19950378 Ver 1_COMPLETE FILE_19950407

?r State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr.., P.E., Director
ID FE Ft
April 10, 1995
Forsyth County
DEM Project # 95378
APPROVAL of 401 Water Quality Certification
City of Winston-Salem
P.O., Box 2511
Winston-Salem, N.C. 27102
GO r i
Dear Sirs:
You have our approval to place fill material in 0.055 acres of wetlands or waters for the purpose
of installing a 8" V.C. sanitary sewer outfall between Herry Street and Sunflower Circle, as you
described in your application dated 4 April 1995. After reviewing your application, we have decided
that this fill is covered by General Water Quality Certification Number 2664. This certification allows
you to use Nationwide Permit Number 12 when it is issued by the Corps of Engineers.
This approval is only valid for the purpose and design that you described in your application. If
you change your project, you must notify us and you may be required to send us a new application.
For this approval to be valid, you must follow the conditions listed in the attached certification. In
addition, you should.get any other federal, state or local permits before you go ahead with your
project.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory
hearing. You must act within 30 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, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and
its conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Environmental Management under Section 401
of the Clean Water Act. If you have any questions, please telephone John Domey at 919-733-1786.
Sincerely,
to oward, Jr.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Winston-Salem DEM Regional Office
Mr. John Domey
Central Files
95378.1tr
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post-consumer paper
FROM 03.17.1994 14:42 NO. 9 P. 4
DEI 117 `1 S O ACTION ID:
Nationwide Permit Requested (Provide Nationwide Permit ft 12, Herry Street Out 2w." , q t 71127
JOINT FORM FOR
Nationwide permits that require notification to the Corps of Engineers
Nationwide permits that require application for Section 401 certification
WILMINGTON DISTRICT ENGINEER
CORPS OF ENGINEERS
DEPARTMENT OF THE ARMY
P.O. Box 1890
Wilmington, NC 28402-1890
ATTN: CESAW-CO-E
Telephone [phone]
WATER QUALITY PLANNINC
DIVISION OF ENVIRONMEN
NC DEPARTMENT OF ENVIR
AND NATURAL RESOURCES
P.O. Box 29535
Raleigh, NC 27626-0535
ATTN: MR. JOHN DORNEY
Telephone [phone]
C, HEALTH,
APR 71995

ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO THE CORPS OF ENGINEERS.
SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT.
PLEASE PRINT.
1. Owners Name: City of Winston-Salem
2. Owners Address: P.O. Box 2511, Winston-Salem, NC 27102
Owners Phone Number (Home): N/A (Work): [phone]
4. If Applicable: Agent's name or responsible corporate official, address, phone number.
N/A
5. Location of work (MUST ATTACH MAP). County: Forsyth
Nearest Town or City: Winston-Salem
Specific Location (Include road numbers, landmarks, etc.): East Winston-Salem: between Herry Street
and Sunflower Circle
6. Name of Closest StreanvRiver: ` Brushy Fork Branch
7. River Basin: Yadkin
8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS I, or WS II? YES [ ] NO F]
9. Have any Section 404 permits been previously requested for use on this property? YES [ j NO. -[ I
If yes, explain.
10. Estimated total number of acres of waters of the U.S., including wetlands, located on project site:
2,400 square feet or .055 acres.
11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project:
NWP 12
Filled: N/A
Drained: N/A
Flooded: N/A
Excavated: .055
Total Impacted: .055

GJ. It. 1VV IF 24 43 No. 9 P. 5
12. Description of proposed work (Attach PLANS-8 112" X 11" drawings only): Installation of
8" V.C. Sanitary Sewer Outfall
13. Purpose of proposed work: To provide sanitary sewer service to the surrounding area
from Herry Street to Sunflower Circle
14. State reasons why the applicant believes that this activity must be carried out in wetlands. Also, note measures
taken to minimize wetland impacts. The proposed sewer must cross wetlands to tie into the _
existing sewer system. Construction shall take place within a 40-foot corridor. Erosion
15. You are required to contact the U .S. Fish and Wildlife Service (USFWS) and/or National Marine Fisheries Service
(NMFS) regarding the presence or any Federally listed orproposed for listing endangered or threatened species or critical
habitat in the permit area that may be affected by the proposed project. Have you done so? YES[ J NO [X]
RESPONSES FROM THE USFWS AND/OR NMFS SHOULD BE FORWARDED TO CORPS.
16. You are required to contact the State Historic Preservation Officer (SHPO) regarding the presence of historic
properties in the permit area which may be affected by the proposed project? Have you done so? YES [ ] NO [X]
RESPONSE FROM THE SHPO SHOULD BE FORWARDED TO CORPS.
17. Additional information required by DEM:
A. Wetland delineation map showing all wetlands, streams, and lakes on the property, see attached
B. If available, representative photograph of wetlands to be impacted by project. N/A
C. If delineation was performed by a consultant, include all data sheets relevant to the placement of the
delineation line. N/A
D. If a stormwater management plan is required for this project, attach copy. N/A
E. What is land use of surrounding property? mostly caw pasture, scarce single-family dwellings
F. If applicable, what is proposed method of sewage disposal? -Sanitary sewer outfall (gravity flow)
T.-- . 3-
Owner' ture
1-4 Date
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401 ISSUED
CITY OF WINSTON-SALEM
PUBLIC WORKS DEPARTMENT
P.O. BOX 2511, WINSTON-SALEM, NORTH CAROLINA 27102
RECEIVED
APR 71995
April 4, 1995
E? ?pNN1EN1AL SCIENCES
pRA?IRH
Mr. John Dorney
Water Quality Planning Division
of Environmental Management
N.C. Dept. of Environment, Health
and Natural Resources
P.O. Box 29535
Raleigh, NC 27626-0535
Dear Mr. Dorney:
I have enclosed seven copies of the 401 Water Quality Certification
Application for Herry Street Outfall. An additional copy has also
been sent to the Corps of Engineers. If you have any questions,
please call me at [phone].
Sincerely,
ENG ERING DIVISION
Paul A. Stimpson
Project Engineer
PAS/ac
Enclosure

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