20150916 Ver 2_SAW200901699permitverification1_20151016

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action id. SAW-2009-01699 County: Randolph U.S.G.S. Quad: NC-FAIR GROVE
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: NC Department of Transportation
Richard Hancock
Address: 1598 Mail Service Center
Ralei�h, NC 27699-1598
Telephone Number: 919-707-6000
Size (acres) 1 acre (approximately) Nearest Town
Nearest Waterway Little Uwharrie River Rivcr Basin Lower Yadkin
USGS HUC 03040103 Coordinates Latitude: 35.7582
Longitude: -80A164
Location descriprion: The site is located along SR 1404 (Fuller Mill Road) over an unnamed tributary to the Little iJwharrie
River at NCDOT Bridge #58 in Randolph County, North Carolina. The site is approximately 2500 feet north of the US
Highwav 64, Fuller Mill Road intersection.
Descnption of projects area and activity: This authorization is for the permanent and temporarv discharge of clean fill material
associated with an existing brid�e replacement 8-5128) proiect as follows: Site #1: Permanent impacts within 871inear feet of
stream associated with the replacement of the existing two span, 36 foot long brid�e with a 58 foot long, double barreled, 7 foot
x 6 foot Reinforced Concrete Box Culvert (RCBC) on the existing allignment. These impacts are authorized under NWP #23;
Site #1: permanent stream impacts for the placement of rip rap within 56 tinear feet of stream channel for bank stabilization.
These impacts are authorized under NWP #13. Site #1: Temporary impacts to 95 linear feet of stream channel are associated
with dewatering activities. These impacts are authorized under NWP #33. Site #2: Temporary impacts to 15 linear feet of
stream channel. These impacts are authorized under NWP #33. Utility Site #1: 0.01 acre of temporary impacts for the
relocation of a utility line. This impact is authorized by NWP #12.
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: NWP 23 Approved Categorical Exclusions;
NWP 33 Temuorarv Construction, Access, and Dewaterin�; NWP 13 Bank Stabilization; NWP 12 Utilitv Line Activities.
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 09/03/2015. Any violation of the attached
conditions or deviation from your submitted plans may subject the permittee to a stop work order, a restoration order, a Class
I administrative penalty, and/or appropriate legal action.
This verification will remain valid until thc cxpirarion date identified below unless thc nationwide authorization is modified,
suspended or revolced. If, prior to the expiration date idcntified below, the nationwide permit authorization is reissucd and/or
modified, this verification will remain valid unril the expiration date identified bclow, provided it complics with all requircments of
thc modificd nationwide permit. If the nationwide permit authorization expires or is suspcnded, revokcd, or is modificd, such that the
activity would no longer comply with the terms and conditions of the nationwide permit, acrivities 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 [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you mList contact the N.C. Division of Coastal Management in Morehead City, NC, at [phone].
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, ar the Corps of Engineers regulatory
program, please contact Andrew Williams at 919-554-4884 x26 or Andrew.E.Williams2(a�usace.armv.mil.
Special Conditions:
1. In order to compensate for impacts associated with this permit, mitigation shall be provided in accordance with the
provisions outlined on the most recent version of the attached Compensatory Mitigation Responsibility Transfer Form. The
requirements of this form, including any special conditions listed on this form, are hereby incorporated as special conditions of
this permit authorization.
2. This USACE permit does not authorize you to take a threatened or endangered species, io particular, the Northern Long-
eared Bat (NLEB) (Myotis septentrionalis). In order to legally take a listed species, you must have separate authorization under
the Endangered Species Act (ESA) (e.g., a Biological Opinion (BO) under the ESA, Section 7, with "incidental take" provisions
with which you must comply). The U.S. Fish and Wildlife Service's (USFWS's) Programmatic BO titled "Northern Long-
eared Bat (NLEB) Programmatic Biological Opinion for North Carolina Department of Transportation (NCDOT) Activities in
Eastern North Carolina (Divisions 1-8)," dated March 25, 2015, and adopted on Apri110, 2015, contains mandatory terms and
conditions to implement the reasonable and prudent measures that are associated with "incidental take" that are speci�ed in
the BO. Your authorization under this USACE permit is conditioned upon your compliance with all the mandatory terms and
conditions (incorporated by reference into this permit) associated with incidental take of the BO. Failure to comply with the
terms and condifions associated with incidental take of the BO, where a take of the listed species occurs, would constitute an
unauthorized take, and would also constitute non-compliance with your USACE permit. The USFWS is the appropriate
authority to determine compliance with the terms and conditions of its BO and with the ESA.
Digitalty signed by
W ILLIAMS.ANDPE W.E1244561655
/, j�� DN: r-U5, o=U.S. Govemment, ou=DoD,
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C��S ��gU1�1,0� O1�1C1�1. c^-WILLIAMS.ANDREW.E.1244561655 T��P. I O/I �/�oI �
Date:2015.10.i50B:19�51-04'00' ll., 1 1 1
Expiration Date of Verification: 03/18/2017
Determination of Jurisdiction:
A. ❑ Based on preliminary infonnation, 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
Secrion 10 of the Rivers and Harbars 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. � Thc jurisdictional arcas within the abovc described project arca havc becn identificd under a previous action. Please refcrence
jurisdictional detcrmination issucd 8/25/2015. Action ID: SAW-2009-01699.
Basis Fot' Detet'mination: The stream is a tributary to the Little Uwharrie River, which is a tributary to the
Uwharrie River, a traditionally navigable water (TNW). The Uwharrie River is a tributary to the Pee Dee River, a navigable
water of the United States. The Ordinary High Water Mark (OHWM) of the unnamed tributary was indicated by the
following physical characteristics: bed and banks, clear natural line impressed on the bank, shelving, and the destruction of
terrestrial vegetation. The wetlands meet the hydrophytic vegetation, wetland hydrology, and hydric soil criteria of the 1987
Corps of Engineers Wetland Delineation Manual and the Eastern Mountains and Piedmont Regional Supplement and are
bordering/contiguous with the unnamed tributary.
RemaYkS: Applicant may request an administrative appeal under Corps regulations at 33 CFR Part 331 prior to
October 25, 2015. Administrative appeal form was provided with the jurisdictional determination dated August 25, 2015.

