HomeMy WebLinkAbout20141204 Ver 1_Application_20141118N
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�I�.. 1 �31 �, �.�►�ay �i����e lZ.t��.d. i�n y't�T�.�u,��, ��►ruu�t�r. �i'hi.� pro,�e+ct r�uu�� �rc�r�. �i�t���. ��flU -� ?��-�� �'�r �
t��a� len� +�f 1.4 �es. I��.�a���.o�.s ��.�`"�,c� ar�, �l� i�+�r��s� b� �,�bout �,� acr+��. "�"��� �►�rrc�,j�� ��1�
req��re the �re�rla���n�.t a� fi��r�� �+�t p�i�►�s� � s�i�rv��. b�l��v:
�►�r��ar� ����t�c��:
� T'hese pipes �%�� r�maa�n perche+d. d�:� ta ��.�ss�ive slc�p�.
T"�e replacem�.t c�� �ie abc��r� �o�� �wet p�ip�s �a�.I� r�qu�ir� t�:��rc�ra� d��a�e�ir��. A�. �npe��i��u.� �a�a.�.b�.;�
dii��e vv�ill �be cc�►�sl�ruct�. �.p�t�r���n c�f �lh� ��sti�:g pi�e� t�► +���a.� a sm�:l �ca��. �`l�a.� �v�t�r �11 %nxp►c�ra���
be pu.��►pe� a�rc�u�+� �he c�on:st��:+��Gic�� �.r�s a��.d �rai.�� b►e c�a�.s��:�ge� ��v��:�tr��m. .��� c�%�t;� �va�ter 1�►+��.t�c�
insi�.� ca� the �ca►r�st�uc�c�� �.re�s � �e �u��nped: infi,� �. ��� b�;� � �.�+���sar�. C��.ce �e �.ev� pip�s are i�
p1ac�, the imp��rious dai�es v��ll. b+� r��c��r�d. and p�r�+�an�Itr�. ,�c�� �1�r+�aa:�bed eleva.t���s wil� b� r��tored.
�'. C�►. ��� 2�t�� �. '�t�"�,,,�.ssc��.ca, �1'� ����'�
Pxr�� �336�� �b'i-�11.1 F� �3��� �+��'�4���
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F��e 2
�c�v��m�r 1 �, 2(} 14
T`�e w�� p��a�� c��arr� �'��`�'�r���� I�T`�''s t�a t�h� �+�ufi�E� :�c��r� :�Tew �:i�.�v+�r �t�I��: � �-). "I�i.� �a��,�e�t w��s ��vi���+�
ft�r �� pre�enc� t��' ��ar��,t���+d an� �n�ara:�+�red �p+�ci�s �� .A�t,�uu�� ��', 2� �. �. '��a%� ���j��t ��� h�.�� �:� �:�i'��t
a� aara.y� fed.e�a�l1� �i�t+�. �nd�n.���rer�. plant +�r ,�run�a:l ���i�s . �:��tc��� �►m�►1��n.+c+� �vc�rk �i.�,� �b���. �o��l���
�d �.o �urve�� w�r� r�quir+e�..
T�� ��r�aj�ect im�►a�ts �re no� s�;�r��i+�a�rt in. �.�:u�� a;�.+d sh�►uu�� no�t r�:mave c�r ���r�.d� ��i���,� �v���r t��.���;�
�.ses. ��+��nv�ater �w�ill be r+�uted #��r�►u,�h g�r�,�s c�� r��:� 1�.�� d��+cl�.��� ���►�r��.iii�,� ��. �h� da.��� li�� �����a
Pip� s��e� us�d ��l be �i� ��rnu��. n�cc�ess��r�y tc� +c�r�t� � s�f'e �rc�.d�r�.�. :�� u�il�,�i�,� �a� �r+a�i�►�. c�a�tral
:r�.��ssu.�e� au�t�.u�.�+d � th� �.tt;�+�bur��n�� t� ��� �p�li�,�ti�n, d�►�m�stt��� ���e�° ��.�lit� ���►+��r�.� �r�l� b�
pr+�tecte�d:. +�Jv��r�l.l wat�r q�.�;�.t� ai� th+e �ar+�a �vi11. b�e i�rnp��r�a��d. ��r pav��n,g fi�:� �C� �tr���� ����. .��
appro��.ate :�1��"s vc�i�l b� �.s�d �.ur�r�� �►�:��tr��i��.
