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HomeMy WebLinkAbout20050550 Ver 1_Complete File_20050223 ~\\ P, ,7;1 ,,,. \~ 1 ~,/ 'r',' \l '.J ~ ';.. , ')-" F,j >.~, ,,"'"'''' ".,', ,3' ,^"'... ..,.".7.", '," [1", "'I' "y,L "-J' '\' I l-, :; I' " ~- '"", "',,""~,'; '.! <\ ' '.~~ ~_ J ~.........:J ''''-V'''' J 'J 050550 community infrastructure consultants February 18, 2005 Mr. Steve Chapin Asheville Regulatory Field Office US Army Corps of Engineers 1 51 Patton Ave. Room 208 Asheville, NC 28801-5006 ~@!@rnDW@!~ FEB 2 3 2005 \'rcr&f~'1j~1m,~9UAlITY , Vl\Mn'ATER BRANCH RE: Iredell Water Corporation WKD# 30236.11.RA Dear Mr. Chapin: The Iredell Water Corporation is proposing to expand their water distribution system approximately 30 miles (Figure 1). The proposed project is for utility line installation only; no tanks or pumping stations are included in the proposed project. This letter is a courtesy pre- construction notification for impacts associated with the proposed project. This project is permitted by Nationwide Permit 12 (Utility Line Activities). Iredell Water Corporation will comply with all conditions, including Wilmington District Regional Conditions, and NCDWQ 401 Certification conditions. The total linear feet of utility line in waters of the U.S. falls below notification thresholds. WK Dickson performed several site visits to assess impacts to waters of the U.S. All work will be conducted within the road right-of-way; typically within five feet of the edge of pavement. Several minor streams will be crossed on top of the existing culvert. Eight streams will be crossed approximately 15 feet from the existing bridge (Figures 2-7). Table 1 details these eight crossings. Crossings #4 and #5 will be directionally drilled to avoid jurisdictional impacts and potential impacts to bridge foundations as a result of drilling and blasting in bedrock. The six remaining stream crossings will be constructed utilizing cut and fill methodology. A total of 323 linear feet of water line will be installed in this fashion. No wetlands will be impacted by the proposed project. No High Quality Waters or Outstanding Resource waters are in the project area. All proposed impacts are temporary for excavation, utility line installation, and backfill and bedding. The stream bank and stream bed will be returned to pre-construction contours and all appropriate BMP's and sediment and erosion controls will be utilized. 3101 ),1111 Humphries \Vym! F~d,-:!ci NC27Gl:2 T<:,I. 91(L'32,O~~'5 F,l\~) j~).7n2.~lG~2 W\\'\\ ,\\ ~dick'on,colTl i'\orth CJrolinJ . South CJrolinJ . GeorgiJ . Flor da Feel free to contact us with any questions about the proposed project. Sincerely, W.K. Dickson & Co., Inc. ~f~ Daniel P. Ingram Staff Scientist cc: Mike Wolfe, WK Dickson Project Manager Division of Water Quality, 41 O/Wetlands Unit V Table 1. Stream Crossing Details Crossing Road Stream Width (ft. bank- Depth of channel NCDWQ Latitude Longitude bank) (ft. approximate) Classification 1 Jennings Patterson 50 8 C 35deg 58min 40sec N 80deg 45min 05sec W Road Creek 2 Highway Snow Creek 43 6 WSIV 35deg 53min OOsec N 80deg 56min 48sec W 115 3 Highway South Yadkin 67 10 WSIV 35deg 55min 33sec N 80deg 51 min 50sec W 115 River 4 Union Hunting 124 (directional 10 WS III 35deg 51 min 02sec N 80deg 51 min 29sec W Grove Road Creek bore. no imoact) 5 Eagle Mill Hunting 79 (directional 7 WSIII 36deg 02min 28sec N 80deg 50min 34sec W Road Creek bore no imoact) 6 Powell Long Branch 50 6 WSIII 35deg 58min 44sec N 80deg 44min 06sec W Road 7 Powell Hunting 90 18 WS III 36deg 01 min 03sec N 80drg 48min 08sec W Road Creek 8 Highway 21 Fifth Creek 23 8 C 35deg 51 min 02sec N 80deg 51 min 29sec W Total: 323 , "....:l\~ .! '. ~l~'~("'" .,"to '~I ,.~ \ -.~ J,;;I;~'''~';;LJ~'(,' -';'. 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", ~~... <_;.~~'. S .' J._ '~f' ;/~ ~ :J~,)', \ ,~.',:-,.. . ~,,'1 <: "r;t ,\ :,.;"'\',);;~;:-"f';, ,.<~. /. ,I,' '1,,' , 'Ii'." '.,:.';:;./, ,.', ,.:,:~~t.. =,1' ~'46)~/?~;c ~! ',;;.'-;,:. ,:,1.~..:.^" ~.J~"''''/'/:/ 3 6 ~ ~\ /~~"^\':>. j '''''It'--"A-..~>.r "':1;.- '.. \' 'I""'" , 'f' ~ 0 I ;'m~ 'rY{~~l0~'~l'&:::~i./1!' ~t~~,;;r~"- M/"V.?