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 ul USDA programs, you should request
a certificd wetland detcrmination from the local officc of the Natural Resourccs Conscrvation Servicc, prior to starting work.
F. AppealS Inf01'matlOn (This information applies only to approved jurisdictional determinations as indicated in B
and C above).
This correspondence constitutes an approved jurisdictional determinaYion for the above described site. If you object to this
determination, you may request an administrarivc appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact shcet and request for appeal (RFA) form. If you r�quest to appeal Yhis 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 Forsyth Street SW, Room 1OM15
Atlanta, Geargia 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 bcen received by the Division Office within 60 days of the date of the NAP. Should you
decidE to submit an RFA fonn, it must be received at the above address by 10 / 2 5/ 2 O l 5.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
qqq � `�fr Di9ltallysignedbyWILL1AM5ANDFCWS.12445 61 65 5
�� l , �A � DN�.r—US,o=U.S.Govemment,ou=DO�,ou=PKl,ou=llSA,
Corps Regulatary Official: �='"�""' `" �de'«'"'"snNOaewE�znnse�ess
O 15 08:19'.13 ��04'aa'
Andrew Williams
Date of JD: 08/26/2015
Expiration Date of JD: August 26, 2020
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete our customer Satisfaction Survey online at http://re�ulatory.usacesurve. .�.
Copy furnished:
NCDOT
Art King
P.O. Box 1057
Aberdeen, NC 28315

Action ID Number: SAW-2009-01699 County: Randolph
Permittee: NC Department of Transportation
Richard Hancock
Project Name: NCDOT/B-5128/Bridge No. 58 on SR 1404 (Fuller Mill Road North) over unnamed
tributary/Div. 8/Randolph County
Date Verification Issued: 10/15/2015
Project Manager: Andrew Williams
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: Andrew Williams
3331 Heritiage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
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

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: NC Department of Transportation File Number: SAW-2009-01699 Date: 08/26/2015
Richard Hancock
Attached is: See Section below
1NITIAL PROFFERED PERMIT
PROFFERED PERMIT (Standarc
PERMIT DENIAL
Permit or Letter of permissi
Permit or Letter of permissi
APPROVED JURISDICTIONAL DETERMINATION
PRELiMINARY JURISDICTIONAL DETERMINATION
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C
0
0
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SECTION I- The following identifies yo�ir rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or htt��://wu�w.usace.army.mil/Missro��s/CivilWorizs/Regulatorypro�ramandPermits.as�x
or the Corns re�ulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you inay 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 Pennit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional detenninations associated with the
pennit.
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. Yon must complete Section II of this fonn and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
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, ar(c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal 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 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 entirery, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with 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 fonn 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 ihe 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 new
information.
• ACCEPT: You do not need to norify 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 entirery, and waive 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
inust be received 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 new information for further consideration by the
Corps to reevaluate the JD.
SECTION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision ar 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 review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental infonnation that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new 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.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
lf you have questions regarding this decision and/or the lf 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, Administrative Appeal Review Officer
Andrew Williams CESAD-PDO
3331 Heritiage Trade Drive, Suite 105 U.S. Army Corps of Engineers, South Atlantic Division
Wake Forest, North Carolina 27587 60 Forsyth Street, Room 1OM15
Atlanta, Georgia 30303-8801
Phone: [phone]
RIGHT OF ENTRY: Your signature below 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 provided a 15 day
notice of any site investigation, and will have the opportunity to participate in all site investigations.
Date: Telephone number:
Signature of appellant or agent.
For Permit denials, Proffered Permits and approved.Iurisdictional Determinations send this for�n to:
Division Engineer, Commander, iJ.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]