20071865 Ver 1_Application_20071102

fLkr~~ is\~
L ,~'\
~~4 ~
~•~ ..
' e} y
,,,,~ ) / ~~.f
JRti,N9`. ,,
STATE of NORTH CAROLINA ~ °"^,;~~
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPET
GOVERNOR SECRETARY
rr pv ~ November 1, 2007
V - ~ SUBJECT: Stokes County -Bridge # 242 on SR 1127, Temporary Rock Causeway
~ ~ Mr. John Thomas
2 ~ US Army Corps of Engineers
6508 Falls of the Neese Road, Suite 120 0
~ Raleigh, NC 27615-6814
~. Dear Mr. Thomas,
e0 In an effort to obtain the necessary permits for a temporary rock causeway, we areproviding a pre-
y construction notification application with supporting documentation. This is a permit for a defined
perennial stream, the Little Yadkin River, with distinct stream banks. There will be 40 feet of temporary
f- stream impacts, and .006 acres of temporary surface water impacts for the construction of a temporary rock
~ causeway. The causeway will be constructed of Class II riprap placed up to 1' below the natural ground
elevation at Bent # 1. It will then be capped off with 1' of class A riprap to provide a stable pad for a
drilling rig. This causeway is necessary to create a work area for the drilling rig at Bent #1. No endangered
species were found on 10/19/07. We believe this project can be accomplished under Nationwide Permit 33.
.After completion of the drilled shafts, the causeway will be removed and the stream profile will be
returned to its original condition. The stream banks will be seeded with a riparian mix and lined with coir
fiber matting.
By copy of this letter, we are also seeking approval from the NC Wildlife Resources Commission,
NC Department of Natural Resources -Water Quality, and the State Historic Preservation Office.
Therefore, we are submitting the enclosed material to them. For DWQ, the WB5 number for this project is
37818. If you have any questions, comments or need additional information after reviewing this material,
please contact me at [phone]. Thank you for your cooperation in this matter.
Respect y,
.~j.~H
Kent Boyer
Division Environmental Officer
Enclosures
Cc: Mr. Pat Ivey, P.E., Division Engineer
Mr. George Teague, Bridge Maintenance Engineer
Mr. Ron Linville, NCWRC
Mr. Peter Sandbeck, SHPO
Ms. Sue Homewood (1 copy), Mr. John Hennessy (7 copies) DENR -Water Quality
Mr. Matt Wilkerson. PDEA
Division of Highways • Division Nine • 375 Silas Creek Parkway, Winston-Salem, NC 27127
Telephone [phone] • Fax [phone] • Courier Box 13-12-04

~~~ U3e ~~y~ Form Version March OS
USACE Action ID No. DWQ No. 2 ~ ~ 7 1 8 6 5
(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 ^ Riparian or Watershed Buffer Rules
^ Section 10 Permit ^ Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ^ Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: 33
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ^
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ^
S. 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: ^
II. Applicant Information
1. Owner/Applicant Information
Name: NCDOT, Kent Boyer -Division Environmental Officer
Mailing Address: 37S Silas Creek Parkway
Winston-Salem, NC 27127
Telephone Number: 336-703-6500 Fax Number: 336-703-6693
E-mail Address:_ kbover(a,dot.state.nc.us
2. AgentlConsultant Information (A signed and dated copy of the Agerrt Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant. )
Name:
Company Afl-iliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page 5 of 13

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 U5GS 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: __ Bridge # 242 Replacement w/Pre-stressed Cored Slabs
2. T.I.P. Project Number or State Project Number (NCDOT Only): WBS # 37818
3. Property Identification Number (Tax PIl~:
4. Location
County:__~tokes _ Nearest Town: Pinnacle
Subdivision name (include phase/lot number):
Directions to site (include road numbers/names, landmarks, etc.): US 52 North to Pinnacle
Exit. Right turn onto Perch Rd. Take Perch Rd. to the Intersection of Old T}TS S2 (SR 1236)
and turn right. Follow Old US 52 until Dalton Rd. Take a right onto Dalton Rd Project
begins at Dalton Rd.
