state (in a cover letter) that only
Buffer Rule approval is sought in writing. Wetlands or waters of the U.S. may not be impacted prior to
issuance or waiver of a Section 401 Water Quality Certification. Upon receipt of a complete application
for a 401 Certification, the Division of Water Quality has 60 days to prepare a written response to the
applicant. This may include a 401 Certification, an on-hold letter pending receipt of additional
requested information, or denial.
Page 2 of 12
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Caldwell Haywood McDowell Swain
US Army Corps of Engineers Alleghany Catawba Henderson Mecklenburg Transylvania
151 Patton Avenue Ashe Cherokee Iredell Mitchell Union
Room 208 Avery Clay Jackson Polk Watauga
Asheville, NC 28801-5006 Buncombe Cleveland Lincoln Rowan Yancey
Telephone: [phone] Burke Gaston Macon Rutherford
Fax: [phone] Cabamis Graham Madison Stanley
Raleigh Regulatory Field Office Alamance Franklin Nash Sunry
US Army Corps Of Engineers Caswell Forsyth Northampton Vance
6508 Falls of the Neuse Road Chatham Granville Orange Wake
Suite 120 Davidson Guilford Person Warren
Raleigh, NC 27615 Davie Halifax Randolph Wilkes
Telephone: [phone] Durham Johnston Rockingham Wilson
Fax: [phone] Edgecombe Lee Stokes Yadkin
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 Carteret* Green Pamlico Wayne
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans *Croatan National Forest Only
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
North Carolina State Agencies
Division of Water Quality
401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Telephone: [phone]
Fax: [phone]
US Fisl
US Fish and Wildlife Service
Raleigh Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
Telephone: [phone]
Division of Water Quality
Ecosystem Enhancement Program
1652 Mail Service Center
Raleigh, NC 27699-1652
Telephone: [phone]
Fax: [phone]
i and Wildlife Service / National M
US Fish and Wildlife Service
Asheville Field Office
160 Zillicoa Street
Asheville, NC 28801
Telephone: [phone]
State Historic Preservation Office
Department Of Cultural Resources
4617 Mail Service Center
Raleigh, NC 27699-4617
Telephone: [phone]
Fax: [phone]
.arine Fisheries Service
National Marine Fisheries Service
Habitat Conservation Division
Pivers Island
Beaufort, NC 28516
Telephone: [phone]
Page 3 of 12
CAMA and NC Coastal Counties
Division of Coastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bertie Craven Hyde Pender
Raleigh, NC 27699-1638 Brunswick Currituck New Hanover Perquimans
Telephone: [phone] Camden Dare Onslow Tyrrell
Fax: [phone] Carteret Gates Pamlico Washington
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator Alleghany Caldwell Watauga
3855 Idlewild Road Ashe Mitchell Wilkes
Kernersville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Surry
Mountain Region Coordinator Buncombe Henderson Polk
20830 Great Smoky Mtn. Expressway Cherokee Jackson Rutherford
Waynesville, NC 28786 Clay Macon Swain
Telephone: [phone] Graham Madison Transylvania
Fax: [phone] Haywood McDowell Yancey
APPLICATION FORM BEGINS ON PAGE 5. PLEASE DO NOT SUBMIT PAGES 1 - 4.
Page 4 of 12
Office Use Only: Form Version March 05
00 1 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".)
1. Processing
1. Check all of the approval(s) requested for this project:
x? Section 404 Permit © Riparian or Watershed Buffer Rules
? Section 10 Permit (I Isolated Wetland Permit from DWQ
? 401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: 12
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), ch D r - DW?
Db
II. Applicant Information JAN 2 3 2006
1. Owner/Applicant Information
Name: Town of Powellsville DENf2 - WA1 rk OUAL FY
RANCH
Mailing Address: P.O. Box 22
Powellsville, NC 27967
Telephone Number: 252-332-6997 Fax Number: 252-332-8126
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: Bradley C. Gillam, P.E.
Company Affiliation: McDavid Associates, Inc.
Mailing Address: P.O. Drawer 49
Farmville, NC 27828
Telephone Number: 252-753-2139 Fax Number: 25 2-753-7220
E-mail Address: [e-mail]
Page 5 of 12
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: 1999 Sanitary Sewer Improvements
2. T.I.P. Project Number or State Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN):
N/A
4. Location
County: Bertie Nearest Town: Powellsville
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers/names, landmarks, etc.): NC 13 south of Powellsville
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): See plats °N See plats aW
6. Property size (acres): Linear project
7. Name of nearest receiving body of water:
Stoney Creek and White Oak Swamp
8. River Basin: Chowan and Roanoke
(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: The existing land use is NC DOT right-of-way
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used:
Sewer force main will be installed by open cut with excavation none
location. All others will be installed by directional drilling.
11. Explain the purpose of the proposed work: Sewer force main will transport sewer
from Town of Powellsville to Town o W n sor or treatment.
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: None
Page 7 of 12
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,
-., A- *., h.,rh etT1,Ct„re and flnnding_
ac. aiat