A��+��.+ed. z� �. 1'r�c�n.�truciio� ��t��.�ii�►n �`+��m�, p��a�: �h�t� wi� pr+apc��e�. +�rc�sic��. �c��trc�� �.���.�r��, �.
m���. c�►�ty m�p ar�.d �. :rn�,�rr�ed to�ca�r��h�r :��,�r.
By +�c�p� �af fi�is e1��rt��ui� l�t�e�r, �t is r�qu�st� �i�:�.� ��r�. ���r��. +�h������r� wit�h ��.� 1"��a��i �a�r�►�i��'�'�ii�.i��
R�s�+�u���s t���m�ni�sic�n �c�����nnt c�ir+���tl� ��+ �a�u �t��.c��r�ir�� �he 4�4 �T��t����.+�+� ��r�r�i.� �p�����.����. �vv��l� �
copy s��� t�► n�.�.
By �o�s� c��' ��.s �le+��arc��.i� l�tt��r, it i� r�q��s%t� �h�t �� ;�i.�i�i�►� �►� �a���° :�.+���►�°��� 4� �.�i�'�����d� ��.��
i��u� �.i� �.��►ra�a�.�te pe��t f+ar �r��t��+ctic�n �� t��� �ro,��c�. I� i� r�u�s��. ��� �.y� �cc���rn�:n�s �r���.��1 �+�
the 4�D � �rt��.c�.�ti�n be �l��trc��.ica�ly� �`c�r���rd�d c�i�r��ly �� n�� �%�� �, ��py� ���� ��► �� �,T� � ���� ��
E�,��.+��rs.
't�% waulc� li�� t�+ �e�gi� ��.��ru�i�c�� a�� s��►r� �s �+��si�►l�. If ��t��� ��'�:���,���►�. �s r�qru�r��, ������ ��i ��
:l�n:�►v�. ''�"c►ur ��r1� r��i��v �+� cc��.sit��r�.�t�r� �:i.l� be �p►��+����,�t�d..
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II�a�� '�"�nu+�h�, �►i�is��►r� �f ��,�te�r �.�so�:rc��
:L��k� ���G��jc►��.� �':�►, �i�i��a� �,��in�e�r
��u� ��1+��, ���iric� �,�.g�in��r
:���v�. �i��.ttir��;tc►n, �c�u.nty �1�aa�.t�n�+�e :��.�.�.e�r
I�+��.t� ��au,�h��r, �iv�.�i�►�. Env�ircr�n�n:��.��. t����+�r
��.c� �c�ufi�er, :�.��.�i�e �,n�iro�����,� �"��ld t�pe�t��ns �`���r�+�i�.
�� �.���f���������'�� affice Use Only:
�
��,r���'��� �-
� � � l`� � Corps action I D no.
. ':'l.�r�(:%�:i�}:%}Y'::i��!,V�i'.�'.�? : A�
� � � � � ,. F � ��............ .� DWQ project na.
� f.���'i..i:::;:i.: �i ::Y: ..
Form Version 1.3 Dec 10 2C1a8
Pre-�onstruction Noti�ication PC�N �'arm --�-._._�._
A. A licant In�'ormation M��
1. Processing
1a. Type(s} of approvai sc�ught from the �;����on 404 Perr�nit Section 10 P rmi
cor s: � C1 e �
p
1 b. Specify Nationwide Permit (NWP) number: 14 ar General �'ermit (C�P) number:
1 c. Has the NWP or GP number been verified by the Corps'? � Yes ��lo
1d. Type(s) of approval sought from the DWQ (check a[I that apply}:
(� 4a1 Water Quality Certification - Regular � N�n-4a4 Jurisdictional General Permit
❑ 401 Water Quality Cerkification -- Express ❑ Ripari�n Buffer Authorization
1 e. Is this natification safely for the record For the recQrd only far aWQ 4�1 Fnr the record anly �ar Corps �'ermit:
because written approval is not required? Certification:
❑ Yes � No � Yes j�j No
'I f. Is payment into a mitig�tion bank or in-lieu fee prograrn proposed for mitig�tion Yes No
�f im acts? If so attach the acce tance letter firom miti atior� bank or �n-lieu � �
p a p �
fee program.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h � Y�� � No
below.