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 36.3119 °N 80.4018 °W
6. Property size (acres):
7. Name of nearest receiving body of water: Little Yadkin River
8. River Basin: Yadkin~Pee Dee
(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: Rural
Page 6 of 13

10. Describe the overall project in detail, including the type of equipment to be used: Re lace
the e~in~le lane brid,Ee with a two lane ore-stressed cored slab bride using a
drilling rig. dozer. motor~rader, and track hoe. All existing and new bents are located
outside of the normal flow of the river.
11. Explain the purpose of the proposed work: To enhance the safety of .the roadway by
replacing a single lane bridge with atwo-lane bridge.
IV. Prior Projeet 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. No previous permits were required. All work was to be performed
without anX stream impacts.
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.
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. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should 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.
Page 7 of 13

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.
l . Provide a written description of the proposed impacts: Placing of riprap in the stream channel
for a temporary causeway.
2. Individually list wetland impacts. Types of 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.
Wetland Impact
Site Number
(indicate on map)
Type of Impact Type of Wetland
(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Floodplain
no Distance to
Nearest
Stream
linear feet Area of
Impact
(acres)

Total Wetland Impact (acres)
3. List the total acreage (estimated) of all existing wetlands on the property: 0.00
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, 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. To calculate acreage, multiply length X width, then divide by 43,560.
Stream Impact
Number
indicate on ma
Stream Name
Type of Impact
Perennial °r
Intermittent? Average
Stream Width
Before Im act Impact
Length
linear feet Area of
Impact
acres
1 Little Yadkin River Temporary fill Perennial 16' 40 0.006

Total Stream Impact (by length and acreage) 40 .006
Page 8 of 13

5. individually list all open water impacts {including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill px~avatinn rlreclQinv_ fl~ndin~_ drainar'e. bulkheads. etC.
Open Water Impact
Site Number
indicate on ma Name of Waterbody

(if applicable)
Type of Impact Type of Waterbody
(lake, pond, estuary, sound, bay,
ocean, etc. Area of
Impact
acres.

Total Open Water Impact (acres)
6. List the cumulative im act to all Waters of the U.S. resultin from the . ra'ect:
Stream I act acres : .006
Wetland act acres
O en Water .act -acres
Total I act to Waters of the U.S. acres .006
Total Stream I act linear feet): 40
7. Isolated Waters
Do any isolated waters exist on the property? ^ Yes ®No
Describe all impacts to isolated wags, and include the type of water {wetland or beam) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
S. 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 appiicatian.
Pond to be created in (check all that apply): ^ uplands ^ stream ^ 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.):
Current land use in the vicinity of the pond:
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. The topog,,raohv of the site at
Page 9 of 13

Bent #1 is a rock shear face In order to gain access for the drilled shaft work. this rock
will need to be cut away and the area benched By placing riprap as a temuorarv fill for a
causeway the e~sting rock face will not be disturbed This will allow a stabilized surface to
remain The contractor will place class II rinran as a base to 1' below the beat ground
elevation IIe wiIl then glace class A ripran on ton of the class II rinran to create a stable
Qad for the drilling rig When the drilled shafts are completed, the contractor will remove
the causeway and return the bank to its original condition. _
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
Permits, published in the Federal Register on January 15, 2002, 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 NCEEP 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~//h2o enr.state.nc.us/ncwetlands/strm~ide.html.
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
Page 10 of 13

2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h2o.enr.state.nc.us/wry/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five 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 ofNon-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federaUstate/local) funds or the use of
public (federaUstate) land? Yes ® No ^
2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
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 ^ No
If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ^ No ^
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
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes ^ No
Page 11 of 13

2. If "yes", 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 multi Tiers.
,~ Impact Required
Zone ~____-- r -,, Multiplier *~;+;,,,,,;~„
1 I I 3 (2 for Catawba)
~- 2 ~ ~ 1.5
Total ~ ~ ~ ~
* Zone 1 extends out 30 feet perpendicular from the top of the neaz bank of channel; Zone 2 extends an
additiona120 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration /Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260. N/A
XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
storrnwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level. No new impervious acreage will be added by
this project NCDOT BMP's will be used to protect the surface waters.
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.
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 ^ No
Is this an after-the-fact permit application? Yes ^ No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ^ No
Page 12 of 13

If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description:
XV. 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).
Applicant/A~ent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 13 of 13

N
T~
~ D
1 ~
co
I~ ;~
~ '
~ ~.