<.,~,,::.~ Yf[.1.~) :"::"!'-!j%';:' s~~[~ f Miles 'i.(ISh\('(l'~t("(~~V~/VJ~>\I'~"fr,,:,<,:_ ~I':\ J' ,l';;.~I;~A.f!: .- 1:- J~~\\J ". '1/" .-....-.-.v ,~...--. ~ ',' "'IY',A.y/- .... USGS 1 :100,000 SALISBURY ~jt$~,;~j--,'/2~t~.. -.\.:' _~..:..,!,~-~~~. '.:.,.~:.. q.... '.7; .., :-:/ : "'~.<:-$Z, :' Source: '" ~ '. :':;..1 ( I}j.' . ','-:'::; : l: "', . ;,;"-...,:.;'" \ . ~'~"l\. ,,:-;j- .' F'lgure 1. Location Map i~%~:t;;~JI';f~iJ;~~~~;~~~:";;t";:;'J, "\~fiT:/.."2:~ {; I; ',::.:~>,~( i.:p,~i/2(~:;-)};'~~~):l!l;t~~, ~ :.'j(">\ y':: ~ <" l'~ ~_ ",~.,l;' ., ,._.-'/ ~ ,1.,'::'\.'--~";:"_";,,,,;,,~'~~'':I'I,_''.~ ,',~'_' :._,l~, c. \.:..'~,~ '..'~_'" '. ',-... . '~,i7;..~,,'. ":J .;.J!:.":'" " s , o . 1,000 ~ 2,000 I ~ Feet \ I Source: USGS Quadrangle Harmony, NC I Figure 2. Stream Crossing #1 .. I ~_ -_. :-...,:-. " I o 1,000 2,000 .'. ..~ .,.,.,.. .........-....,. Feet Source: USGS Quadrangle Central, NC Figure 3. Stream Crossing #2 and #3 ~ "...._'\.~~ . ~ ;..,,---,..~"'-....-:-'.--- . I. 'J ;1' \ I'll / \ tll J l,@r " II \ ,.J.. \....~ /1'" \ '/ } ;~ Ji 'j N ~I .ff ",A_,. ~'"- _.I'J".r ... ...._...... ,,/ r. r . ..../..'". \ ...~ .,)/" " '....--,_.~_~, ~ I '..... ./ /' .r ", j",",,-~__ ../0"/_ \. _ "" ..,/r ......., _/ "I. ,~\, . !j \\, //:'".\,\ ,I' .\\::_ i ".~_J w.Jt, s \ o 1,000 2,000 Feet '. Source: USGS Quadrangle Brooks Crossroads, NC Figure 4. Stream Crossing #4 (Directional Bore) ,_1 .- ....... \l._ _, " ...~.~-;;';" , ',- ~""~""---...'4-,. ..."......_n " " i. ' / ".., ........... -- .~.~ - .............. I.".,. _. ......., -oj' ~_.r-/06.... '........(. ..........,... "t.,'" " 'j , ',',. " ---. , ~- ". -.~ .... " I i , i \.) "\ Ii ./" i I \. \ " \ 1 \ \ ' \ \ 1 \) I \ / '" 'I (~' Ii, '. ":-::. \~ .:, ...~\ \ , I '. / ~ .. r/ / 11./ II ..,..... )/ ',- " t' l / ,/ ", ""\ } I f ,. /,,-- " l I ( I .J" /'" o (------.., ,.. r .. ~......... , "--... ... \, I ..... ,/ \ "" iI.;....----- 1,..- -'" "\" .'- _.. - I -~. _....~~J".--:...~,~) 1 . '" ..... --r-- -" "~.... I \ ,-,_':-~-f--l · ."...... /~:'~, \, -. ,-- j . ~.... '" -..:~ ........ Feet /'.' 1\ (-,- ./ ""'" ~~'~,. .......\ /~ ' ) ....."""... . T.... ....-" '\ '..~~., -... ....._. ___/ ~r-~-'J~< ;-, l ...........,.,...', \ . "':.~~"'" USGS Quadrangle Brooks Crossroads, NC /' 'I i '-..- \ \, ) "1:'i'" " / 1'~'11. J\ ". '-..=:.,~ /-) ~. ~ ._"r./'i i ',\ ....... ...-".. ....... ~ -A .:' ./ \\ ~- j ~ r /" ./ ,...I .' I- ,~__~..........I \) J ,'~, ':~~. N w4t, s ...- ....... 1,000 2,000 .' ;:- Source: :- Figure 5. Stream Crossing #5 (Directional Bore) ". '. ." . N w.. s 0 1,000 2,000 .. ,.,..". Feet USGS Quadrangle Calahan, NC Figure 6. Stream Crossing #6 and #7 . ' - ."-11'\.. I. :"- ... N w~, s 0 1,000 2,000 . I Feet Source: USGS Quadrangle Statesville East, NC Figure 7. Stream Crossing #8 ,.,-... '\. ,...... "\ .. \., &/g@/gllW@W FEB 2 3 2005 \\~~~~ WATER QUALITY STORMWATER BfW :CIf o ~,'J:}~! ~-t'> ~/"... ~,,' T Oc, !IDW, ", r- '0 \Z;~j?):; Pre-Construction Notification (PCN) Application Form For Scction 404 and/or Scction 10 Nationwidc, Rcgional and Gcncral Pcrmits, Scction 401 Gcncral \Vatcr Quality Ccrtifications, and Riparian Buffcr and \Vatcrshcd Buffcr Rulcs 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 Pennit application form is available online at http://www.saw.usace.army.mil/wetlands/Permapp.htm . The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide, Regional or General pennits, and to determine which permit applies to your project, please go to the USACE website at http://www.saw.usace.army.mil/wetlands/regtour.htm. 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 Pennit type has been determined by the USACE. Applicants are encouraged to visit DWQ's 401/Wetlands Unit website at http://h20.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 (919) 733-1786. 