'Ih. Is the project iacated within a NC DCM Area af Environmental Concern (AEC)? ❑ Yes � No
2. Proj�ct Information
2a. �1ame nf project: SR 1331 B, Raby Greene Rc�ad
2b. County: Watauga
2c. Nearest municipality 1 town. Boone
2d. 5ubdivisian narne:
2e. NCDOT on1y, T.1. P. or stafie .-�...-.---_��......__..�._
project no:
11 C.095101
3. CC�wner lnform�tion
3a. Name(s} c�n Recorded Deed: NCDOT
3b. C�eed Boc�k and Page No.
3c. Responsi bl� Party (for L LC i f -�-�-- -- �---�-�-- _�._.._.�...._�..._______....��...._�.�._
applicabie):
3d. Street address: 801 Statesville Road
3e. City, state, zip: North Wilkesboro, NG 286�9
3f. Telephone no.: 336-9n3-9202
3g. Fax no.: 336-667-4549
3h. Email address: hslaughter�C�ncdot.gov
P�ge 1 c�f 1 C�
P�N Form -- Versian 1.3 Dec�mber 1�, 2aG8 V�rsic�r�
4. Applicant Informatic�n (if dififerent from owner)
4a. Applicant is: [] Agent ❑ Other, speci�Fy:
4b. Name:
4c. Busines s narne
(if �pplicable):
4d. Street address:
4e. City, state, zip:
4f. Telephc�ne no.:
4g. Fax no.:
4h. Emaii address:
5. Agent/Consultant lnformation (if applicable)
5a. f�ame:
5b. Business name
(if applicable).
5c. Street address:
�d. City, state, Zip:
5e. Telephone na.:
5f. Fax no.:
5g. Ernail address:
Page 2 �f � C�
P�N Farm -- Version 1.3 December 10, 20�8 Versic�n
B. Praject Information and Prior Project History
1. Property Identification
1 a. Property identificatian no. (tax PIN or parcel ID):
L�titude: 36.24�09 �.ongitude: - 81.�3�19
1 b. �ite coordinates (in decimal degrees): ��p.pDDDDC2) -DD.DDDDDD
� )
1c. Praperty size: 8.5 acres
2. �urface Waters
2a. Name of nearest body of water (stream, river, etc.) to UTs to SFI�R
proposed project:
Zb. Water Quality Classificatian of nearest receiving water: C+
2c. River basin: � �New ���
3. Praject Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the praject at the time af fihis
applicatian:
Unpaved road in a rural area.
3b. List the total estimated acreage of all existing wetlands on the prr�perty:
0 acres
3c. List the tota! estimated linear fieet of all existing streams (intermitt�r�t and perennial) on the properfiy:
200 linear feet
3d. Explain the purpose of the proposed project:
Upgrade roadway.
3e. Describe the overall prnject in detail, including the type of equipment to be used:
�ee attached cover letfier.
4. Jurisdictional Deterrninations
4a. Nave jurisdictional wetland or stream de�erminatians by the
Corps or State been requested or abtained for this property /
praject (including all prior phases) in the past? d Yes � No [�] Unknawn
Comments:
4b. If the Corps made the jurisdictional determinatian, what type
of determinatian was made? � F'relirninary ❑ Fin�l
4c. If yes, who delineated the jurisdictional areas? Agency/Gnnsultant Company:
Name (if known): CC�ther:
4d. If yes, list the d�tes of the Corps jurisdictional determinations or �tate determinafiions and att�ch documentation.
5. �roject Histor�
5a. Nave permits or certific�tions been requested or obtained for � Yes j� No ❑ Unknown
th�s pra�ect (including all prior phases) �n the past?
5b. 1f yes, explain in detail according to "help fiie" instructions.
6. Future Project Plans
6a. Is this a phased project? ❑ Yes (� No
6b. If yes, explain.
P�ge 3 af 10
P�N Fnrm -- Version �1.3 CJecember 1 n, ZOq8 �/"er�ion
C. Proposed Impacts Inventory �
1. lmpacts Summary ��
1 a. Which sections were completed below far your project (check aii that apply):
❑ Wetlands j� Streams - tributaries � Buffer�
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this questian fc�r each wetland area imp�cted.