P
~~
f
a
I ~
V
f
1~

7849248607
P_03
m~
,1
I/"
~~.' ~ a
a .a ,~
.~
r
- h ~ vim'
V r~J
~h•
V
N
~N ~
~ ~ N
~ ,
r
-C
i
U
~ o`
S
OCT-16-67 84:16 PM 732876726370NS
!YI
3 A
,/\ ~~
I~ ~i~~ ~ ~
')( `1gFr
~ ~ ~ ~ '`
0 ~ ~,
~ r
a~ ~ X
~l .' V T~ n~VO~ _ ~ r

~ _ ~;,J J 7,~ / .f~ I J' -.1 \/ III r r i' U~~V;' -~ 1/ ~ ~~ i ~fJ1'J I{I,.
•r ,' r -~ '~. ~ ~ ( ~~ -V it ~ ~ I i,~. ~ ~-' ~ R 1! o d -..~~ ~ ~~i ~ r (~
t ~j\ '~/ ~~~_ ~ ~\ ~\\.`.99/ i L^ ~.\~~ ,~~ ~CYi ~`~ '/~ ~~7,/~ i r r '1'. r~ j!a~r
_~ ~ !~ '` ~ ~ `1, • ti~ ~~~ Imo/ i I ~ ~ , ~)1 ~ ~ I , ~" ~ ,,,~ ^ ,,~%"~
;~ ~. ~~;; ~ I r r r~ 1 I i r - s ~ t 9~ '
y '.
_ ~ r i
~r~ ` r \+n ~ '~'~ ~- ~~ ~ 882 ~ . i 88 A~_ P~. i.j--
`-~ dt58' ~ ' ~ r ~ ~ I l ~ ,~ ~~' ,,..,~~
1 •a~ '', sH ~b ~
~ ~~ !~ ~ ~ ~ ~ -.~~ ~ ~` ~r ~ ~1 ~~ ~~ "~~ 1. "
_ed_ ~ -. 1~I/) r '~ i...a 'y cJ
~~ \~ \~ -" ~/ r \ O I r / I ~ ~ _ ~ I~~ \ Sao ~' 1 \~~
-r-" ,, tip,} ,` '~ .- ~ ~ ~ ~ o ~ r* ~°~
~ ~~~ ' ~I-,,lS~~ ~-. _ 'c /~ i , ~ ~ J° J \ ~ ~ ' x i -~i~S~~ -1i'~' r ;o'er ~-~,
c1~"- A~ .~ ~ ¢ ~ f V ~~ _ _yy 4
_~ • ° ~~ ~~
~y~~`~ ~`` - `'`` l~ ~ i V rr ~o.,' Jam; 1 p j ~1AD. r ~ ~ . - - ~ ~' . ~ ~ ~ ~
l ~ ~r ~ c ~: / ~ ~~ 4s /~
I rood \` ~ -~~, ~ • ~ ' k~'~ _ ~ I ~ _ ' 1 ~ ~
~~\'~, ~ ~
`jai try' ~T43 ~ \ ~ ! 1 ~'~ r _ }j~. ~~ ~ // ~A .,~~~/'~ ~y~~ I~ T®~ ~~ 999x
!~ )ri: ~ ~ V~ ~ ~ `~ 9661 ~ I / - ~ ~ l ~/'~s`rt~~'T / ~l V ° _
/J ~ r
~~!' -Q~ ~ ~1~ ~ y ~._~ ~ 1 q 1 A i ~ ~ ~' ~ ~'~ ~ 1 LJ / i IK~ ~ i'~~ ~~ /q
,' ZY `\..,;I ~~...ila ,-y a ;~ ~ ',"~. ,~j,, i Q~ ~ r/ / ~' ~,I~~ r fir!- u.. 4`0
'c I~lt/~~ I F-V r- ~ ~ Da~on~ '~)tt ~ BM~. ~' ,,~ ~~'r
\c ~ [ -,-~W 1 4 ~ ~'~ ~ 857 _ T'
<< ~ ~; h b-_~e~'~. ~~ ~ it Z
~I~ ~' I ~. ~~,1 . _ Rest-Area ~ ~ 2, (~ "~ 1 I ~i S• ~ ~a~ ~` ~ r ~
,(,~ ` ,~
~~ ~ ~ J~ ,~ L >y ~ i • ~n I
' ~ \`Q~~tf ,~o~ l/~ ~ ~ ~ ~ "\\ . ~\ ~': - ~ ~` i ~ 1 ~ ~ ~}~ ~ 966 , % ~. n t~~$ ~ `` - ~ ~
r` C ~- ~ ~~ - ~ ~D` rG ~~~2' - ~- ~ 1 ~ ~~ . ~a - _
l } ~. y\,';,,~l~j !~/ ~ ~ - Ba 1g;6i~ .gpD% I~~~/~~ ~ ,~.~ V" ; V ~~~4=2 94A r~ ~,•\,,~ 1 .>" - _ ~ ~~
g : ; I} ,fir ~=- ~, _ .~ Q ~ "' ~~' ~'
;~~ ~ roc'„` r~i J O ',( ~~ i (~ ~^
'`~'
Ijl~ r ~!~\~l'~l~l i~e-ng q~?8.~ - ~~=i 12~ ~ r r ~ '~j'11 ~ r~r ~ ~ ~(~ !!
