20150068 Ver 2_03_Pembroke_Eng_Form_4345_fillable_rev160217(1)_20160218

U.S. ARMY CORPS OF ENGINEERS
APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT OMB APPROVAL NO. 0710-0003
EXPIRES: 28 FEBRUARY 2013
33 CFR 325. The proponent agency is CECW-CO-R.
Public reporting for this collection of information is estimated to average 11 hours per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding
this burden estimate or any other aspect of the collection of information, including suggestions for reducing this burden, to Department of Defense,
Washington Headquarters, Executive Services and Communications Directorate, Information Management Division and to the Office of Management and
Budget, Paperwork Reduction Project (0710-0003). Respondents should be aware that notwithstanding any other provision of law, no person shall be
subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT
RETURN your form to either of those addresses. Completed applications must be submitted to the District Engineer having jurisdiction over the location of
the proposed activity.
PRIVACY ACT STATEMENT
Authorities: Rivers and Harbors Act, Section 10, 33 USC 403; Clean Water Act, Section 404, 33 USC 1344; Marine Protection, Research, and Sanctuaries
Act, Section 103, 33 USC 1413; Regulatory Programs of the Corps of Engineers; Final Rule 33 CFR 320-332. Principal Purpose: Information provided on
this form will be used in evaluating the application for a permit. Routine Uses: This information may be shared with the Department of Justice and other
federal, state, and local government agencies, and the public and may be made available as part of a public notice as required by Federal law. Submission
of requested information is voluntary, however, if information is not provided the permit application cannot be evaluated nor can a permit be issued. One set
of original drawings or good reproducible copies which show the location and character of the proposed activity must be attached to this application (see
sample drawings and/or instructions) and be submitted to the District Engineer having jurisdiction over the location of the proposed activity. An application
that is not completed in full will be returned.
(ITEMS 1 THRU 4 TO BE FILLED BY THE CORPS)
1. APPLICATION NO. 2. FIELD OFFICE CODE 3. DATE RECEIVED 4. DATE APPLICATION COMPLETE
(ITEMS BELOW TO BE FILLED BY APPLICANT)
5. APPLICANT'S NAME 8. AUTHORIZED AGENT'S NAME AND TITLE (agent is not required)
First - Marc Middle -L. Last - Hamel First - Scott Middle -G. Last - Davis
Company - NC Department of Transportation, Rail Division Company - Axiom Environmental, Inc.
E-mail Address -mhamel @ncdot.gov E-mail Address [e-mail]
6. APPLICANT'S ADDRESS: 9. AGENT'S ADDRESS:
Address- 1553 Mail Service Center Address- 218 Snow Avenue
City - Raleigh State - NC Zip - 27699 Country -USA City - Raleigh State - NC Zip - 27603 Country -USA
7. APPLICANT'S PHONE NOs. w/AREA CODE 10. AGENTS PHONE NOs. w/AREA CODE
a. Residence b. Business c. Fax a. Residence b. Business c. Fax
�a �919� �0�-4�os �9i9� �is-6sgo �a �9i9� 696-3o4s nia
STATEMENT OF AUTHORIZATION
11. I hereby authorize, Axiom Environmental staff to act in my behalf as my agent in the processing of this application and to furnish, upon request,
supplemental information in support of this permit application.
SIGNATURE OF APPLICANT DATE
NAME, LOCATION, AND DESCRIPTION OF PROJECT OR ACTIVITY
12. PROJECT NAME OR TITLE (see instructions)
P-4900A,D Pembroke Rail Connector
13. NAME OF WATERBODY, IF KNOWN (if applicable) 14. PROJECT STREET ADDRESS (if applicable)
Bear Swamp Address n/a
15. LOCATION OF PROJECT
Latitude: �N 34.680952 Longitude: �W -79.175585 City - State- Zip-
16. OTHER LOCATION DESCRIPTIONS, IF KNOWN (see instructions)
State Tax Parcel ID NCDOT Right-of-way Municipality Pembrol<e, NC
Section - -- Township - Pembroke Range - --
ENG FORM 4345, OCT 2012 PREVIOUS EDITIONS ARE OBSOLETE. Page 1 of 3