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 ofthis 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 detennine 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 fonn, 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 pennits, as well as information required for State authorizations, certifications, and coordination. Fully providing the information requested on this fonn will result in a complete application for any of the USACE Nationwide, Regional or General pennits. To review the minimum amount of information that must be provided for a complete PCN for each USACE Nationwide permit, see Condition 13, 65 Fed. Reg. 12893 (March 9, 2000), available at http://www.saw.usace.army.mil/wetlands/nwpfinaIFedReg.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 \Vater 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, 401lWetlands 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://h20.ehnr.state.nc.us/ncwetlands/fees.html. 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 Anny Corps of Engineers Alleghany Catawba Henderson Mecklenburg Transylvania 151 Patton Avenue Ashe Cherokee Iredcll Mitchell Union Room 208 A very Clay Jackson Polk Watauga Asheville, NC 28801-5006 Buncombe Cleveland Lincoln Rowan Yancey Telephone: (828) 271-7980 Burke Gaston Macon Rutherford Fax: (828) 281-8120 Cabarrus Graham Madison Stanley Raleigh Regulatory Field Office Alamance Franklin Nash S urry US AmlY 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: (919) 876-8441 Durham Johnston Rockingham Wilson Fax: (919) 876-5823 Edgecombe Lee Stokes Yadkin Washington Regulatory Field Office Beaufort Currituck Jones Pitt US Anny Corps Of Engineers Bertie Dare Lenoir Tyrrell Post Office Box 1000 Camden Gates Martin Washington Washington, NC 27889-1000 Carteret* Green Pamlico Wayne Telephone: (252) 975-1616 Chowan Hertford Pasquotank Fax: (252) 975-1399 Craven Hyde Perquimans *Croatan National Forest Only Wilmington Regulatory Field Office Anson Duplin Onslow US Anny Corps Of Engineers Bladen Harnett Pender Post Office Box 1890 Brunswick Hoke Richmond Wilmington, NC 28402-1890 Carteret Montgomery Robeson Telephone: (910) 251-4511 Columbus Moore Sampson Fax: (910) 251-4025 Cumberland New Hanover Scotland North Carolina State Agencies Division of Water Quality 401 Wetlands Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Telephone: (919) 733-1786 Fax: (919) 733-6893 Division of Water Quality Wetlands Restoration Program 1619 Mail Service Center Raleigh, NC 27699-1619 Telephone: (919) 733-5208 Fax: (919) 733-5321 State Historic Preservation Office Department Of Cultural Resources 4617 Mail Service Center Raleigh, NC 27699-4617 Telephone: (919) 733-4763 Fax: (919) 715-2671 US Fish and \Vildlife Service / National Marine Fisheries Service US Fish and Wildlife Service Raleigh Field Office Post Office Box 33726 Raleigh, NC 27636-3726 Telephone: (919) 856-4520 US Fish and Wildlife Service Asheville Field Office 160 Zillicoa Street Asheville, NC 28801 Telephone: (828) 258-3939 National Marine Fisheries Service Habitat Conservation Division Pivers Island Beaufort, NC 28516 Telephone: (252) 728-5090 Page 3 of 12 Division of Coastal Management 1638 Mail Service Center Raleigh, NC 27699-1638 Telephone: (919) 733-2293 Fax: (919) 733-1495 Western Piedmont Region Coordinator 3855 Idlewild Road Kemersville, NC 27284-9180 Telephone: (336) 769-9453 Mountain Region Coordinator 20830 Great Smoky Mtn. Expressway Waynesville, NC 28786 Telephone: (828) 452-2546 Fax: (828) 452-7772 CAMA and NC Coastal Counties Beaufort Bertie Brunswick Camden Carteret Chowan Craven Currituck Dare Gates NC\VRC and NC Trout Counties Alleghany Ashe A very Burke Buncombe Cherokee Clay Graham Haywood Caldwell Mitchell Stokes S urry Henderson Jackson Macon Madison McDowell Hertford Hyde New Hanover Onslow Pamlico Watauga Wilkes Polk Rutherford Swain Transylvania Yancey Pasquotank Pender Perquimans Tyrrell Washington APPLICATION FORM BEGINS ON PAGE 5. PLEASE DO NOT SUBMIT PAGES 1 - 4. Page 4 of 12 ~rn,@rn,uwrn,~ FEB 2 3 2.005 Office Use Only: DENR.WAT~~~~~rAAl~ Fonn Version May 2002 WETWIDSN-lO STVfV'\" USACE Action ID No. D'VQ No. 0 5 0 5 5 0 (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 D D Section 10 Permit D ~ 401 Water Quality Certification Riparian or Watershed Buffer Rules Isolated Wetland Permit from DWQ 2. Nationwide, Regional or General Permit Number(s) Requested:-11 3. If this notification is solely a courtesy copy because written approval