~ti~.-- ~,~~~b \~/ri' 1 1( `~J `~•: ~' 51'1 ~ 1G~% ~.%i ~ _ ~e /r~,.,0~ ~ •~•~ ~+Ji~ '`~
~ ~ ~ t - !ff4nu~ 9'
- ~~ Q
STd~(ES ~O . ~oPYri9M (C)1998, Mapt~h, Ina _ 1
f ~ ~'i l~Li7

vI [G ~ ~! QTY NIAP

APPROVED JURISDICTIONAL DETERMNATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section N of the 7D Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD): 10/31/2007
B. DISTRICT OFFICE, FILE NAME, AND NIIMBER: Wimington District
C. PROJECT LOCATION AND BACKGROUND INFORMATION: NCDOT Division 9
State:NC County/parish/bomugh: Stokes City: Pinnacle
Center coordinates of site (lat/long in degree decimal format): Lat. 36.3119° N, Long. 80.4018° W.
Universal Transverse Mercator:
Name of nearest waterbody: Little Yadkin River
Name of nearest Traditional Navigable Water (TNW) ]nto which the aquatic resource flows: Yadkin river
Name of watershed or Hydrologic Unit Code (HiJC): Yadkin-Pee Dee
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
^ Check if other sites (e. g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different ID form
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date: 10/31/07
Field Determination. Date(s):
SECTION II: SiIbIlVIARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Are no "navigable waters of the U.S "within ]rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
[] Waters subject to the ebb and flow of the tide.
^ Waters are presently used, or have been used in the past, or may be susceptible for use to transpa~rt interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Are "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.5. in review area (check all that apply): r
^ TNWs, including territorial seas
^ Wetlands adjacent to TNWs
® Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
^ Non-RPWs that flow directly or indtrectly into TNWs
^ Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
^ Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
^ Wetlands adjacent to non RPWs that flow directly or indirectly into TNWs
^ Impoundments of jurisdictional waters
^ Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 6001inear feet: 16width (ft) and/or acres.
Wetlands: acres.
c. Limits (boundaries) of jurisdiction based on: Established by OHWM.
Elevation of established OHWM (if known):
2. Non-regWated waters/wetlands (check if applicable) 3
^ Potentially jurisdictional waters and/or weflands were assessed within the review area and determined to be not jurisdictional.
Explain:
' Boxes checked below shall be supported by completing the appropriate sections in Section III below.
z For purposes of this form, an RP W is defined as a tributary that is not a T'N W and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months).
' Supporting documentation is presented in Section III.F.

SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWa and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.l and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.l and 2
and Section III.D.1.; otherwise, see Section ]II.$ below.
1. TNW
Identify TNW:
Summarize rationale supporting detemunation:
2. Wetland adjacent to TNW
Sununarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (iF ANY):
This section summarizes information regarding characteristics ofthe tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. Ifthe aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
sltip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant news between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. Tf the JD covers a tributary with adjacent wetlands, complete Section lII.B.I for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section lII.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 8 square miles
Drainage area: 8 square miles
Average annual rainfall: 30 inches
Average annual snowfall: 2 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
® Tributary flows directly into TNW.