Wetland Impact

Site Number
(indicate on map) %.i 11at. 1111 aWL0 uab w

ype of Impact a+..••• •••------- --- - ---
T e of Wetland
yp

(e.g., forested, marsh,
herbaceous, bog, etc.) -
Located within

100-year
100lain_
es/no
Distance to

Nearest
Stream
(linear feet
Area of

Impact
(acres)
None

Total Wetland Impact (acres)
3. List the total acreage (estimated) of all existing wetlands on the property: 0.00
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
___"L _ ]-_1__.3_1 T- --1....1..?s --an(,- -111tiniv length X width- then divide by 43.560.
li1LLSl U

Stream Impact
Number
indicate on ma e 111CLUUCU. 1 V 1. a1%.

Stream Name
••..-•
ulaw "W- f,-9
Type of Impact
-- - ---- -- -

Pee mrittrnt?
- ----. -
Average
Stream Width
Before Impact

th
:in!c-ar act
feet

Area of
Impact
acres
See attached

Total Stream Impact (by length and acreage)
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
d' dra' bulkheads etc
fill, exc
Open Water Impact

indicate Site on Number ma avation, dyed n , floo

Name of Waterbody
(if applicable) to , tna e,

Type of Impact .
Type of Waterbody
Oake, pond, estuary, sound, bay,
ocean, etc.
Area of
Impact
acres
None