7. DIRECTIONS TO THE SITE
'rom points north, south, and east of the Town of Pembroke, travel on Interstate 95 to Exit 17 and exit onto NC72/NC711 (South Caton
:oad). Turn right onto NC72/NC7ll and travel northwest for approximately 10.1 miles to Union Chapel Road (SR 1563) in the Town of
'embroke. Turn right and travel approximately 09 mile to the proposed crossing of the Rail over Union Chapel Road.
points west of the Town of Pembroke, travel east on Interstate 74 to Exit 200 and exit onto NC710. Turn left and travel north for
ximately 4.9 miles to Union Chapel Road in the Town of Pembroke. Turn left and travel approximately 0.9 mile to the proposed
ng of the Rail over Union Chapel Road.
18. Nature of Activity (Description of project, include all features)
The proposed project will involve the preparation for and installation of approximately 2.4 miles of connector track, including a grade-
separated crossing at Union Chapel Road; and the relocation of the existing Jones Road at-grade crossing to eliminate the existing sharp
turn adjacent to the rail crossing. Please see the attached letter.
19. Project Purpose (Describe the reason or purpose of the project, see instructions)
The purpose of this project is to provide efficient movemenY of equipment, supplies, and personnel between the CSX Milan Yard, military
facilities at Fort Bragg (Honeycutt Marshalling Yard, Fort Junction), and port faciliries at the North Carolina State Port at Wilmington and
the Military Ocean Terminal at Sunny Point (MOTSU). Currently, a train movement between Wilmington and Fayetteville has to pass
through Pembroke, turn at the siding at Wilkes or the yard at Hamlet and reYurn through Pembroke a second time to access the connection
in the northwest quadrant of the existing at-grade diamond crossing. This maneuver requires crossing of ten at-grade crossings twice each.
The proposed project would bypass these at-grade crossings, which would reduce the exposure of vehicular traffic to rail traffic, maximize
efficiency, minimize inconvenience to cirizens and motorisYs, and reduce negative air quality effects produced by idling vehicles while
reducing the number of freight trains traveling through downtown Pembroke and improving the routing of freight trains between
Wilmington and points north. Please see the attached letter.
USE BLOCKS 20-23 IF DREDGED AND/OR FILL MATERIAL IS TO BE DISCHARGED
20. Reason(s) for Discharge
Please see thc attached letter.
21. Type(s) of Material Being Discharged and the Amount of Each Type in Cubic Yards:
Type Type Type
Amount in Cubic Yards Amount in Cubic Yards Amount in Cubic Yards
Please see attached letter.
22. Surtace Area in Acres of Wetlands or Other Waters Filled (see instructions)
Acres 2.24 acres of permanent impacts to jurisdictional wetland areas
or
Linear Feet 423 linear feet of permanent impacts to jurisdictional streams
23. Description of Avoidance, Minimization, and Compensation (see instructions)
In general, the location of the proposed Rail Connector alignment has been situated just above the outer edge of the Bear Swamp floodplain
in order to avoid as many jurisdictional areas as possible while also minimizing the impact on adjacent farmland. Fill slopes have been
steepened in areas where stability is not a concern, and Bear Swamp is being crossed by a bridge structure rather than an extension of the
double box culverts currently in service under the existing rail. Please see the attached letter.
ENG FORM 4345, OCT 2012 Page 2 of 3

24. Is Any Portion of the Work Already Complete? �Yes �No IF YES, DESCRIBE THE COMPLETED WORK
n/a
� 25. Addresses of Adjoining Property Owners, Lessees, EtC., WhOS2 PPOp21'ty Ad)OiIIS the WBtel'bOdY (if more than can be entered here, please attach a supplemental list).
� a. Address- please see attached list
City -
b. Address-
City -
c. Address-
City -
d. Address-
City -
e. Address-
City -
State - Zip -
State - Zip -
State - Zip -
State - Zip -
State - Zip -
List of Other Certificates or Approvals/Denials received from other Federal, State, or Local Agencies for Work Described in This Application.
AGENCY TYPE APPROVAL* IDENTIFICATION DATE APPLIED DATE APPROVED DATE DENIED
NUMBER
WA FONSI P-4900 2014-03-27 2014-12-08
EEP Mitigation acceptance P4900STR-RW-LU03 2015-01-12 2015-01-13
� DMS Mitigation acceptance P4900Add-RW-LU03 2016-02-16 2016-02-17
' Would include but is not restricted to zoning, building, and flood plain permits
27. Application is hereby made for permit or permits to authorize the work described in this application. I certify that this information in this application is
complete and accurate. I further certify that I possess the authority to undertake the work described herein or am acting as the duly authorized agent of the
applicant.
SIGNATURE OF APPLICANT DATE SIGNATURE OF AGENT DATE
The Application must be signed by the person who desires to undertake the proposed activity (applicant) or it may be signed by a duly
authorized agent if the statement in block 11 has been filled out and signed.
18 U.S.C. Section 1001 provides that: Whoever, in any manner within the jurisdiction of any department or agency of the United States
knowingly and willfully falsifies, conceals, or covers up any trick, scheme, or disguises a material fact or makes any false, fictitious or
fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false, fictitious or
fraudulent statements or entry, shall be fined not more than $10,000 or imprisoned not more than five years or both.
ENG FORM 4345, OCT 2012 Page 3 of 3