^ Tributary flows through Pick List tributaries before entering T]WV.
Project waters are 5-10 river miles from TNW.
Project waters aze 1(or less) river miles from RPW.
Project waters are 5-10 aerial (straight) miles from TNW.
Project waters are 1(orless) aerial (straight) miles fromRPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNWS: The Little Yadkin River flows southwest from Stokes County and empties directly into the
Yadkin River in Forsyth County.
Note that the Instructional Guidebook contains additional infoamation regarding swales, ditches, washes, and erosional features generally and in the and
West.
s Flow mute can be described by identifying, e.g., tributary a, which flows through the review saes, to flow into tributary b, which then flows into TNW.

Tributary stream order, if known: 1st.
(b) General Tributary Characteristics (check all that atmlv):
Tributary is: ®Natural
^ Artificial (man made). Explain:
^ Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: 45 feet
Average depth: 7 feet
Average side slopes: 2:1.
Primary tributary substrate composition (check all that apply):
® Silts ®Sands ^ Concrete
® Cobbles ®Gravel ^ Muck
® Bedrock ^ Vegetation. Type/% cover:
^ Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain: Very good vegetation on banks.
Presence of nut/rillle/pool complexes. Explain: Present in project area..
Tributary geometry: Relatively straight
Tributary gradient (approximate average slope): 1-2
(c) Flow:
Tributary provides for: Seasonal -flow
Estimate average number of flow events inreviewarea/year: 20 (or greater)
Describe flow regime: Continuous.
Other information on duration and volume:
Surface flow is: Discrete and confined. Characteristics:
Subsurface flow: t7nknown. Explain findings:
^ Dye (or other) test performed:
Tributary has (check all that apply):
® Bed and banks
® OHWM6 (check all indicators that apply):
® clear, natural line impressed on the bank
^ changes in the character of soil ^
^ shelving ^
® vegetation matted down, bent, or absent ^
® leaf litter disturbed or washed away ^
® sediment deposition
^ water staining ^
^ other (list):
^ Discentinuous OHWM.~ Explain:
the presence of litter and debris
destruction ofterrestrial vegetation
the presence of wrack line
sediment sorting
scour.
multiple observed or predicted flow events
abrupt change in plant community
If factors other than the OHWM were used to determine lateral extent of CWA jurisdiction (check all that apply):
^ High Tide Line indicated by: ^ Mean High Water Mark indicated by:
^ oil or scum line along shore objects ^ survey to available datum;
^ fine shell or debris deposits (foreshore) ^ physical markings;
^ physical markings/characteristics ^ vegetation lines/changes in vegetation types.
^ tidal gauges
^ other (list):
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water q-aality; general watershed characteristics, etc.).
Explain: Water color is clear and has continuous flow.
Identify specific pollutants, if known:
6A natural or man-made discontinuity in the OH WM does not necessarily sever jurisdiction (e.g., where the stream temporarily Bows underground, or where
the OH WM has been removed by development or agricultural practices). Where there is a break in the OHW M that is unrelated to the waterbody's flow
regime (e. g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.

(iv) Biological Characteristics. Channel supports (check all that apply):
® Riparian corridor. Characteristics (type, average width): Vegetation-trees, shrubs, and herbaceous.
^ Wetland fringe. Characteristics:
^ Habitat for:
^ Federally Listed species. Explain findings:
^ Fish/spawn areas. Explain findings:
^ Other environmentally-sensitive species. Explain findings: .
® Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow RelationshiQwithNoh TNW:
Flow is: Pick List. Explain:
Surface flow is: PlckList
Characteristics:
Subsurface flow: Fick List. Explain findings:
^ Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
^ Directly abutting
^ Not directly abutting
^ Discrete wetland hydrologic connection. Explain:
^ Ecological connection. Explain:
^ Separated by berm/barrier. Explain:
(d) Proximity_(Relationshipl to TNW
Project wetlands are Plcit List river miles from TNW,
Project waters are F'1cklist aerial (straight) miles from TNW.
Flow is from ~'Ick'Yist.