for the 401 Certification is not required, check here: ~ 4. Ifpayment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete section VIII and check here: D 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: D II. Applicant Information 1. Owner/Applicant Information Name: Iredell Water Corporation Mailing Address: 115 Jennings Road Statesville, NC 28625 Telephone Number: 704-876-0672 E-mail Address: Fax Number: 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: W.K. Dickson and Co., Inc. Company Affiliation: Mailing Address: 3101 John Humphries Wynd Raleigh, NC 27612 Telephone Number: 919-782-0495 Fax Number: 919-782-9672 E-mail Address:dingram@wkdickson.com 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 infonned that the project has been placed on hold until decipherable maps are provided. 1. Name of project: Iredell Water Corporation Utility Line Expansion 2. T.I.P. Project Number or State Project Number (NCDOT Only): 3. Property Identification Number (Tax PIN): 4. Location County: Iredell Nearest Town: Statesville, Harmony Subdivision name (include phase/lot number): Directions to site (include road numbers, landmarks, etc.): see attached location map 5. Site coordinates, if available (UTM or LatlLong): see attached letter (Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the coordinates for each crossing of a distinct waterbody.) 6. Property size (acres): approximately 30 linear miles 7. Nearest body of water (streamlriver/sound/ocean/lake): various 8. River Basin: Yadkin (03040102 HUe) (Note - this must be one of North Carolina's seventeen designated major river basins. The River Basin map is available at http://h20.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: All proposed work will be in existing road right-of-way, primarily within five feet of the edge of pavement. The right-of-way is maintained herbaceous habitat. Some small hardwood trees are present on stream banks. Page 6 of 12 10. Describe the overall project in detail, including the type of equipment to be used: The proiect consists of excavating a trench, installing water supply line and backfilling and bedding. At least two streams will be directionally drilled, resulting in no impacts to waters of the U.S. Other minor streams will be crossed within the fill slope atop an existing culvert resulting in no impacts to waters of the U.S. Six streams may be crossed utilizing cut and cover. All disturbed banks and stream beds will be stabilized and returned to the pre-construction contours. Equipment to be used includes excavators, directional drill equipment, and miscellaneous equipment. 11.Explain the purpose of the proposed work: The proposed proiect will expand water supply lines to provide current and future county residents with public water supply. IV. Prior Project History If jurisdictional determinations and/or pennits 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 pennits, 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. No future permit requests are anticipated for this proiect. Future development utilizing the new utility line may require future permits on a case by case basis. VI. Proposed Impacts to \Vaters of the United States/\Vaters of the State It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to wetlands, open water, and stream channels associated with the project. The applicant must also provide justification for these impacts in Section VII below. All proposed impacts, permanent and temporary, must be listed herein, and must be clearly identifiable on an accompanying site plan. All wetlands and waters, and all streams (intennittent and perennial) must be shown on a delineation map, whether or not impacts are proposed to these systems. Wetland and stream evaluation and delineation forms should be included as appropriate. Photographs may be included at the applicant's discretion. If this proposed impact is strictly for wetland or stream mitigation, list and describe the impact in Section VIII below. If additional space is needed for listing or description, please attach a separate sheet. Page 7 of 12 1. Provide a written description of the proposed impacts: Six streams will be crossed utilizing a cut and cover methodology. A total of 323 linear feet (measured from top of bank) of utility line will be installed below the stream bed. All impacted stream banks and beds will stabilized and returned to pre-construction contours. There are no wetland impacts associated with the proposed proiect. 