Total Onen Water Impact (acres)
Page 8 of 12
6. List the cumulative im act to all Waters of the U.S. resulting from the project
Stream Impact (acres
Wetland Impact (acres :
Open Water Impact acres :
Total Impact to Waters of the U.S. acres
Total Stream Impact (linear feet :
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.
N/A
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:
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. In most cases horizontal
directional drilling is being used to minimize impact.
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.
Page 9 of 12
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/ncwet]ands/strmgide.htm1.
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.
N/A
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/wm/index.htin. 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): 0.0
Amount of buffer mitigation requested (square feet): 0.0
Amount of Riparian wetland mitigation requested (acres): 0.0
Amount of Non-riparian wetland mitigation requested (acres): 0.0
Amount of Coastal wetland mitigation requested (acres):_ 0.0
Page 10 of 12
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 ?X 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
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
(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 V Yes ? No F&I
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 multinliers.
Zone* Impact
(square feet Multiplier Required
Mitigation
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.
Page 11 of 12
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)
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.
The proposed facilities will transport sewer from Powellsville to Windsor
for treatment -
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 211.0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application? Yes ? No x?
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 El No R?
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/newetlands. If no, please provide a short narrative description: This
eject will Prevent the future leaching of sewer from Powersville.
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).
Page 12 of 12
ApplicanVAgent's signature UALU
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Stream Impact
Number
(indicate on map)
Stream Name
Type of Impact
Intermittent. Perennial Intermittent? Average
Stream Width
Before Impact Impact
Length
(linear feet) Area of
Impact
(acres)
1 Quiccosa Swamp directional drilling Perennial 40' 0' 0 acres
2 UT to Quiccosa Swamp directional drilling Perennial 15' 0' 0 acres
3 UT to Wildcat Swamp directional drilling Perennial 15' 0' 0 acres
4 UT to Wildcat Swamp directional drilling Perennial 20' 0' 0 acres
5 Wildcat Swamp directional drilling Perennial 20' 0' 0 acres
6 White Oak Swamp directional drilling Perennial 40' 0' 0 acres
7 UT to White Oak Swamp excavation Perennial 10' 4' 0.0009 acres
8 White Oak Swamp directional drilling Perennial 60' 0' 0 acres
Total Stream Impact (by length and acreage) 4' 0.0009 acres
INC.
McDAVIDAsSOCUTES, INC.
Engineers • Planners • Land Surveyors
CORPORATE OFFICE
[phone] • Fax [phone]
E-mail: [e-mail]
3714 N. Main Street • P.O. Drawer 49
Farmvillc, NC 27828
GOLDSBORO OFFICE
[phone] • Fax [phone]
E-mail: [e-mail]
109 E. Walnut Street • PO. Box 1776
Goldsboro, NC 27533
January 18, 2006
?nn0011<9
NC Department of Environment and Natural Resources
Division of Water Quality
1617 Mail Service Center
Raleigh, NC 27699-1617
ATTN: Mr. John Dorney
Q .???
C C
JAS: *2 ; ?U j
DENR - l',V ER ( IkA i -
V&_MD3AN0Si(:, VVATERHANCN
SUBJECT: 401 General Water Quality Certification
Permit Request
Contract No. 1 - Sanitary Sewer, Pump
Station and Force Main
1999 Sanitary Sewer Improvements
Town of Powellsville
Dear Ms. Wheeler:
In reference to the subject project, please find enclosed the following:
One (1) set of the following plan excerpts:
A. Index map Nos. 2 and 3 of 86 and creek crossing plan drawings from Sheet
Nos. 36, 37, 42, 44, 45, 47, 51 and 52 of 86 (MAI P-775 Orange) from the
subject contract.
B. Standard Drawings SD 70030 and SD 70040 which show a typical Creek
Crossing, plan and section views.
2. Seven (7) copies of the signed permit forms.
3. Copy of letter to US Army Corps of Engineers.
This project consists of 2.9 miles of gravity sewer and 12.8 miles of force main. Gravity
sewer and force main lines will be installed in NC DOT and Town of Powellsville right-of-ways.
Creek Crossings installed by horizontal directional drilling will have six (6) feet minimum bury depth.
Ditch crossing installed by open cut will have four (4) feet minimum bury depth. We are not aware
of any wetlands that will be open cut by this project.
D405BCG06
POWELLSVILLE X99-CNI-SSI-CE401-PERNI-REQ.LTR;2
10:41am
060118
Please find enclosed MAI Check No. 20014 in the amount of $200.00 for 401 permit.
Request permit or permit waiver at your earliest convenience.
Sincerely,
McDAVID ASSOCIATES, INC.
Bradley C. Gillam, PE
Farmville Office
BCG:lcm
Enclosures
cc: Thomas Asbell, Mayor, Town of Powellsville
D405BCG06 2 iN? d1 ?m
POWELLSVILLE-99-CN I -SSI-CE401-PERh1-REQ. LTR;2 0 118

