20051045 Ver 1_Complete File_20050609

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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

Mr. Roger Bardsley
Guilford County
Parks & Recreation Division
P. O. Box 3427
Greensboro, NC 27402

~~@~DW~fID
JUL 1 4 2005

July 11, 2005
DWQ# 05-1045
Guilford County

DENR. WATER QUAliTY
'rVETlNIDS mo STORMWATER BfWlCH

APPROVAL of 401 'Vater Quality Certification with Additional Conditions

Dear Mr. Bardsley:

Guilford County has our approval, in accordance with the attached conditions, to place permanent fill in 90
linear feet of perennial stream in order to construct a low-water road crossing for the Northeast Park located on
High Rock Road in Washington Township, Guilford County, as described in your application received by the
Division of Water Quality (DWQ) on June 9, 2005. After reviewing your application, we have determined that
this fill is covered by General Water Quality Certification Number 3404, which can be viewed on our web site
at http://h2o.enr.state.nc.us/ncwetlands.This Certification allows you to use Nationwide Permit Number 14
when it is issued by the U.S. Army Corps of Engineers. In addition, you should secure any other applicable
federal, state or local permits before you proceed with your project, including (but not limited to) those required
by Sediment and Erosion Control, Non-Discharge, and Water Supply Watershed regulations. Also, this
approval will expire when the accompanying 404 permit expires unless otherwise specified in the General
Certification.

This approval is valid only for the purpose and design that you have described in your application. If you
change your project, you must notify us in writing, and you may be required to send us a new application for a
new certification. 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 wetland fill for this project (now or
in the future) exceeds one acre, compensatory mitigation may be required as described in 15A NCAC 2H .0506
(h). For this approval to be valid, you must follow the conditions listed in the attached Certification, as
well as the additional conditions listed below:

1. The following impacts are hereby approved as long as all other specific and general conditions of this
Certification are met. No other impacts, including incidental impacts, are approved:

Amount Approved Plan Location or Reference
Streams 90 linear feet Reedy Fork Creek, Northeast Park,
Washington Township, Guilford County.
Reference: Low Water Crossing Exhibit and
Sheets 1 & 2 of the Site Plan

N1>1thCarolina
/Vat/mIll!!

North Carolina Division of Water Quality
Wetlands Certification Unit 1650 Mail Service Center Raleigh, NC 27699-1650
2321 Crabtree Blvd. Raleigh, NC 27604-2260
Customer Service Number: 1-877-623-6748

Phone [phone] FAX [phone]
Internet htto//:h2oenr.state.ncus/ncwetlands

An Equal Opportunity/Affirmative Action Employer - 50% RecycledJ10% Post Consumer Paper

Mr. Roger Bardsley
Page 2,
July 11, 2005

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2. Appropriate sediment and erosion control measures 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 (available from the Division of Land Resources at NCDENR
regional offices or the central office), whichever is more appropriate, shall be designed, installed and
maintained properly to assure compliance at all times with the North Carolina water quality standards
that are applicable to Class C, NSW waters as described in 15A NCAC 02B .0211 Fresh Surface Water
Quality Standards For Class C Waters. Such measures must equal or exceed the requirements specified
in the most recent version of the North Carolina Sediment and Erosion Control Manual. These
measures must be maintained on all construction sites, borrow sites, and waste pile (spoil) sites,
including contractor owned and leased borrow pits, which are associated with this project.

3. 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 measures in wetlands or waters is unavoidable,
they shall be removed and the natural grade restored within six months of the date that the project is
completed or, if applicable, within six months of the date that the project is released by the North
Carolina Division of Land Resources.

4. 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.

5. The low-water bridge required for this project shall be installed in such a manner that the original stream
profile is not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed).
Existing stream dimensions (including the pattern and profile) are to be maintained above and below the
location of the bridge. The low-water bridge shall be designed and installed to prevent head cutting of
the stream. If head cutting develops after installation, the Applicant must submit a plan and receive
written approval from this Office for any corrective action plan (e.g., use of cross vanes downstream of
the low-water bridge).