2. Individually list wetland impacts below: Wetland Impact Area of Located within Distance to Site Number Type ofImpact* Impact IOO-year Floodplain** Nearest Stream Type of Wetland** * (indicate on map) (acres) (yes/no) (linear feet) * List each impact separatcly and identifY temporary impacts. Impacts include, but arc not limited to: mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams, separatcly list impacts due to both structure and flooding. ** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps (FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or online at http://www,fema,gov. *** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond, Carolina Bay, bog, etc.) Indicate if wetland is isolated (detennination of isolation to be made by USACE only). List the total acreage (estimated) of all existing wetlands on the property: N A Total area of wetland impact proposed: 0.00 3. Individually list all intermittent and perennial stream impacts below: Stream Impact Length of Average Width Perennial or Site Number Type ofImpact* Impact Stream Name** of Stream Intermittent? (indicate on map) (linear feet) Before Impact (please specify) 1 Temp 4 Patterson Creek 50 Perennial excavation 2 Temp 4 Snow Creek 43 Perennial excavation 3 Temp 4 South Yadkin River 67 Perennial excavation 6 Temp 4 Long Branch 50 Perennial excavation 7 Temp 4 Hunting Creek 90 Perennial excavation 8 Temp 4 Fifth Creek 23 Perennial excavation List each impact separately and identifY temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap, dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain), stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included. ** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at * Page 8 of 12 .. www.usgs.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com, www.mapquest.com. etc.). Cumulative impacts (linear distance in feet) to all streams on site: approximately 24 feet 4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic Ocean and any other water ofthe U.S.) below: Open Water Impact Area of Name of Water body Type of Water body Site Number Type ofImpact* Impact (lake, pond, estuary, sound, (indicate on map) (acres) (if applicable) bay, ocean, etc.) * List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging, flooding, drainage, bulkheads, etc. 5. Pond Creation If construction of a pond is proposed, associated wetland and stream impacts should be included above in the wetland and stream impact sections. Also, the proposed pond should be described here and illustrated on any maps included with this application. Pond to be created in (check all that apply): 0 uplands 0 stream 0 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.): 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 altemative, 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. The proposed proiect is a linear utility line that by necessity must cross waters of the U.S. The utility line will be installed entirely within existing road right-of-way and will cross over several minor streams on top of existing culverts. Additionally, two streams will be crossed with directional drilling, eliminating impacts. The remaining streams will be temporarily impacted. All appropriate sediment and erosion control BMP's will be utilized to minimize impacts to waters of the U.S. and stream bed and banks will be stabilized and returned to pre-construction contours. Page 9 of 12 ,. VIII. Mitigation DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC Division of Water Quality for projects involving greater than or equal to one acre of impacts to freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial streams. USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide Pennits, published in the Federal Register on March 9, 2000, mitigation will be required when necessary