2a. 2b. 2c. 2d. 2e. 2f. ____...___.�...�
Wetland impact Type of jurisdiction
number — Type of impact Type of wetland For�sted (Carps - 404, 10 Area of imp�c�
Permanent (P) or {if known) D'U1IQ — non-4�4, �ther) (�cres)
Tem orar T
d Y�s 0 Corps �.�.._..
W 1 ❑ P❑ T N o D1l1/
� ❑ �
❑ Yes [� Carps _......�
W2 ❑ P❑ T N� DWQ
❑ �
❑ Yes � Carps ._....... ..�.....��._ .�.._
W3 ❑ P � T Nr� DWQ
� d
[�] Y�s d Corps �
W4 � P � T N� DWQ
❑ ❑
❑ Y�s ❑ Garps _ ..._._.� _..�..._........._M.......�..�...._.
W5 ❑ P ❑ T �� D�
� � �
� Y�s ❑ Corps __...
W6 ❑ P C] T N� DW
� 0 �
2g. Totai wetiand impacts
2h. Comments:
3. Stream impacts
If there are perennial or intermittent stream impacts (including tempor�ry impacts) proposed on �he sifie, then c�mplete this
question far all stream sites imp�cted.
3a 3b. 3c. 3d. 3e. 3f. ____.�.�... �g .w_�
Stream impact Type af impact Stream name Per�nnial Type of jurisdiction Aver�ge ��p���
number - (P�R) or (Corps -�4U4, 1 Q str�arn leng�h
Permanent {P) or intermittent p�/(� -. �an-404, width (��n��►�"
TemporarY iT) CI�T)? other) (fe�t) �e��)
P i pi ng, Ri prap & � P� R � Corps __���.�.�..�_ �...�.._.___.�. ...��...�.._��.���
�� �) P I� T Dewaterin UT#1 to SFNR Ii�T DWQ � �6
g ❑ �
P i p i n g, R i p ra p& � P� R j�j C a rp s.�_._...__..� .��...�....� �..� ..��..�..
S 2 � P� T p�waterin U T# 2 t o S F N R Ii�T DWQ 1 ��
� � �
P i p i n g, R i p ra p& ❑ P� R � C o rp s ..��......._..___�.w �.._.....�.� �_..�.w.�_.__....�..��_
S3 (� P� T pewaterin UT#3 to SFNR 1 �2
g � II�T � �WQ
__._V �. . _ �._.� _._.�.�._. .�..._�_.____..
❑ F'�R [� Corps
S4 ❑ P❑ T I i�T DV1/Q
� �.i
�_ [� P E R �[� C o rps ...��_._. __.___ ._�..._�_.....�.�..
S5 [� P[� T INT DWC�
❑ ❑
[� P � R �.] Corps _ �....._.__�..__..�__,�
S6 ❑ P❑ T I1�T C�WQ
❑ �
3h. Total stream and tributary impacts 199
3i. Camments: 49 pipe, 34 riprap, 124 dewater
Page 4 af 1 �
P�N Farm — Versian 1.3 December 1 a, 2�Q8 Version
4. Open Wafier Impacfis
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, fihe'Atlantic C�cean, or any ather open water o�
the U.S. then individualiy list all open water impacts below.
4a. 4b. 4c. 4d. � 4e.
apen water Name of waterbody
impact number — (if applicable) Type of imp�ct Waterbody tYpe Ar�a of impact (acres)
Permanent {P} or
Tem orar T
CJ1 ❑P�]T
Q2❑P❑T
03 ❑P❑T
CJ4 ❑P❑T
4f. Total open water impacts
4g. Cc�mments:
5. Pand or Lake Cc�nstruction
If ond or lake consfiructian ra osed, then com lefie the chart below.
�a. 5b. 5c. 5d. 5e.
Wetland lmpacts (acres) Sfiream lmpac�s (feet} Upl�nd
Pond ID Proposed use or purpose (�cres)
number of pond _ _
_ ..�____M_..� _�.�..�..��
Flooded Filled Excavated Flaod�d Fill�d Excava�ed Flooded
P1
P2
5f. Total
5g. Comments: N/A
5h. Is a dam high h�zard permit required?