Qd
?a
o? SIP"
?s
of

Pre-Construction Notification (PCN) Application Form
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
This form is to be used for projects qualifying for any of the U.S. Army Corps of Engineers' (USACE)
Nationwide, Regional or General Permits as required by Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act, and for the North Carolina Division of Water Quality's
(DWQ) associated General 401 Water Quality Certifications. This form is also to be used for any
project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water
Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401
Water Quality Certification. The USACE Individual Permit application form is available online at
www.saw.usace.army.mil/wetlands/Permits.html.
The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide,
Regional or General permits, and to determine which permit applies to. your project, please go to the
USACE website at www.saw.usace.army.miI/wetlands/index.htm1, or contact one of the field offices
listed on page 3 of this application. The website also lists the responsible project manager for each
county in North Carolina and provides additional information regarding the identification and regulation
of wetlands and waters of the U.S.
The DWQ issues a corresponding Certification (General or Individual), and cannot tell the applicant
which 401 Certification will apply until the 404 Permit type has been determined by the USACE.
Applicants are encouraged to visit DWQ's 401/Wetlands Unit website at
http://h2o.enr.state.nc.us/ncwetlands to read about current requirements for the 401 Water Quality.
Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The
applicant is also advised to read the full text of the General Certification (GC) matching the specific 404
Permit requested. In some cases, written approval for General Certifications is not required, provided
that the applicant adheres to all conditions of the GC. Applicants lacking access to the internet should
contact DWQ's Central Office in Raleigh at [phone].
Trout Waters Coordination - Special coordination with the North Carolina Wildlife Resources
Commission (NCWRC) is required for projects occurring in any of North Carolina's twenty-five
counties that contain trout waters. In such cases, the applicant should contact the appropriate NCWRC
regional coordinator (listed by county on page 4 of this application) prior to submittal of the application.
2 0 0 60 1 1 8
Page 1 of 12
Coastal Area Management Act (CAMA) Coordination - If the project occurs in any of North Carolina's
twenty coastal counties (listed on page 4) the applicant should contact the North Carolina Division of
Coastal Management (DCM). DCM will determine whether or not the project is within a designated
Area of Environmental Concern, in which case DCM will act as the lead permitting agency. In such
cases, DCM will require a CAMA Permit and will coordinate the 404/401 Permits.
The applicant may also choose to coordinate with the United States Fish and Wildlife Service to ensure
that the proposed project will have no impact upon any endangered or threatened species or critical
habitat as regulated by the Endangered Species Act, and the State Historic Preservation Office, North
Carolina Department of Cultural Resources to ensure that the proposed project will have no impact upon
any properties listed or eligible for listing on the National Register of Historic Places. Compliance with
these regulations is required to be eligible for any Department of the Army permit. The addresses for
both agencies are listed on page 3 of this application.
USACE Permits - Submit one copy of this form, along with supporting narratives, maps, data forms,
photos, etc. to the applicable USACE Regulatory Field Office. Upon receipt of an application, the
USACE will determine if the application is complete as soon as possible, not to exceed 30 days. This
PCN form is designed for the convenience of the applicant to address information needs for all USACE
Nationwide, Regional or General permits, as well as information required for State authorizations,
certifications, and coordination. Fully providing the information requested on this form will result in a
complete application for any of the USACE Nationwide, Regional or General permits. To review the
minimum amount of information that must be provided for a complete PCN for each USACE
Nationwide permit, see Condition 13, 67 Fed. Reg. 2090 (Jan. 15, 2002), available at
http://www.usace.army.mil/inet/functions/cw/cecwo/rea/2002nwps.pdf. Processing times vary by
permit and begin once the application has been determined to be complete. Please contact the
appropriate regulatory field office for specific answers to permit processing periods.
401 Water Quality Certification or Buffer Rules - All information is required unless otherwise stated
as optional. Incomplete applications will be returned. Submit seven collated copies of all USACE
Permit materials to the Division of Water Quality, 401/Wetlands Unit, 1650 Mail Service Center,
Raleigh, NC, 27699-1650. If written approval is required or specifically requested for a 401
Certification, then a non-refundable application fee is required. In brief, if project impacts include less
than one acre of cumulative wetland/water impacts and less than 150 feet cumulative impacts to
streams, then a fee of $200 is required. If either of these thresholds is exceeded, then a fee of $475 is
required. A check made out to the North Carolina Division of Water Quality, with the specific name of
the project or applicant identified, should be stapled to the front of the application package. For more
information, see the DWQ website at http://h2o.ehnr.state.nc.us/ncwetiands/fees.htm1. The fee must be
attached with the application unless the applicant is a federal agency in which case the check may be
issued from a separate office. In such cases, the project must be identifiable on the U.S. Treasury check
so that it can be credited to the appropriate project. If written approval is sought solely for Buffer Rules,
the application fee does not apply, and the applicant should clearly state (in a cover letter) that only
Buffer Rule approval is sought in writing. Wetlands or waters of the U.S. may not be impacted prior to
issuance or waiver of a Section 401 Water Quality Certification. Upon receipt of a complete application
for a 401 Certification, the Division of Water Quality has 60 days to prepare a written response to the
applicant. This may include a 401 Certification, an on-hold letter pending receipt of additional
requested information, or denial.
Page 2 of 12
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Caldwell Haywood McDowell Swain
US Army Corps of Engineers Alleghany Catawba Henderson Mecklenburg Transylvania
151 Patton Avenue Ashe Cherokee Iredell Mitchell Union
Room 208 Avery Clay Jackson Polk Watauga
Asheville, NC 28801-5006 Buncombe Cleveland Lincoln Rowan Yancey
Telephone: [phone] Burke Gaston Macon Rutherford
Fax: [phone] Cabamts Graham Madison Stanley
Raleigh Regulatory Field Office Alamance Franklin Nash Sung
US Army Corps Of Engineers Caswell Forsyth Northampton Vance
6508 Falls of the Neuse Road Chatham Granville Orange Wake
Suite 120 Davidson Guilford Person Warren
Raleigh, NC 27615 Davie Halifax Randolph Wilkes
Telephone: [phone] Durham Johnston Rockingham Wilson
Fax: [phone] Edgecombe Lee Stokes Yadkin
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 Carteret* Green Pamlico Wayne
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans *Croatan Nati onal Forest Only
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
North Carolina State Agencies
Division of Water Quality
401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Telephone: [phone]
Fax: [phone]
US Fis
US Fish and Wildlife Service
Raleigh Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
Telephone: [phone]
Division of Water Quality
Ecosystem Enhancement Program
1652 Mail Service Center
Raleigh, NC 27699-1652
Telephone: [phone]
Fax: [phone]
h and Wildlife Service / National N
US Fish and Wildlife Service
Asheville Field Office
160 Zillicoa Street
Asheville, NC 28801
Telephone: [phone]
State Historic Preservation Office
Department Of Cultural Resources
4617 Mail Service Center
Raleigh, NC 27699.4617
Telephone: [phone]
Fax: [phone]
.arine Fisheries Service
National Marine Fisheries Service
Habitat Conservation Division
Pivers Island
Beaufort, NC 28516)
Telephone: [phone]
Page 3 of 12
CAMA and NC Coastal Counties
Division of Coastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bertie Craven Hyde Pender
Raleigh, NC 27699-1638 Brunswick Currituck New Hanover Perquimans
Telephone: [phone] Camden Dare Onslow Tyrrell
Fax: [phone] Carteret Gates Pamlico Washington
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator Alleghany Caldwell Watauga
3855 Idlewild Road Ashe Mitchell Wilkes
Kemersville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Sung
Mountain Region Coordinator Buncombe Henderson Polk
20830 Great Smoky Mtn. Expressway Cherokee Jackson Rutherford
Waynesville, NC 28786 Clay Macon Swain
Telephone: [phone] Graham Madison Transylvania
Fax: [phone] Haywood McDowell Yancey
APPLICATION FORM BEGINS ON PAGE 5. PLEASE DO NOT SUBMIT PAGES I - 4.
Page 4 of 12
Office Use Only: 2 0 0 Fo 0 e1 ion'M r h 05
6 8
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
x? 401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: 12
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: ?H. Applicant Information U OW=
1. Owner/Applicant Information JAN 2 3 2006
Name:

Mailing Address: Town of Powellsville
„ tK QUALITY
P.O. Box 22
N:'ETLn._neeun?To o?n?w??o .,???
Powellsville, NC 27967

Telephone Number: 252-332-6997 Fax Number: 252-332-8126
E-mail Address:
2. Agent/Consultant Info rmation (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: Bradley C. Gillam, P.E.
Company Affiliation:
Mailing Address: McDavid Associates, Inc.
P.O. Drawer 49
Farmville, NC 27828

Telephone Number: 252-753-2139 Fax Number: 25 2-753-7220
E-mail Address: [e-mail]
Page 5 of 12
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 ofproject: 1999 Sanitary Sewer Improvements
2. T.I.P. Project Number or State Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PN: N/A
4. Location
County: Bertie Nearest Town: Powellsville
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers/names, landmarks, etc.): NC 13 south of Powellsville
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): See plats °N See plats aW
6. Property size (acres):
7. Name of nearest receiving body of water:
8. River Basin: Chowan and Roanoke
(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: The existing land use is NC DOT right-of-way
Linear project
Stoney Creek and White Oak Swamp
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used:
Sewer force main will be installed by open cut with excavation n one
location. All others will be installed by directional drilling.
11. Explain the purpose of the proposed work: Sewer force main will transport sewer
from Town of Powellsville to Town o Windsor or treatment.
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:
None
Page 7 of 12
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,
...,tel.. 1- :,.,.,.,,.to .411P tr.',nth ,tnichure and flooding.
JM Y14?

