700 North Tryon Street
Charlotte, NC 28202
Fax: 704.336.4391
DATE
Name and Title of Applicant
Company Name
Mailing Address
Re:
PROJECT NAME
Approval of Request for Stream Exemption
Project Location
Town Name, North Carolina
Dear Applicant Name:
Please be advised that the Request for Stream Exemption that you submitted for
PROJECT NAME has been approved by this Office. The stream reach to which this
exemption applies is shown on the attached aerial photograph. This stream reach will not
be subject to the buffer requirements of the Post Construction Storm Water Ordinance.
Please note that this letter does not exempt the stream reach from compliance with other
local, state, or federal ordinances involving jurisdictional stream / wetland requirements,
such as Section 401 and 404 of the Clean Water Act.
This approval is required prior to the approval of your Concept Plan for this project and
prior to your submittal of the Storm Water Management Permit Application. Please be
sure to attach a copy of this approval letter to your Concept Plan Application and Storm
Water Management Permit Application to avoid delay in application review.
The Planning Department for the TOWN NAME is being notified of this approval by
copy of this letter.
If you have any questions, please call Inspector Name at _________________ .
Sincerely,
Rusty Rozzelle
Storm Water Administrator
Attachment
CC: Town Planning Department
David Kroening
Inspector Name
Form #PCO41
To report pollution, call: 704.336.5500
To report drainage problems , call: 311
http://stormwater.charmeck.org
Stream Reach Aerial Photograph
Project Name: Example
Project Location: 101 Smith Street
LEGEND:
= Stream reach exempt from the Post Construction buffer requirements
Stream Reach Evaluation Form
Date:
Project:
Evaluator:
Easting:
Northing:
Total Points:
Stream is at least intermittent if > 19 or perennial if > 30*
(right-click the purple number and left-click Update Field to summarize points)
Absent
Weak
Moderate Strong
Continuity of channel bed and bank
0
1
2
3
2. Sinuosity of channel along thalweg
0
1
2
3
3. In-channel structure: riffle- / step- pool sequence
0
1
2
3
4. Particle size of stream substrate
0
1
2
3
5. Active/relic floodplain
0
1
2
3
6. Depositional bars or benches
0
1
2
3
7. Recent alluvial deposits
0
1
2
3
8. Headcuts
0
1
2
3
9. Grade controls
0
0.5
1
1.5
10. Natural valley
0
0.5
1
1.5
11. Second or greater order channel
No = 0
Yes = 3
Geomorphology Subtotal
a
Man-made ditches are not rated: see discussion in NCDWQ Manual
A. Geomorphology
0.0
SCORE
1a.
0.0
B. Hydrology
12. Presence of Baseflow
13. Iron Oxidizing Bacteria
14. Leaf litter
15. Sediment on plants or debris
16. Organic debris lines or piles (Wrack lines)
17. Soil-based Evidence of high water table?
0
0
1.5
0
0
1
1
1
0.5
0.5
No = 0
2
3
2
3
0.5
0
1
1.5
1
1.5
Yes = 3
Hydrology Subtotal
0.0
C. Biology
18.
19.
20.
21.
22.
23.
24.
25.
26.
Fibrous roots in streambed
Rooted upland plants in streambed
Macrobenthos (note diversity and abundance)
Aquatic Mollusks
Fish
Crayfish
Amphibians
Algae
Wetland plants in streambed
3
2
1
0
3
2
1
0
0
1
2
3
0
1
2
3
0
0.5
1
1.5
0
0.5
1
1.5
0
0.5
1
1.5
0
0.5
1
1.5
FACW= 0.75, OBL= 1.5, Other= 0
Biology Subtotal
* perennial streams may also be identified using other methods. See page 35 of NCDWQ manual.
Notes:
I certify that this evaluation conforms to the latest version of
the NCDWQ document entitled Methodology for Identification
of Intermittent and Perennial Streams and their Origins.
0.0
____________________________________
Signature of Certified Evaluator
(version 4.11)