❑ Yes (� No If yes, permit f� nca:
5i. Expected pand surFace area (acres):
5j. Size ofi pond watershed (acres�:
�k. Method of construction:
6. �uffer Impacts (for DWQ)
lf project will impact � protected riparian buffer, then complete th� ch�rt below. If yes, then individually Iist �11 bu#fer imp�cts
belaw. If an impacts require mitiqafiion, then you �l1ST fill out Section D of this form.
6a.
[� N�use (� Tar-Pamlico ❑ CJth�r:
Project is in which protected basin? (� C�t�wba [�] Randlem�r�
6 b. 6�. 6d . 6�. � 6f. �� �---.-�-.-�—�_.__...�._. _..�.
Buffer impact
number-- Reason �uff�r Zone 1 impact Zone � irnpact
Permanent (P} or for Stream name mitig�tion (square feet} {square fee�)
Tem orar T im act re uired�
__. ❑ Y�s _ _�_.�._._�....._._..._.�....�
B1 ❑P❑T N�
�
❑ Y�s _ �_..._ ..�....
B2 ❑P�T ��
❑
Q� Yes . _
B3 ❑ P ❑ T N�
❑
6h. Total buffer impacts
6i. Comments:
Page5�f1�
P�N Form — Version 1.3 December 10, 2�08 �fersion
D. Irr�pact Justificatican and Mitigation ��� �
1. Avaidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize th� prapased impacts in designing project.
The pipe lengths are the mir�imum needed to improve roadway.
1 b. Specifically describe measures taken fio avoid or minimize th� proposed' impacts through construcfiion techniques.
All appropriate BMPs will be used during construction
2. Campensatory Mitigation for Impacts to Waters of the Uo�. or Waters of the �tate
2a. Does the project require Campensatory Mitigation for � Y�s [�J No
impacts to Waters af the U.S. or Vllaters of the State?
2b. If yes, mi�igatior� is required by (check �.11 that apply): � C�WQ ❑ Cor'p�
❑ I�/litigation bank
2c. If yes, which rnitig�t ion option will be used for this
ro'�ect'? � Payment t� in-Iieu fee pro�ram
� 1
0 Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) iype Quantity
3c. Comments:
4. Complete if Making a Paymen# to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. � Y�s �
4b. Stream mitigation requested: 98 linear feet
4c. If using stream mitigation, stream temper�ture: ❑ w�rm ❑ cot�l �cold ��
4d. Buffer mitiga�ion requested (DWQ onLy): sguare feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Corn�plete if Using a Permit#ee �.esponsible Mitigation Plan
5a. Ifi using a permittee responsible mitigation plan, provide a description of the proposed miiigation pl�n.
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P�N Form -- Version 1.3 C�ecember 10, 20�8 Version
6. Buffer Mitigation (State Regulated Riparian Buffer Ruies) — required by DWQ
6a. Will the project result in an impact within a pr�tected riparian buffer that require� ❑ Yes � Rlo
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Cal�ulate the
amount of mitigation required.
6c. 6d. � �e. �
Zone ��ason for impact Tatal impact Muifiiplier Required mitigation
(square feet) �square feet)
Zane 1 3(2 for Catawba)
Zone 2 1.5
6f. Total buffer mi�tigatic�n req�aired:
6g. If buffer mitigation is required, discuss what type c�f mitigation is propc�sed {e.g., payment �a private mitigation barik,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Cc�mments:
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P�N Form -- Versian 1.3 December 10, 200� Ver�ion
E. Stormwater Management and Diffuse Flow Plan (required by i�WQ)
1. C�iffuse F'Iow Plan
� a. Does the prc�ject include or is it adjacent to protected riparian buffers identified
within one of the NC Ri arian Buffer Protection Rules? � Yes j� N°
p
1 b. If yes, then is a diffuse flow plan included? 1f no, explain why.
[.� Yes ❑ Na
Comments:
2. Stormwater Mana ement Plan
2a. What is the overall percent imperviousness of this project? °Ia
2b. Does this project require a Stormwater lVlanagement Plan? � Yes ��I�
2c. If this praject DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Managemenfi Plan, then provide a brief, narrative description �f the plan:
Falls under DOT NPDES Permifi
0 Certified Lc�cal Governmenfi
2e. Who will be responsible for the review of the Stormwater Mar�agement Plan? 0 DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified �ocal Government Stormwater Review
3a. In which local government's jurisdiction is this project?