6. Where riprap is required for energy dissipation and scour protection, it shall be limited to the minimum
dimensions specified by appropriate engineering calculations. Riprap may only be used below the
normal high water level. The original grade and elevation of the stream's cross-section must be
maintained. Riprap placed in the stream bottom must be inserted into the bottom matrix to a depth
sufficient to provide the thickness of riprap required for scour protection. The elevation of the stream
bottom must not be increased by the placement of riprap. Placement of riprap must not result in
destabilization of the streambed or banks upstream or downstream.

7. Energy dissipation and sheet flow must be provided for all discharges of stormwater before such
discharges reach stream channels or wetlands.

8. The proposed project must comply with the local water supply and stormwater management ordinances
of Guilford County approved by the N. C. Environmental Management Commission.

,~

Mr. Rog~r Bardsley
Page 3,
July 11, 2005

9. All construction activities associated with this project shall minimize built-upon surface area, direct
stormwater runoff away from surface waters, and incorporate best management practices to minimize
water quality impacts. If concrete is used with any fill material, it shall not be allowed to come in
contact with surface waters until it has cured. If any stormwater must be collected for discharge into a
stream channel, it shall not enter the stream as a point source, but shall be slowed and discharged as
sheet flow prior to entering the riparian buffer on either side of the stream.

10. Upon completion of the project, the Applicant shall complete and return the enclosed "Certificate of
Completion" form to notify NCDWQ when all work included in the S401 Certification has been
finished. This certificate should be sent to the 401/Wetlands Unit of the NC Division of Water Quality
at the address listed on the form. Along with the Certificate of Completion form, please send
photographs upstream and downstream of the low-water bridge site to document correct installation.

If you do not accept any of the conditions of this certification, 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.

This letter completes the review of the Division of\Vater Quality under Section 401 of the Clean Water Act. If
you have any questions, please telephone Daryl Lamb in the DWQ Winston-Salem Regional Office at 336-771-
4600, extension 293.

Sincerely,

(4&v~

/~lan W. Klimek, P.E.

A WKlcdl

Attachments

cc: Todd Tugwell, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Central Files
Wetlands/401 File Copy
Michael B. Westcott, Westcott Engineering & Consulting, PC, 4135 Mendenhall Oaks Park-way, Suite 140,
High Point, NC 27265

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[;:] North Carolina Wildlife Resources Commission E_]

Richard B. Hamilton, Executive Director

FROM:

Cyndi Karoly
401 Oversight/Express Permits Unit
Division of Water Quality

David R. Cox, Supervisor ~ ) jJ
Habitat Conservation Prograb- Ut>~'"

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JUL 0 8 2005

MEMORANDUM

TO:

OENR . WATEi< QUALITY
WETUJiDS AriD STO.;I,l\VATER BRANCH

fy

DATE:

07 July 2005

SUBJECT:

Pre-construction Notification Application for Guilford County Parks and Recreation
Department, Northeast Park, Guilford County, North Carolina. DWQ ID: 051045

Biologists with the North Carolina Wildlife Resources Commission (NCWRC) have reviewed the
subject document and we are familiar with the habitat values of the area. An on site visit was made on 30
June 2005. Our comments are provided in accordance with provisions of the Clean Water Act of 1977 (as
amended), Fish and Wildlife Coordination Act (48 Stat. 401, as amended; 16 U.S.C. 661-667d), and
North Carolina General Statutes (G.S. 113-131 et seq.).

Applicant proposes to impact 90 linear feet of Reedy Fork Creek. Impacts to Reedy Fork Creek
will result from the installation of pipes, concrete fill, and rip rap for the construction of a concrete low
water crossing. During low water periods, stream flow will be concentrated through the concrete
structure by 14 pipes that are set along the stream substrate and are approximately 42 feet long and 15
inches in diameter. There are no records for federal or state listed species in Reedy Fork Creek.

We are concerned that this project does not provide adequate passage for aquatic life during
periods of low flow. The proposed length and diameter of pipe to direct stream flow will hinder or
completely eliminate the passage of aquatic organisms due to increased water velocities and reduced
sunlight. Fewer pipes that are shorter in length with larger diameters would help lessen the negative
impacts to aquatic life passage.

However, impacts to habitat for fish and wildlife would be significantly reduced if a bridge was
constructed that fully spanned the bankfull channel. Therefore, we are not opposed to a stream crossing
at this location; however, we recommend that an alternative design be used.

We have the following additional recommendations regarding the project.