to ensure that adverse effects to the aquatic environment are minimal. Factors including size and type of proposed impact and function and relative value of the impacted aquatic resource will be considered in detennining acceptability of appropriate and practicable mitigation as proposed. Examples of mitigation that may be appropriate and practicable include, but are not limited to: reducing the size of the project; establishing and maintaining wetland and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of aquatic resource functions and values by creating, restoring, enhancing, or preserving similar functions and values, preferable in the same watershed. If mitigation is required for this project, a copy of the mitigation plan must be attached in order for USACE or DWQ to consider the application complete for processing. Any application lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as incomplete. An applicant may also choose to review the current guidelines for stream restoration in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at http://h20.enr.state.Bc.us/Bcwetlands/strmgide.htm 1. 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 Wetlands Restoration Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at (919) 733-5208 to determine availability and to request written approval of mitigation prior to submittal of a PCN. For additional information regarding the application process for the NCWRP, check the NCWRP website at http://h20.enr.state.nc.us/wrp/index.htm. If use of the NCWRP is proposed, please check the appropriate box on page three and provide the following information: Page 10 of 12 "! ' .. Amount of stream mitigation requested (linear feet): Amount of buffer mitigation requested (square feet): Amount of Riparian wetland mitigation requested (acres): Amount of Non-riparian wetland mitigation requested (acres): Amount of Coastal wetland mitigation requested (acres): IX. Environmental Documentation (required by D\VQ) Does the project involve an expenditure of public (federal/state) funds or the use of public (federal/state) land? Yes ~ No D If yes, does the project require preparation of an environmental document pursuant to the requirements of the National or North Carolina Environmental Policy Act (NEP A/SEP A)? Note: If you are not sure whether a NEP A/SEP A document is required, call the SEP A coordinator at (919) 733-5083 to review current thresholds for environmental documentation. Yes D No ~ If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a copy of the NEP A or SEP A final approval letter. Yes D No D X. Proposed Impacts on Riparian and \Vatershed 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. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233 (Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please identify )? Yes D No ~ If you answered "yes", provide the following information: Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer mitigation is required calculate the required amount of mitigation by applying the buffer multipliers. Zone* Impact Multiplier Required (square feet) Mitigation 1 3 2 1.5 Total Page 11 of 12 .. ~'",) ~ * Zone I extends out 30 feet perpendicular from ncar bank of channel; Zone 2 extends an additional 20 feet from the edge of Zone I. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as identified within 15A NCAC 2B .0242 or .0260. XI. Stormwater (required by D\VQ) Describe impervious acreage (both existing and proposed) versus total acreage on the site. Discuss stormwater controls proposed in order to protect surface waters and wetlands downstream from the property. N/A XII. Sewage Disposal (required by D\VQ) Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from the proposed project, or available capacity of the subject facility. N/A XIII. Violations (required by DWQ) Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules? Yes D No [2J Is this an after-the-fact permit application? Yes D No [2J XIV. 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). N/A Applicant! Agent's Signature Date (Agent's signature is valid only if an authorization letter from the applicant is provided.) Page 12 of 12