Impact
Wetland
Site Number
(indicate on map) ..1 1106 1111 -6. u?.v rv

ype of Impact vv ??
-----
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)
None

Total Wetland Impact (acres)
3. List the total acreage (estimated) of all existing wetlands on the property: 0.00
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
.?t U : ..l..aea T„ nntr•.,tatP nRTencre. mnltinly length X width. then divide by 43,560.
111LLJ1 U
Stream Impact
Number
indicate on ma V lllVlLLVl.rt1. iv

Stream Name ---

Type of Impact --1-1 ---- --- -
Perennial or
Intermittent? -
Average
Stream Width
Before Impact
Impact
Length
inear feet
Area of
Impact
acres
See attached

Total Stream Impact (by length and acreage)
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 atton dr d ' floodin draina a bulkheads etc.
exc
Open Water Impact
Site Number
indicate on ma av, e n ,

Name applicable)
(if ape)

Type of Impact >
Type of Waterbody
(lake, pond, estuary, sound, bay,
ocean, etc.
Area of
Impact
acres
None

Total Open Water Impact (acres)
Page 8 of 12
6. List the cumulative im act to all Waters of the U.S. resulting from the project
Stream Imp act (acres):
Wetland Impact acres :
Open Water Impact acres :
Total Impact to Waters of the U.S. (acres)
Total Stream Impact (linear feet :
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ?x 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.
N/A
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:
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. In most cases horizontal
directional drilling is being used to minimize impact.
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.
Page 9 of 12
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/strm gi de.htm1.
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.
N/A
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): 0.0
Amount of buffer mitigation requested (square feet): 0.0
Amount of Riparian wetland mitigation requested (acres): 0.0
Amount of Non-riparian wetland mitigation requested (acres): 0.0
Amount of Coastal wetland mitigation requested (acres): 0.0
Page 10 of 12
IX.
X.
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 ?x 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 FX]
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 ?
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
(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 V Yes ? No F&I
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 multiuliers.
Zone* Impact Multiplier Required
(square feet Mitigation
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.
Page 11 of 12
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)
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.
The proposed facilities will transport sewer from Powellsville to Windsor
fnr trPntTn-"f-
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 211.0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application? Yes ? No x?
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 x?
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: This
project will Prevent the future leaching of sewer from Powersville.
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).
Page 12 of 12
Applicant/Agent's signature U4LC
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Stream Impact
Number
(indicate on map)
Stream Name
Type of Impact
Perennial Intermittent? t? Average
Stream Width
Before Impact Impact
Length
(linear feet) Area of
Impact
(acres)
1 Quiccosa Swamp directional drilling Perennial 40' 0' 0 acres
2 UT to Quiccosa Swamp directional drilling Perennial 15' 0' 0 acres
3 UT to Wildcat Swamp directional drilling Perennial 15' 0' 0 acres
4 UT to Wildcat Swamp directional drilling Perennial 20' 0' 0 acres
5 Wildcat Swamp directional drilling Perennial 20' 0' 0 acres
6 White Oak Swamp directional drilling Perennial 40' 0' 0 acres
7 UT to White Oak Swamp excavation Perennial 10' 4' 0.0009 acres
8 White Oak Swamp directional drilling Perennial 60' 0' 0 acres
Total Stream Impact (by length and acreage) 4' 0.0009 acres
McDavld Associates, Inc. 3714 N. MAIN ST., P.O. DRAWER 49 FARMVILLE, N.C. 27828
NC Department of Environment and Natural Check Number: 20014 020014
Resources Date: 1/17/2006 Check Amt: $200.00
Tran k Invoice Type Date Reference Balance Discount Pay Amount
52 060116 Invoice 01/16/06 1-99-0410-9038 401 water Qual $200.00 $0.00 $200.00
o sf;z?
?AN,2 ? `tQt Ei
Y01P DS NM SToF JXNATFR BRANON