19950711 Ver 1_COMPLETE FILE_19950103

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
4 &T ?? W*AA
?EHNR
July 7, 1995
Forsyth County
DEM Project # 95711
APPROVAL of 401 Water Quality Certification
Mr. Tom Griffin
Winston-Salem/Forsyth County Utility Commission
P. O. Box 2511
Winston-Salem, N. C. 27102
FIL
Dear Mr. Griffin:
You have our approval to place fill material in 0.032 acres of wetlands or waters for the purpose
of installing a 8-inch water line across Salem Creek (Clemmonsville Project), as you described in your
application dated 30 June 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 br 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 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, 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 Dorney at 919-733-1786.
S' cerely,
Presto Howard, Jr. P.E.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Winston-Salem DEM Regional Office
Mr. John Domey
Central Files
95711.1tr
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
DENt iD t `J I Clemmonsv
• A?:11Vt?i 1J ?•
Nationwide Permit Requested (Provide Nationwide Permit #: 401 j_ ,?J I: 0
JOINT FORM FOR
Nationvi ide permits that require notification to the Corps of Engineers
Nationwide- permits that require.application for Section 401 certification
WELNMaMNT DISTRICT ENGINEER
CORPS OF ENGINEERS
DEPARTI MM OF TIC ARMY
P.O. Box 1890
Wigton, NC 2UM-1890
ATrx: CESAw-CO-E
Telephone [phone]
WATER QUALITY PLANNING
DIVISION OF ENVIRONMENTAL MANAGEMENT
NC DEPAIM'MENT OF ENVIRONU[ NT,( E i,
AND NATURAL RESOURCES
P.O. Box 29535 JUL 6 1995
Ral ' NC 27626.0535
?M L JOHN DORNEY ENVIRONMENTAL SCIENCES
Telephone [phone] aae,i^q
ONE (1) COPY OF THIS COMPLETED APPLICATION SHOULD BE SENT TO THE CORPS OF EMMEERS.
SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
PLEASE PRINT.
1. Owners Name: Winston-Salem/Forsyth County Utility Commission
2. Owners Address' P.O. Box 2511. Winston-Salem. North .arn7ina 9.7102
3. Owners Phone Number (Home):
(Work): 910-727-8418
4. If Applicable: Agent's name or responsible corporate official, addma, phone number.
Tom Griffin
(Same as above)
5. Location of work (MUST ATTACH MAP). County: Forsyth
Nearest Town or City: Winston-Salem
Specific Location (Include road numbers, landmarks, etc.): Crossing of Salem Creek along
Clemmonsville Road (SR 1120).
6. Name of Closest Stream/River. Salem Creek flows to Muddy -Crt--,-k
7. River Basin: Yadkin
8. Is this project located in a watershed classified as Trout, SA, HQW, ORW, WS L or WS H? YES [ ] NO [ ]
9. Have any Section 404 permits been previously requested for use on this property? YES j ] NO g]
If yes,explain.
10. Estimated total number of acres of waters of the U.S., including wetlands, located on project site:
1400 soft. = .032 acres
11. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project:
Filled:
Drained:-
Flooded-
Excavated:
Total Impacted: 1400 sq. f t . = .032 acres
r
12. Description of proposed work (Attach PLANS-81/2" X 11" drawings only): 8-inch water line---
installed across Salem Creek
13. Purpose of proposed work To improve water pressure in the area
14. State reasons why the applicant believes that this activity must be carried out in wetlands. Also, note measures
taken to minimize wedand impacts. Need to tie line across Salem Creek. The water line will be
installed, then all grades returned to preconstruction conditions.
15. You are required to contact. the U.S. Fish and Wildlife Service (USFWS) andlor National Marine Fisheries Service
(NMFS) regarding the presence or any Federally listed or proposed for listing endangered ordnwtened species or critical
habitat in the permit area that maybe affected by the proposed project. Have you done so? NR YES( ] NO [ ]
RESPONSES FROM THE USFRrS 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 [ ]
RESPONSE FROM THE SHPO SHOULD BE FORWARDED TO CORPS. NR
17. Additional information required by DEM:
A. Wetland de:lneation map showing all wetlands, streams, and lakes on the property.
B. If available, representative photograph of wetlands to be impacted by project
C. If delineation was performed by a consultant, include all data sheets relevant to the placement of the
delineation line.
D. If a stormwater management plan is required for this project, attach copy.
E. What"is land use of surrounding property'
F. If applicable, what is proposed method of

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CLEMMONSVILLE RORD CROSSING
DATE: 7-3-95
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