Estimate approximate location of wetland as within the Flck List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e. g, water color is clear, brown, oil filth on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
^ Riparian buffer. Characteristics (type, average width):
^ Vegetation type/percent cover. Explain:
^ Habitat for:
^ Federally Listed species. Explain findings:
^ Fish/spawn areas. Explain findings:
^ Other environmentally-sensitive species. Explain findings:
^ Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pick List
Approximately ( )acmes in total are being considered in the cumulative analysis.

For each wetland, specify the following:
Directly abuts? ,(Y/I~ Size (in acres) Directly abuts? (Y/l~ Size (in acres)
Summarize overall biological, chemical and physical fixncrions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more titan a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant news include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and ita adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW7
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section lII.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLI~:
TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
^ TNWs: linear feet width (ft), Or, acres.
^ Wetlands adjacent to TNWs: acres.
RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year~ound are jurisdictional. Provide data and rationale indicating that
tributary is perennial: The Little Yadkin River has continuous flow.
^ Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this wnclusion is provided at Section I17.B. Provide rationale indicating that tributary flows
seasonally.

Provide estimates for jurisdictional waters in the review area (check all that apply):
^ Tnbutary waters: linear feet width (ft).
^ Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWsB that flow directly or indirectly into TNWs.
Q Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
^ Tributary waters: linear feet width (ft).
^ Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
^ Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
~] Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section ]II.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
^ Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section lII.B and rationale in Section ]II.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands that do not directly abut an ]tPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section ]II.C.
Provide acreage estimates for jurisdictional wetlands in the review area.: acres.
6. Wetlands adjacent to non-RPWs that fYow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section ]II.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
Impoundments of jurisdictional waters.9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
^ Demonstrate that impoundment was created from `waters of the U. S.," of
^ Demonstrate that water meets the criteria for are of the categories presented above (1-~, or
^ Demonstrate that water is isolated with a nexus to commerce (see E below),
E. ISOLATED [IlVTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMIVVII;RCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):10
^ which are or could be used by interstate or foreign travelers for recreational or other purposes.
from which fish or shellfish are or could be taken and sold in interstate or foreign cemmerce.
which are or could be used for industrial purposes by industries in inerstate commerce.
^ Interstate isolated waters. Explain:
^ Other factors. Explain:
Identify water body and summarize rationale supporting determination:
aSee Footnote # 3.
To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
10 Prior to asserting or declining CWA jurisdiction based soL:ly on fhb category, Corpa Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Mrmorandwn Regarding CWA Act Jurlsdlctlon Following Rapanos.

Provide estimates for jurisdictional waters in the review area (check all that apply):
Tn'bulary waters: linear feet width (ft).
^ Other non wetland waters: acres.
^ Wetlands:
acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPL1~:
^ If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
^ Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
^ Prior to the Jan 2001 Supreme Court decision in "SYYANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Q Waters do not meet the "Significant Nexus" standard, where such a fording is required for jurisdiction. Explain:
^ Other: (explain, if not covered above):
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for imgated agriculture), using best professional
udgment (check all that apply):
Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
Lakes/ponds: acres.
^ Other non-wetland waters: acres. List type of aquatic resource:
[] Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a fording is required for jurisdiction (check all that apply):
~] Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
^ Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply -checked items shall be included in case file and, where checked
and requested, appropriately reference sources below):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
Datasheets prepared/submitted by or on behalf of the applicant/consultant.
^ Otlice concurs with data sheets/delineationrcport.
^ Oflice does not concur with data sheets/delineation report.
^ Data sheets prepared by the Corps:
^ Gorps navigable waters' study:
^ U.S. Geological Survey Hydrologic Atlas:
^ USGS NHD data.
^ USGS 8 and 12 digit HUC maps.
U. S. Geological Survey map(s). Cite scale & quad name:
^ USDA Natural Resources Conservation Service Soil Survey. Citation:
^ National wetlands inventory map(s). Cite name:
^ State/Local wetland inventory map(s):
^ FEMA/FIRM maps:
^ 100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
^ Photographs: ^ Aerial (Name & Date):
or ^ Other (Name & Date):
^ Previous deternunation(s). File no. and date of response letter:
^ Applicable/supporting case law:
^ Applicable/supporting scientific literature:
Other information (please specify): Site inspection.
Identify type(s) of waters:
B. ADDITIONAL COMMENTS TO SUPPORT JD: