20171353 Ver 1_Jurdistictional Determination_20171023

Jurisdictional Determination Request
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.
US Army Corps
of Engineers.
Wilmington 6ishic[
This form is intended for use by anyone requesting a jurisdictional determination (7D) from the
U. S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
to the appropriate Corps Field Office (or project manager, if known) via mail, electronic mail, or
facsimile. A current list of county assignments by Field Office and project manager can be
f�»ncl �n-linP at: http://www.saw.usace.army.mil/Missions/Re�,ulatoryPermitPro�ram.aspx , by
telephoning: 910-251-4633, or by contacting any of the field offices listed below:
ASHEVILLE REGULATORY FIELD OFFICE
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number: [phone]
Fax Number: [phone]
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
General Number: [phone]
Fax Number: [phone]
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number: [phone]
Fax Number: [phone]
WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number: 910-251-4633
Fax Number: [phone]
Version: December 2013 Page 1

Jurisdictional Determination Request
1NSTRUCTIONS:
All requestors must complete Parts A, B, C, D, E and F.
If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part G.
Please be aware that a117D
requests must include the current property owner authorization for the Corps to proceed with the
determination, which may include inspection of the property when necessary. This form must be
signed by the current property owner to be considered a complete request.
Property owner authorization/notification for 7D
requests associated with North Carolina Department of Transportation (NCDOT) projects will be
conducted according to the current NCDOT/LJSACE proiocois.
A Corps approved or preliminary JD 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 also request a certified wetland determination from the local office of the Natural
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Version: December 2013 Page 2

Jurisdictional Determination Request
A. PARCEL INFORMATION
StT'eet AddT'eSS: N/A (Linear Transportation Project)
Clty, State: Kinston, North Carolina
COUrity: Lenoir
Lii���ivi�S: See Figure 1: Vicinity Map
pai'C01 IridOX NUrilbOi'�S� �p��: N/A (Linear Transportation Project)
B. REQUESTOR INFORMATION
Name: NCDOT; ATTN: Hon Yeung, Division 2
Malllrig AC1C1T'eSS: 105 Pactolus Highway NC 33, P.O. Box 1587, Greenville, NC 27835
Telephone Number: (2s2) a3s-2s2�
Electronic Mail Addressl: nryeu�[e-mail]�
Select one:
� I am the current property owner.
❑ I am an Authorized Agent or Environmental Consultant�
❑ Interested Buyer or Under Contract to Purchase
❑ Other, please explain.
C. PROPERTY OWNER INFORMATION
Name: NCDOT; ATTN: Hon Yeung, Division 2
Malllrig AddT'eSS: 105 Pactolus Highway NC 33, P.O. Box 1587
Greenville, NC 27835
Telephone Number: (2s2) a39-2s2�
Electronic Mail Address3: n�veU�g@n�dot.go�
� Proof of Ownership Attached (e.g. a copy of Deed, County GIS/Parcel/Tax Record data)
1 If available
z Must attach completed Agent Authorization Form
3 If available
Version: December 2013 Page 3

Jurisdictional Determination Request
D. PROPERTY OWNER CERTIFICATION4
I, the undersigned, a duly authorized owner of record of the property/properties identified herein,
do authorize representatives of the Wilmington District, U. S. Army Corps of Engineers (Corps)
to enter upon the property herein described for the purpose of conducting on-site investigations
and issuing a determination associated with Waters of the U.S. subject to Federal jurisdiction
under Section 404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of
1899.
Property Owner (please print)
Property Owner Signature
E. JURISDICTIONAL DETERMINATION TYPE
Select One:
Date
� I am requesting that the Corps provide a preliminarv 7D for the property identified herein.
This request does include a delineation.
� I am requesting that the Corps provide a preliminary 7D for the property identified herein.
This request does NOT include a delineation.
� I am requesting that the Corps investigate the property/proj ect area for the presence or
absence of WoUSS and provide an �proved JD for the property identified herein. This
request does NOT include a request for a verified delineation.
� I am requesting that the Corps delineate the boundaries of all WoUS on a property/proj ect
area and provide an a�proved 7D (this may or may not include a survey plat).
� I am requesting that the Corps evaluate and approve a delineation of WoUS (conducted
by others) on a property/proj ect area and provide an approved 7D (may or may not
include a survey plat).
4 For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
5 Waters of the United States
Version: December 2013 Page 4

F.
�
Jurisdictional Determination Request
ALL REQUESTS
Map of Property or Proj ect Area (attached). This Map must clearly depict the boundaries
of the area of evaluation.
❑✓ Size of Property or Proj ect Area 4_7
n
G.
acres
I verify that the property (or proj ect) boundaries have recently been surveyed and marked
by a licensed land surveyor OR are otherwise clearly marked or distinguishable.
JD REQUESTS FROM CONSULTANTS OR AGENCIES
(1) Preliminary 7D Requests:
� Completed and signed Preliminarv Jurisdictional Determination Form6.
� Project Coordinates: 35.243096 Latitude -��'������
Maps (no larger than l 1x17) with Project Boundary Overlay:
0
0
�
�
❑
Longitude
Large and small scale maps that depict, at minimum: streets, intersections, towns
Aerial Photography of the project area
USGS Topographic Map
Soil Survey Map
Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
6 See Appendix A of this Form. From Regulatory Guidance Letter No. 08-02, dated June 26, 2008
Version: December 2013 Page 5

Jurisdictional Determination Request
Delineation Information (when applicable)�:
Wetlands:
� Wetland Data Sheets8
❑�
❑
❑✓
Upland Data Sheets
Landscape Photos, if taken
Tributaries:
� USACE Assessment Forms
� Other Assessment Forms
(when appropriate)
Field Sketch overlain on legible Map that includes:
■ All aquatic resources (for sites with multiple resources, label and identify)
■ Locations of wetland data points and/or tributary assessment reaches
■ Locations of photo stations
■ Approximate acreage/linear footage of aquatic resources
(2) Approved 7Ds including Verification of a Delineation:
� Proj ect Coordinates:
Latitude
Maps (no larger than l 1x17) with Project Boundary Overlay:
❑
�
❑
�
�
Longitude
Large and small scale maps that depict, at minimum: streets, intersections, towns
Aerial Photography of the project area
USGS Topographic Map
Soil Survey Map
Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site Plan,
previous delineation maps)
' 1987 Manual Regional Supplements and Data forms can be found at:
http://www.usace.armv.mil/Missions/CivilWorks/Re�ulatorvPro�ramandPermits/re� supp.aspx
Wetland and Stream Assessment Methodologies can be found at:
http://portal.ncdenr.org/c/document library/get file?uuid=76f3c58b-dab8-4960-ba43-45b7faf06f4c&groupld=38364 and,
http://www.saw.usace.army.mil/Portals/59/docs/regulatory/publicnotices/2013/NCSAM Draft User Manual 130318.pdf
$ Delineation information must include, at minimum, one wetland data sheet for each wetland/community type.
Version: December 2013 Page 6

Jurisdictional Determination Request
Delineation Information (when applicable):
Wetlands:
� Wetland Data Sheetsy
❑
❑
❑
Upland Data Sheets
Landscape Photos, if taken
Tributaries:
� USACE Assessment Forms
� Other Assessment Forms
(when appropriate)
Field Sketch overlain on legible Map that includes:
• All aquatic resources (for sites with multiple resources, label and identify)
• Locations of wetland data points and/or tributary assessment reaches
• Locations of photo stations
• Approximate acreage/linear footage of aquatic resources
Supporting Jurisdictional Information (for Approved 7Ds only)
u
�
Approved Jurisdictional Determination Form(s) (also known as "Rapanos
Form(s)")
Map(s) depicting the potential (or lack of potential) hydrologic connection(s),
adj acency, etc. to navigable waters.
9 Delineation information must include, at minimum, one wetland data sheet for each wetland/community type.
Version: December 2013 Page 7

Jurisdictional Determination Request
I. REQUESTS FOR CORPS APPROVAL OF SURVEY PLAT
Prior to final production of a Plat, the Wilmington District recommends that the Land
Surveyor electronically submit a draft of a Survey Plat to the Corps proj ect manager for
review.
Due to storage limitations of our administrative records, the Corps requires that all hard-
copy submittals include at least one ori�inal Plat (to scale) that is no lar�er than 11"x17"
(the use of match lines for larger tracts acceptable). Additional copies of a plat, including
those larger than 11"x17", may also be submitted for Corps signature as needed. The
Corps also accepts electronic submittals of plats, such as those transmitted as a Portable
Document Format (PDF) file. Upon verification, the Corps can electronically sign these
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(1) PLATS SUBMITTED FOR APPROVAL
�❑
�❑
❑
❑
❑�
❑�
❑�
�
Must be sealed and signed by a licensed professional land surveyor
Must be to scale (all maps must include both a graphic scale and a verbal scale)
Must be legible
Must include a North Arrow, Scale(s), Title, Property Information
Must include a legible WoUS Delineation Table of distances and bearings/metes
and bounds/GPS coordinates of all surveyed delineation points
Must clearly depict surveyed property or project boundaries
Must clearly identify the known surveyed point(s) used as reference (e.g. property
corner, USGS monument)
When wetlands are depicted:
• Must include acreage (or square footage) of wetland polygons
• Must identify each wetland polygon using an alphanumeric system
Version: December 2013 Page 8

Jurisdictional Determination Request
� When tributaries are depicted:
• Must include either a surveyed, approximate centerline of tributary with
approximate width of tributary OR surveyed Ordinary High Water Marks
(OHWM) of tributary
• Must identify each tributary using an alphanumeric system
• Must include linear footage of tributaries and calculated area (using appro�mate
widths or surveyed OHWM)
• Must include name of tributary (based on the most recent USGS topographic
map) or, when no USGS name exists, identify as "unnamed tributary"
� all depicted WoUS (wetland polygons and tributary lines) must intersect or tie-to
surveyed project/property boundaries
� Must include the location of wetland data points and/or tributary assessment
reacnes
� Must include, label accordingly, and depict acreage of all waters not currently
subject to the requirements of the CWA (e.g. "isolated wetlands", "non-
jurisdictional waters"). NOTE: An approved 7D must be conducted in order to
make an official Corps determination that a particular waterbody or wetland is not
jurisdictional.
� Must include and survey all existing conveyances (pipes, culverts, etc.) that
rran���rt «��TTc
Version: December 2013 Page 9

Jurisdictional Determination Request
(2) CERTIFICATION LANGUAGE
� When the entire actual Jurisdictional Boundary is depicted:
include the following Corps Certification language:
"This certifies that this copy of this plat accurately depicts the boundary of the jurisdiction
of Section 404 of the Clean WaterAct as determined by the undersigned on this date.
Unless there is a change in the law or our published regulations, the determination of
Section 404 jurisdiction may be relied upon for a period not to exceed five (S) years from
this date. The undersigned completed this determination utilizing the appropriate Regional
Supplement to the 1987 U.S. Army Corps of Engineers Wetlands Delineation Manual."
Regulatory Official:
Title:
Date:
USACEAction ID No.:
� When uplands may be present within a depicted Jurisdictional Boundary:
include the following Corps Certification language:
"This certifies that this copy of this plat identifies all areas of waters of the United States
regulated pursuant to Section 404 of the Clean Water Act as determined by the
undersigned on this date. Unless there is change in the law or our published regulations,
this determination of Section 404 jurisdiction may be relied upon for a period not to exceed
five years from this date. The undersigned completed this determination utilizing the
appropriate Regional Supplement to the 1987 U.S. Army Corps of Engineers Wetlands
Delineation Manual."
Regulatory Official:
Title:
Date:
USACEAction ID No.:
Version: December 2013
Page 10

Jurisdictional Determination Request
(3) GPS SURVEYS
For Surveys prepared using a Global Positioning System (GPS), the Survey must include
all of the above, as well as:
� be at sub-meter accuracy at each survey point.
� include an accuracy verification:
One or more known points (property corner, monument) shall be located with the
GPS and cross-referenced with the existing traditional property survey (metes and
bounds).
� include a brief description of the GPS equipment utilized.
Version: December 2013 Page 11

ATTACHMENT A
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD):
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
NCDOT; ATTN: Hon Yeung, Division 2
105 Pactolus Highway NC 33, P.O. Box 1587, Greenville, NC 27835
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT
SITES)
State: NC County/parish/borough: �eno�r Clty: Kinston
Center coordinates of site (lat/long in degree decimal format):
Lat. 35.243096 °N; Long. 77�70772� °W
Universal Transverse Mercator: 18
Name of nearest waterbody: Fa���ns creek
Identify (estimate) amount of waters in the review area:
Non-wetland waters:
204 linear feet: 15 width (ft) and/or acres.
COWaPC�lll C�aSS: Riverine
StC@alll F�OW: Perennial (Whitelace Creek)
Wetlands: n�a acres.
Cowardin Class: nia
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal: n�a
NOn-Tidal: nia
1

E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
� Office (Desk) Determination. Date:
� Field Determination. Date(s):
SUPPORTING DATA. Data reviewed for preliminary JD
(check all that apply - checked items should 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: Nc�oT
❑� Data sheets prepared/submitted by or on behalf of the
appl�nt/consultant.
Office concurs with data sheets/delineation report.
� Office does not concur with data sheets/delineation report.
❑ Data sheets prepared by the Corps:
❑ Corps 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:1:24,0000 (Deep Run)
❑✓ USDA Natural Resources Conservation Service Soil Survey.
CltatlOCl: Lenoir County (1977)
❑ 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: ❑✓ A@C'IaI �Na111@ $c Dat@�: NC Statewide Orthoimagery Project (2015) Or
� Other (Name & Date):
� Previous determination(s). File no. and date of response letter:
� Other information (please specify):
2

1. The Corps of Engineers believes that there may be jurisdictional waters of the
United States on the subject site, and the permit applicant or other affected party
who requested this preliminary JD is hereby advised of his or her option to
request and obtain an approved jurisdictional determination (JD) for that site.
Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the option to obtain an approved JD in
this instance and at this time.
2. In any circumstance where a permit applicant obtains an individual permit, or
a Nationwide General Permit (NWP) or other general permit verification requiring
"pre-construction notification" (PCN), or requests verification for a non-reporting
NWP or other general permit, and the permit applicant has not requested an
approved JD for the activity, the permit applicant is hereby made aware of the
following: (1) the permit applicant has elected to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional waters; (2) that the applicant has the option to request an approved
JD before accepting the terms and conditions of the permit authorization, and
that basing a permit authorization on an approved JD could possibly result in less
compensatory mitigation being required or different special conditions; (3) that
the applicant has the right to request an individual permit rather than accepting
the terms and conditions of the NWP or other general permit authorization; (4)
that the applicant can accept a permit authorization and thereby agree to comply
with all the terms and conditions of that permit, including whatever mitigation
requirements the Corps has determined to be necessary; (5) that undertaking
any activity in reliance upon the subject permit authorization without requesting
an approved JD constitutes the applicant's acceptance of the use of the
preliminary JD, but that either form of JD will be processed as soon as is
practicable; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a preliminary JD constitutes agreement that all
wetlands and other water bodies on the site affected in any way by that activity
are jurisdictional waters of the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative appeal or in any Federal court; and (7) whether
the applicant elects to use either an approved JD or a preliminary JD, that JD
will be processed as soon as is practicable. Further, an approved JD, a proffered
individual permit (and all terms and conditions contained therein), or individual
permit denial can be administratively appealed pursuant to 33 C.F.R. Part 331,
and that in any administrative appeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary
to make an official determination whether CWA jurisdiction exists over a site, or
to provide an official delineation of jurisdictional waters on the site, the Corps will
provide an approved JD to accomplish that result, as soon as is practicable.
3

This preliminary JD finds that there "may be" waters of the United States on the
subject project site, and identifies all aquatic features on the site that could be
affected by the proposed activity, based on the following information:
IMPORTANT NOTE: The information recorded on this form has not
necessarilv been verified bv the Corps and should not be relied uqon for
later iurisdictional determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
� 3/zo/l�
Signature a da e of
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)

Estimated
Cowardin amount of Class of
Site number Latitude Longitude Class aquatic aquatic
resource in resource
review area
Whitelace 35.243166 -77.707731 Riverine 2041inear Non-
Creek feet section
10 — non-
tidal

North Carolina Division of Water Quality - Stream Identification Form, Version 4.11
Date: 3/5/2017 ProjecUSite: �/hitelace Creek Latitude: 35.243173
Bridge 55
B. Reed (Kimley-Horn)
EV8IU8t01': W. Sullivan (Kimley-Horn) County: Lenoir Longitude: -77.70775
Total Points: 35 Stream Determination (cir Other
Stream is at least intermittent Ephemeral Intermitten erennial e.g. Quad Name: Deep Run
if >_ 19 or perennial if >_ 30
Whitelace
Creek
A. Geomorphology Subtotal = 16 Absent Weak Moderate Strong Score
1a. Continuity of channel bed and bank 0 1 2 3 3
2. Sinuosity of channel along thalweg 0 1 2 3 2
3. In-channel structure: ex. riffle-pool, step-pool, ripple- 0 1 2 3 1
ool sequence
4. Particle size of stream substrate 0 1 2 3 1
5. Active/relic floodplain 0 1 2 3 1
6. Depositional bars or benches 0 1 2 3 3
7. Recent alluvial deposits 0 1 2 3 2
8. Headcuts 0 1 2 3 0
9. Grade control 0 0.5 1 1.5 0
10. Natural valle 0 0.5 1 1.5 0
11. Second or reater order channel No = 0 Yes = 3 3
artificial ditches are not rated; see discussions in manual
B. Hydrology Subtotal = g.5
12. Presence of Baseflow 0 1 2 3 3
13. Iron oxidizing bacteria 0 1 2 3 0
14. Leaf litter 1.5 1 0.5 0 1.5
15. Sediment on plants or debris 0 0.5 1 1.5 0.5
16. Organic debris lines or piles 0 0.5 1 1.5 0.5
17. Soil-based evidence of high water table? No = 0 Yes = 3 3
C. Biology Subtotal = 10.5
18. Fibrous roots in streambed 3 2 1 0 2
19. Rooted upland plants in streambed 3 2 1 0 3
20. Macrobenthos (note diversity and abundance) 0 1 2 3 0
21. Aquatic Mollusks 0 1 2 3 2
22. Fish 0 0.5 1 1.5 1.5
23. Crayfish 0 0.5 1 1.5 0
24. Amphibians 0 0.5 1 1.5 0
25. Algae 0 0.5 1 1.5 0.5
26. Wetland plants in streambed FACW = 0.75; OBL = 1.5; Other = 0 1.5
*perennial streams may also be identified using other methods. See p. 35 of manual.
Notes:
Whitelace Creek is a channelized, perennial tributary to Falling Creek. The
substrate within Whitelace Creek is composed primarily of silt and sand displaced
from the surrounding agricultural fields. Flow within Whitelace Creek is moderate
and the water is slightly turbid and 2' deep. The bankful width is 15' and the
height is 4'. Minnows and mollusks were observed in the channel.