� [,� Phase II
3b. Which of the followin locall -im lemented starrnwater mana ement ro rams ����
g Y � 9 p g ❑ U;� �/I P
apply (check a!I that apply):
[� Water Supply W�tershed
[� �Jther:
3c. Has the approved Stormwater Management Plan with proof of appraval been ❑ Yes � Na
attached?
4. D'1�VVQ Stormwater Program �eview
❑ Cc�astal countie�
❑ HQW
4a. Which of the following state-implemented storrnwater manag�ment programs apply ���W
(check all th�t applY):
�] Sessior� Law 2�06-24�
❑ C�th��: .
4b. Has the �pproved Stormwater Management Plan with proof of approval beer�
att�ched? ❑ ��� ❑ ��
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriat� requirements? ❑ Yes ❑ No
5b. Have all of the 441 Unit submittal requirements been met? � Y�� ���
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P�N Form -- Versic�n 1.3 December 10, 20�8 Version
F. Supplementary Information
1. Environmental Documentation {DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/statellaca(} funds ar the �,�s
use of public (federal/state) land'? � � �°
1 b. If you answered "yes" to the abc�ve, does the project require prep�ration of an
environmental document pursuant to the requirements af the National or �tate ❑ Yes � No
(North Carolina) Environmental Palicy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the abave, has the document review been finalized by the
�tate Clearing Hause? (ff so, attach a copy c�t the NEPA or �EPA final approval
letter.) [� Yes � i�a
Cornments:
2. �'iolations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Ru1es (15A NCAC 2H .0500}, Isnlated
Wetland Rules (15A NCAC 2H .� 300), DWQ Surface Water �r W�tiand Standards, [�j Yes j� Na
or Riparian 8uffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application'? � Yes � No
2c. If you answered "yes" to one or both af the abt�ve questions, provide an explanation of the violation(s).
3. Cumulative Impacts (�WQ Requirement)
3a. Wiil this project (based on past and reasonably anticipated fu�ure impacts} result in � Y�s ���
additional development, which could impact nearby downstre�m �nrater qu�lity?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance wifih the
mc�st recent DWQ paiicy. lf you answered "no," provide a shor� narr�tive description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition {nc�n-discharg� or discharge) of wastevvater ger�erated fror�
the proposed praject, or available capacity of the subject fa�iiity.
N/A
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P�N Form -- Version 1.3 December 10, Zt��8 Version
5. Endangered Species and Designated Critical Mabitat (Corps Requirement�
5a. Wiil this project occur in or near an area with federally protected species or ��es No
habEtat? �
5b. Nave you checked with the USFWS concerning Endangered Spe�ies Act �,�5 �
impacts? ❑ � °
0 Raleigh
5c. Ifi y�s, ind icafie the U�FWS Field Ofifice you have contacted,
[�] Asheville
5d. What data sources did you use to determine whether your site w�uld impact Endangered Sp�cies c�r Designated Crifiical
Habitat'?
G15 and visu�l observation
6. Essential Fish Nabitat �Corps Requirement)
6a. Will this project occur in or near an area designated as essen�i�l fish habitat? ❑ Yes i� No
6b. What data sources did you use to determine whether your site wauld impact Essenti�l Fish f�abitat?
WRC will comment
7. Nistoric or Prehistoric Cultural Resc�urces (Corps Requir�ment)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation �.�e� ���
status (e.g., Nation�l Histor�c Trust designation or properties significant in
North Carolina histary and archaeoiogy)?
7b. What d�ta sources did you use to determine whether your sit� wauld impact historic or �rcheological resources?
Praject submitted to HEU
8. Flood Zone Designation {Corps Requirement)
8a. Will this project occur in a FEMA-designated 1Q0-year floodpl�in? � Yes � Nc�
8b. If yes, explain how project meets FEMA requirements: Road will be undercut to maintain current elevation.
8c. What source(s) did you use to make the floodplain det�rmin�tion? FRiS
��
J. �eath Slaughter -�. 11 /18/14
� d
Applicant/Ag�ent's Printed Name Applicant/Agent's Sign re C�ate
(Agent's si ature is valid oniy if an authori�at� letter from fih� applicant
_ �� is provided.) __
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P�N Farm -- Version 1.3 december 1Q, 2008 Version