20130052 Ver 1_404 Permit_20130425

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW- 2013 -00762 County: Guilford U.S.G.S. Quad: NC- SUMMERFIELD
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Perrnittee: NC Department of Transportation
Gregory Thorpe
Address: 1598 Mail Service Center
Raleigh, NC, 27699 -1598
Telephone Number: 919- 707 -6129
Size (acres) 2.9 acres Nearest Town Summerfield
Nearest Wateiwav_ Reedv Fork River Basin Haw. North Carolina.
USGS HUC 3030002 Coordinates Latitude: 36.1797259999996
Longitude: - 79.907306
Location description: The project location is Bridge 120 over Reedv Fork Creek on SR 2128, near Summerfield in Guilford
Countv, NC. NCDOT has identified this proiect as TIP B -4756.
Description of projects area and activity: This permit verifies 0.03 -acre of permanent forested wetland impact during the
replacement of Bridge 120 over Reedv Fork Creek on SR 2128, near Summerfield in Guilford Countv, NC. Due to the
minimal loss of water, no compensatory mitigation is required. NCDOT has identified this proiect as TIP B -4756.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number or Nationwide Permit Number: 23
SEE ATTACHED RGP or NWP GENERAL, REGIONAL AND SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and attached information dated January 9, 2013. Any violation of the attached
conditions or deviation from your submitted plans may subject the permittee to a stop work order, a restoration order and /or
appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and /or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide permit. If the nationwide permit authorization expires or is suspended, revoked, or is modified, such that the
activity would no longer comply with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case -by -case basis to modify, suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Quality (telephone 919 - 807 -6300) to determine Section 401 requirements.
For activities occurring within the riventy coastal counties subject to regulation under the Coastal Area Management Act (LAMA),
prior to beginning work you must contact the N.C. Division of Coastal Management in Morehead City, NC, at (252) 808 -2808.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals /permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program, please contact Monte Matthews at 919 - 554 -4884 x30 or Monte .KMatthews'd.usace.armv.mil.
/) j �}�t Digitally signed by
ref _._j,. .yJ(a ;ti,__ MATiH[WS.MO NTL K. 1284867633
Corps Regulatory Official: Monte Matthews �'° 111 Dat, 2 °13. °4251434°°- °4°° Date: 4/25/2013
Expiration Date of Verification: 3/18/2017

Determination of Jurisdiction:
A. ❑ Based on preliminary information, there appear to be waters of the US including wetlands within the above described project
area. This preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
( Reference 33 CFR Part 331).
B. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements of
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
C. ® There are waters of the US and /or wetlands within the above described project area subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
D. ❑ The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued . Action ID: SAW-
Basis For Determination: Use of the 1987 Wetlands Delineation Manual and the current regional supplement.
Remarks: This determination is limited to the permit area only, and does not extend to other areas of the property.
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conseivation Seivice, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B
and C above).
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsvth Street SW, Room 1OM15
Atlanta, Georgia 30303 -8801
Phone: [phone]
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by 6/23/2013.
* *It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence. **
n1 Digitally zig.ld by
M— HEWS.MONTE.K.128486I633
Corps Regulatory Official: Monte Matthews i D- .2013.°4.251434,30 - 0
Date of JD: 4 /25/2013

Expiration Date of JD: 4 /25/2018
Action ID Number: SAW- 2013 -00762 County: Guilford
Permittee: NC Department of Transportation
Gregory Thorpe
Project Name: NCDOT / B4756 / SR2128 / BR120 / DIV7
Date Verification Issued: 4/25/2013
Project Manager: Monte Matthews
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn: Monte Matthews
3331 Heritage Trade Drive, Suite 105
Wake Forest, NC 27587
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. If you fail to comply with this permit you are subject to permit suspension,
modification, or revocation.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee
Date

Applicant: NC Department of Transportation I File Number: SAW- 2013 -00762
Date: 4 /25/2013
Attached is: I See Section belo-
U
INITIAL PROFFERED PERMIT (Standard Permit or Letter of permission)
A
❑
PROFFERED PERMIT (Standard Permit or Letter of permission)
B
❑
PERMIT DENIAL
C
®
APPROVED JURISDICTIONAL DETERMINATION
D
F-1
PRELIMINARY JURISDICTIONAL DETERMINATION
E
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A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you receik-ed a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and ,vaive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated ,vith the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be receik-ed by the district engineer ,,within 60 days of the date of this notice, or you
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer "will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously ,N- ritten. After
evaluating your objections, the district engineer,,N -111 send you a proffered permit for your reconsideration, as indicated in
Section B belo,,N -.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you receik-ed a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and ,vaive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated ,vith the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer -within 60 days of the date of this notice.

D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide ne-,N-
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps -within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and , aive all rights to appeal the approved JD.
• APPEAL: If you disagree -with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be recei"-ed by the division engineer -within 60 days of the date of this notice.
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you -,wish, you may request an approved JD (-which may be appealed),
by contacting the Corps district for further instruction. Also you may provide ne-,N- information for further consideration by the
Corps to reevaluate the JD.
{
ECTIUN II - REQTES I FUR A1Z'EA it O$JEC IQIT" TO A�*I TNITIA FROFEID `FERMZZ
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify -where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a revie-,v of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the revie-,v officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add ne-,N- information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
PUIN'oF COl*1IACT FOR`QUETOI �RTNFOUTATrOT
If you have questions regarding this decision and /or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division, Attn:
Mr. Jason Steele, Administrati'-e Appeal Revie-,v Officer
Monte Matthews
CESAD -PDO
3331 Heritage Trade Drive, Suite 105
U.S. Army Corps of Engineers, South Atlantic Division
Wake Forest, NC 27587
60 Forsyth Street, Room 1OM15
Atlanta, Georgia 30303 -8801
Phone: [phone]
RIGHT OF ENTRY: Your signature belo-,N- grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You -will be prodded a 15 day
notice of anv site investigation, and -will have the opportunity to participate in all site investigations.
Date:
Telephone number:
Signature of appellant or agent.
For approved Jurisdictional Determinations appeals send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele, Administrative Appeal
Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303 -8801
Phone: [phone]