1. As stated above, use bridges for all permanent roadway crossings of streams to eliminate the need
to fill and culvert. If culverts must be used, the culvert should be designed to allow passage of

Mailing Address: Division of Inland Fisheries · 1721 Mail Service Center · Raleigh, NC 27699-1721
Tclcphonc: [phone] · Fax: [phone]

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~age 2

7 July 2005
Northeast Park
DWQ ID No. 051045

aquatic organisms. Generally, this means that the culvert or pipe invert is buried at least one foot
below the natural streambed. Ifmultiple cells are required, the second and/or third cells should
be placed so that their bottoms are at stream bankfull stage. This will allow sufficient water depth
in the culvert or pipe during normal flows to accommodate movements of aquatic organisms. If
culverts are long and sufficient slope exists, baffle systems are recommended to trap gravel and
provide resting areas for fish and other aquatic organisms. If multiple pipes or cells are used, at
least one pipe or box should be designed to remain dry during normal flows to allow for wildlife
passage. In addition, culverts or pipes should be situated so that no channel realignment or
widening is required. Widening of the stream channel at the inlet or outlet of structures usually
causes a decrease in water velocity causing sediment deposition that will require future
maintenance. Finally, riprap should not be placed on the streambed.

2. Concrete is toxic to aquatic life and should not be allowed to come in contact with surface waters
until cured.

3. We advise that specialized efforts and techniques be implemented to reduce sediment runofffrom
construction activities.

Thank you for the opportunity to provide input during the planning stages for this project. Ifwe
can provide further assistance, please contact Shari Bryant, Piedmont Coordinator at [phone].

cc: Andrea Wade, USACOE
ec: Daryl Lamb, DWQ-WSRO

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{liP Michael F. Easley, Governor

\A William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources

Alan W. Klimek, P.E. Director
Division of Water Quality

July 11,2005
DWQ# 05-1045
Guilford County

Mr. Roger Bardsley
Guilford County
Parks & Recreation Division
P. O. Box 3427
Greensboro, NC 27402

APPROVAL of 401 Water Quality Certification with Additional Conditions

Dear Mr. Bardsley:

Guilford County has our approval, in accordance with the attached conditions, to place permanent fill in 90
linear feet of perennial stream in order to construct a low-water road crossing for the Northeast Park located on
High Rock Road in Washington Township, Guilford County, as described in your application received by the
Division of Water Quality (DWQ) on June 9, 2005. After reviewing your application, we have determined that
this fill is covered by General Water Quality Certification Number 3404, which can be viewed on our web site
at http://h20.enr.state.nc.us/ncwetlands.This Certification allows you to use Nationwide Permit Number 14
when it is issued by the U.S. Army Corps of Engineers. In addition, you should secure any other applicable
federal, state or local permits before you proceed with your project, including (but not limited to) those required
by Sediment and Erosion Control, Non-Discharge, and Water Supply Watershed regulations. Also, this
approval will expire when the accompanying 404 permit expires unless otherwise specified in the General
Certification.

This approval is valid only for the purpose and design that you have described in your application. If you
change your project, you must notify us in writing, and you may be required to send us a new application for a
new certification. 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 wetland fill for this project (now or
in the future) exceeds one acre, compensatory mitigation may be required as described in 15A NCAC 2H .0506
(h). For this approval to be valid, you must follow the conditions listed in the attached Certification, as
well as the additional conditions listed below:

1. The following impacts are hereby approved as long as all other specific and general conditions of this
Certification are met. No other impacts, including incidental impacts, are approved:

Amount Approved Plan Location or Reference
Streams 90 linear feet Reedy Fork Creek, Northeast Park,
Washington Township, Guilford County.
Reference: Low Water Crossing Exhibit and
Sheets 1 & 2 of the Site Plan

N<6"rthCarolina
;Vatllm//!/

North Carolina Division of Water Quality
Wetlands Certification Unit 1650 Mail Service Center
2321 Crabtree Blvd.
Customer Service Number: 1-877-623-6748

Raleigh. NC 27699-1650
Raleigh, NC 276~-2260

Phone [phone] FAX [phone]
Internet h \tpl/: h2o. e n r.sta Ie. nc. uslncwetland s

An Equal Opportunity/Affirmative Action Employer - 50% Recycled/l0% Post Consumer Paper

Mr. Roger Bardsley
Page 2,
July 11, 2005

2. Appropriate sediment and erosion control measures 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 (available from the Division of Land Resources at NCDENR
regional offices or the central office), whichever is more appropriate, shall be designed, installed and
maintained properly to assure compliance at all times with the North Carolina water quality standards
that are applicable to Class C, NSW waters as described in 15A NCAC 02B .0211 Fresh Surface Water
Quality Standards For Class C Waters. Such measures must equal or exceed the requirements specified
in the most recent version of the North Carolina Sediment and Erosion Control Manual. These
measures must be maintained on all construction sites, borrow sites, and waste pile (spoil) sites,
including contractor owned and leased borrow pits, which are associated with this project.

3. 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 measures in wetlands or waters is unavoidable,
they shall be removed and the natural grade restored within six months of the date that the project is
completed or, if applicable, within six months of the date that the project is released by the North
Carolina Division of Land Resources.

4. 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.

5. The low-water bridge required for this project shall be installed in such a manner that the original stream
profile is not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed).
Existing stream dimensions (including the pattern and profile) are to be maintained above and below the
location of the bridge. The low-water bridge shall be designed and installed to prevent head cutting of
the stream. If head cutting develops after installation, the Applicant must submit a plan and receive
written approval from this Office for any corrective action plan (e.g., use of cross vanes downstream of
the low-water bridge).

6. Where riprap is required for energy dissipation and scour protection, it shall be limited to the minimum
dimensions specified by appropriate engineering calculations. Riprap may only be used below the
normal high water level. The original grade and elevation of the stream's cross-section must be
maintained. Riprap placed in the stream bottom must be inserted into the bottom matrix to a depth
sufficient to provide the thickness of riprap required for scour protection. The elevation of the stream
bottom must not be increased by the placement of riprap. Placement of riprap must not result in
destabilization of the streambed or banks upstream or downstream.

7. Energy dissipation and sheet flow must be provided for all discharges of stormwater before such
discharges reach stream channels or wetlands.

8. The proposed project must comply with the local water supply and stormwater management ordinances
of Guilford County approved by the N. C. Environmental Management Commission.

Mr. Roger Bardsley
I Page 3,
July 11,2005

9. All construction activities associated with this project shall minimize built-upon surface area, direct
stormwater runoff away from surface waters, and incorporate best management practices to minimize
water quality impacts. If concrete is used with any fill material, it shall not be allowed to come in
contact with surface waters until it has cured. If any stormwater must be collected for discharge into a
stream channel, it shall not enter the stream as a point source, but shall be slowed and discharged as
sheet flow prior to entering the riparian buffer on either side of the stream.

10. Upon completion of the project, the Applicant shall complete and return the enclosed "Certificate of
Completion" form to notify NCDWQ when all work included in the S401 Certification has been
finished. This certificate should be sent to the 401/Wetlands Unit of the NC Division of Water Quality
at the address listed on the form. Along with the Certificate oj Completion Joml, please send
photographs upstream and downstream oJthe low-water bridge site to document correct installation.

If you do not accept any of the conditions of this certification, 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.

This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If
you have any questions, please telephone Daryl Lamb in the DWQ Winston-Salem Regional Office at 336-771-
4600, extension 293.

Sincerely,

Alan W. Klimek, P.E.

A WKlcdl

Attachments

cc: Todd Tugwell, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Central Files
Wetlands/401 File Copy
Michael B. Westcott, Westcott Engineering & Consulting, PC, 4135 Mendenhall Oaks Parkway, Suite 140,
High Point, NC 27265

Triage Check List

Date:

6/15/05

Project Name: Guilford County Northeast Parli Crossing
DWQ#: 05-1045
~: ~ l [ G ~ P V County: Guilford

Daryl Lamb, Winston-Salem Regional Office

To:

60-day processing time:

6/9/05

8/7/05

From: Cyndi Karoly Telephone: [phone]

The file attached is being forwarded to your for your evaluation.
Please call if you need assistance.

D Stream length impacted
D Stream determination
D Wetland determination and distance to blue-line surface waters on USFW topo maps
Minimization/avoidance issues
D Buffer Rules (Neuse, Tar-Pamlico, Catawba, Randleman)
D Pond fill
D Mitigation Ratios
Ditching
D Are the stream and or wetland mitigation sites available and viable?
D Check drawings for accuracy
D Is the application consistent with pre-application meetings?
Cumulative impact concern
D
D
D

Comments: As per our discussion regarding revision of the triage and delegation processes,
please review the attached file. Note that you are the first reviewer, so this file will need to be
reviewed for administrative as well as technical details. If you elect to place this project on hold,
please ask the applicant to provide your requested information to both the Central Office in
Raleigh as well as the Asheville Regional Office. As we discussed, this is an experimental, interim
procedure as we slowly transition to electronic applications. Please apprise me of any
complications you encounter, whether related to workload, processing times, or lack of a "second
reviewer" as the triage process in Central had previously provided. Also, if you think of ways to
improve this process, especially so that we can plan for the electronic applications, let me know.
Thanks!

I. .

rr,i n, n, f1 P,' n,', \)\:1, I
~"ull!: ~~j ;

i\ ~\j~, t L:j'

Office Use Only:

Form Version May 2002

USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)

051045

I. Processing

1. Check all of the approval(s) requested for this project:
~ Section 404 Penn it 0
D Section 10 Pennit 0
~ 401 Water Quality Certification

Riparian or Watershed Buffer Rules
Isolated Wetland Pennit from DWQ

2. Nationwide, Regional or General Pennit Number(s) Requested: 42

3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: D

4. If payment 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: 0

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 o~JPh ~~fnfrea of
Environmental Concern (see the top of page 2 for further det'llif~~!~~ ~

II. Applicant Information JUN 9 2005

1. Owner/Applicant Infonnation
Name: Guilford County / Roger Bardsley
Mailing Address: PO Box 3427
Greensboro, NC 27402

. DENR . WATER QUALITY
\."ETIANOS MD STORM\VATER BRN~

Telephone Number: 336-641-3544 Fax Number:
E-mail Address:[e-mail]

2. Agent/Consultant Infonnation (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: Westcott Engineering & Consulting, PC / Michael B. Westcott, PE
Company Affiliation: Consultant'
Mailing Address: 4135 Mendenhall Oaks Pkwy Suite 140
High Point. NC 27265

Telephone Number: 336-812-3546 Fax Number: 336-812-8075
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: Northeast Park Low Water Crossing

2. T.I.P. Project Number or State Project Number (NCDOT Only):

3. Property Identification Number (Tax PIN): 011811670020000002

4. Location
County: Guilford Nearest Town: Gibsonville
Subdivision name (include phase/lot number): NE Park
Directions to site (include road numbers, landmarks, etc.): From 1-40 take Hwy 70 North
Turn right on Hicone Rd. At dead end take left onto Huffine Mill Rd and then left onto
High Rock. Park entrance is approximately 200' on the right.

5. Site coordinates, if available (UTM or Lat/Long):UTM 17.624748E 40.03492N NAD83
(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): 369.40 Ac

7. Nearest body of water (stream/river/sound/ocean/lake): Reedy Fork

8. River Basin: Cape Fear
(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: The existing condition of the site is a river with a deeply
insized bed. The banks are vertical slopes 10' - 12' with the bottom in bedrock. The land
use of the property is a recreational park.

Page 6 of 12

10. Describe the overall project in detail, including the type of equipment to be used: The
proiect is a concrete low water crossing providing access to walking/biking/horse trails as
well as maintenance access to the other side of the river. Equipment used will be backhoes.
bu1\dozers. and cranes.

11. Explain the purpose of the proposed work: The purpose is to provide both pedestrian
and vehicular access to the park lands on the other side of the river. This crossing will be
used by the public to access recreational trails as we1\ as for maintenance of those trails by
park staff.

IV. Prior Project History

If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including a1\ 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.
None

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.
None

VI. Proposed Impacts to Waters of the United States/Waters of the State

It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream

Page 7 of 12

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: The proposed impact is 90
LF of stream impacts by constructing a concrete low water crossing.

2. Individually list wetland impacts below:

Wetland Impact Area of Located within Distance to
Site Number Type of Impact* Impact 100-year Floodplain** Nearest Stream Type of Wetland** *
(indicate on map) (acres) (yes/no) (linear feet)

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at hltp://www.fcIll3.gm:.
*** 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 (determination of isolation to be made by USACE only).

List the total acreage (estimated) of all existing wetlands on the property:
Total area of wetland impact proposed:

3. Individually list all intermittent and perennial stream impacts below:

Stream Impact Length of A verage Width Perennial or
Site Number Type of Impact* Impact Stream Name** of Stream Intermittent?
(indicate on map) (linear feet) Before Impact (please specify)
I Piping of stream 90 Re(fdy Fork 71 ' Perennial

List each impact separately and identify temporary impacts. Impacts include, but are not limited to: eulverts 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
www.lIsgs.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., WWW.toDozone.com,
www.mapquest.com. etc.).

...

Cumulative impacts (linear distance in feet) to all streams on site: 90'

Page 8 of 12

4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:

Open Water Impact Area of Name of Waterhody Type of Water body
Site Number Type of Impact* 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): D uplands D stream D 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 stonnwater 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 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.
There is no way to access the other side of the river for the property owner without this impact.
The impact was minimized by only crossing in one location where there will be no impacts
to wetlands.

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 March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.

If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h20.enr.sta te.ne. us/newet lands/strm gi de. I1tm I.

1. Provide a brief description of the proposed mitigation plan. The description should provide
as much infommtion 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.
No mitigation is proposed.

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
[phone] 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:

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):

Page 10 of 12

IX. Environmental Documentation (required by DWQ)

Do.es the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes [8] No 0

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 [phone] to review current thresholds for environmental documentation.
Yes 0 No [8] Verified with Alex at 919-733-5083

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 0 No 0

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.

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 0 No [8] 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
I 3
2 1.5
Total

*

Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.

Page II of 12

If buffer mitigation is required, please discuss what type of mitigation is proposed (Le., 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 DWQ)

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.
Since this proiect is in-stream, there is no stormwater control possible.

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.
No wastewater is generated from this proiect.

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 181

Is this an after-the-fact permit application?
Yes D No 181

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).

~ :; {ls-
Applicant/Agent's Signature < Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Page 12 of 12

TopoZone - The Web's Topographic Map

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Office Use Only:

Form Version May 2002

USACE Action ID No. DWQ No. D 5 1 U ..} {)
(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: 42

3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: D

4. If payment 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

II.

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:C~@ ~W~

Applicant Information ~ ~
JUN 9 2005

1. Owner/Applicant Information
Name: Guilford County / Roger Bardsley
Mailing Address: PO Box 3427
Greensboro, NC 27402

DENR. WATER QUALITY
WE~DS AND SlOOM\i'^IER Erw:ett

Telephone Number: 336-641-3544 Fax Number:
E-mail Address:[e-mail]

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: Westcott Engineering & Consulting, PC / Michael B. Westcott, PE
Company Affiliation: Consultant
Mailing Address: 4135 Mendenhall Oaks Pkwy Suite 140
High Point, NC 27265

Telephone Number: 336-812-3546 Fax Number: 336-812-8075
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: Northeast Park Low Water Crossing

2. T.I.P. Project Number or State Project Number (NCDOT Only):

3. Property Identification Number (Tax PIN): 011811670020000002

4. Location
County: Guilford Nearest Town: Gibsonville
Subdivision name (include phase/lot number): NE Park
Directions to site (include road numbers, landmarks, etc.): From 1-40 take Hwy 70 North
Turn right on Ricone Rd. At dead end take left onto Huffine Mill Rd and then left onto
High Rock. Park entrance is approximately 200' on the right.

5. Site coordinates, if available (UTM or Lat/Long):UTM 17.624748E 40.03492N NAD83
(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): 369.40 Ac

7. Nearest body of water (stream/river/sound/ocean/lake): Reedy Fork

8. River Basin: Cape Fear
(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 condition of the site is a river with a deeply
insized bed. The banks are vertical slopes 10' - 12' with the bottom in bedrock. The land
use orthe property is a recreational park. .

Page 6 of 12

10. Describe the overall project in detail, including the type of equipment to be used: The
proiect is a concrete low water crossing providing access to walkinglbiking/horse trails as
well as maintenance access to the other side of the river. Equipment used will be backhoes,
bulldozers, and cranes.

11. Explain the purpose of the proposed work: The purpose is to provide both pedestrian
and vehicular access to the park lands on the other side of the river. This crossing will be
used by the public to access recreational trails as well as for maintenance of those trails by
park staff.

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.
None

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.
None

VI. Proposed Impacts to Waters of the United StateslWaters of the State

It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream

Page 7 of 12

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: The proposed impact is 90
LF of stream impacts by constructing a concrete low water crossing.

2. Individually list wetland impacts below:

Wetland Impact Area of Located within Distance to
Site Number Type ofImpact* Impact I DO-year Floodplain** Nearest Stream Type ofWetland***
(indicate on map) (acres) (yes/no) (linear feet)

*

**

List each impact scparately and identify temporary impacts. Impacts include, but are not limited to: mechanized c1caring, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separatcly list impacts due to both structure and flooding.
100-Year floodplains arc identificd through the Federal Emcrgcncy Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps arc available through the FEMA Map Service Center at 1-800-358-9616, or
online at htlp://www,fcl1la.gQY.
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 (detcnnination of isolation to be madc by USACE only).

***

List the total acreage (estimated) of all existing wetlands on the property:
Total area of wetland impact proposed:

3. Individually list all intennittent and perennial stream impacts below:

Stream Impact Length of A verage Width Perennial or
Site Number Type ofImpact* Impact Stream Name** of Stream Intennittent?
(indicate on map) (linear feet) Before Impact (please specify)
I Piping of stream 90 Rc4dy Fork 71 ' Perennial

List each impact separately and identify temporary impacts. Impacts includc, 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 (cemcnt 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.
.. Strcam 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
www,lIsgS.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapqucst.com. ctc.).

.

Cumulative impacts (linear distance in feet) to all streams on site: 90'

Page 8 of 12

4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:

Open Water Impact Area of Name of Water body Type of Water body
Site Number Type of Impact* Impact (lake, pond, estuary, sound,
(indicate on map) (acres) (if applicable) bay, ocean, etc.)

*

List cach 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): D uplands D stream D 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 stonnwater 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 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.
There is no way to access the other side of the river for the property owner without this impact.
The impact was minimized by only crossing in one location where there will be no impacts
to wetlands.

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 March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.

If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
hI tp://h20.enr.stale.ne.lIs/ncwetlands/strl11l5ide.html.

1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
No mitigation is proposed.

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
[phone] 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:

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):

Page 10 of 12

IX. Environmental Documentation (required by DWQ)

Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes [8J No 0

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 NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes 0 No [8J Verified with Alex at 919-733-5083

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 0 No 0

X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)

It is the applicant's (or agent's) responsibility to detennine, 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 28 .0233
(Neuse), 15A NCAC 28 .0259 (Tar-Pamlico), 15A NCAC 28 .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes 0 No ~ If you answered "yes", provide the following infonnation:

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
I 3
2 1.5
Total

* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.

Page II of 12

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 DWQ)

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.
Since this proiect is in-stream. there is no stormwater control possible.

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.
No wastewater is generated from this proiect.

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 ~

Is this an after-the-fact permit application?
Yes D No ~

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).

a~~ 5 a.r 03---
Applicant/Agent's Signature ' Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Page 12 of 12

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o Engineering
~onsulting, PC

o 5 ., 0 l~ 5

Date: June 2, 2005

To: Division of Water Quality
401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650

From: Michael B. Westcott, PE
Westcott Engineering & Consulting, PC
Suite 140
4135 Mendenhall Oaks Parkway
High Point, NC 27265

We are sending you ~ attached D under separate cover the following items:

D Shop Drawings
D Prints
D Contracts

D Estimate
D Specifications
D Copy of Letter

D Disk
~ Other

# COPIES DRAWING NO DESCRIPTION DISPOSITION
7 4011404 Permit Application for For Review &
Northeast Park Low Water Approval
Crossing
1 Review Fee check ($475)

REMARKS:

mm@~~~~ ~

JUN 9 _ '100~

. DENR. WATEr: Co';;;\!.; (c Jl'~
\',E1NIDS AND STOi"'i:.i(j^'~1\ lllWl'Jtt

cc: File

'il35 Mendenhall Oaks Parkway Suite l.iO, High Point, NC 27265 . Phone: [phone] · Fa:'\:: [phone]