20091068 Ver 1_401 Application_20091009

`d
09`1068
Letter of Transmittal
S&ME, Inc-
9751 9751 Southern Pine Blvd. *S&ME
Charlotte, NC 28273
[phone]
[phone] fax
N.C. Division of Water Quality
401 Wetlands Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, North Carolina, 27604-2260
WE ARE SENDING YOU
? Shop drawings
® Copy of letter
DATE: September 30, 2009 I JOB NO: 1357-09-027
ATTENTION: Ms. Cyndi Karoly
RE: Dawn Circle Project
1P A I
® Attached ? Under separate cover via
? Prints ? Plans ? Draft
? Report
- the following items:
? Specifications
COPIES DATE NO DESCRIPTION
5 9.30.09 1 WQC/Nationwide Permit No. 14 Application Package
1 9.30.09 3 Check for $240.00 WQC Processing Fee
? 15??t1?L5
THESE ARE TRANSMITTED AS CHECKED BELOW: 0 C T .s 2009
® For approval ? For your use
? As requested ? For review and comment ? DENR-WATER QUALITY
ETLAmDS AND STORMWATER BRANCH
? FORBIDS DUE: ? PRINTS RETURNED AFTER LOAN TO US
REMARKS: Attached please find the above. Please let Joey Lawler know if you have questions, Thank you.
SIGN:
COPY TO: File
IF ENCLOSURES ARE NOT AS NOTED, PLEASE NOTIFY US AT ONCE.
This Letter of Transmittal and the documents accompanying this Letter of Transmittal contain information from S&ME, Inc., which is confidential and legally
privileged. The information is intended only for use of the individual or entity named on this Letter of Transmittal. If you are not the intended recipient, you
are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on these documents is strictly prohibited.
S&ME SFG-001
(Rev. 04/04)
*S&ME
September 30, 2009
U.S. Army Corps of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
Attention: Mr. Stephen Chapin
N.C. Division of Water Quality
401 Wetlands Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, North Carolina 27604-2260
Attention: Ms. Cyndi Karoly
Reference: Application for Nationwide Permit No. 14 and
Request for Jurisdictional Determination
Dawn Circle Sidewalk Project
Charlotte, North Carolina
S&ME Project No. 1357-09-027
Dear Mr. Chapin and Ms. Karoly:
0 9- 1 0 6 8
PA I
S&ME, Inc. (S&ME) is submitting this application for impacts to waters of the U.S. in
accordance with Department of the Army Nationwide Permit (NWP) No. 14 - Linear
Transportation Projects, along with supporting documentation for verification of the
jurisdictional boundaries located within the project area. S&ME has been retained by
Charlotte Storm Water Services (CSWS), the applicant for the proposed project, to
provide services related to acquisition of the NWP and corresponding North Carolina
Water Quality Certification (WQC) pursuant to the Clean Water Act. The project will
involve replacement of a 42 linear foot (If), 36-inch reinforced concrete pipe (RCP) with
a 53 If, 66-inch RCP to accommodate sidewalk construction and the Charlotte
Department of Transportation (CDOT) safety requirements for residential roads.
Proposed construction of the sidewalk and upgrading the existing RCP are associated
with the Hidden Valley Neighborhood Improvement Project (NIP) in Charlotte,
Mecklenburg County, North Carolina. In support of this NWP No. 14 application, please
find enclosed the following:
• Appendix I: Pre-Construction Notification (PCN);
• Appendix 11: Figures - Site Vicinity Map (Figure 1), USGS Topographic Map
(Figure 2), 2007 Aerial Photograph (Figure 3), Mecklenburg County Soil Survey
Map (Figure 4), Approximate Waters of the U.S. Map (Figure 5);
• Appendix Ill: Stream Crossing Plan and Profile (Exhibit 1);
S&ME, INC. / 9751 Southern Pine Boulevard / Charlotte, NC 28273-5560 / p 704.523.4726 f 704.525.3953 / www.smeinc.com
Nationwide Permit No.14/Request for Jurisdictional Determination SWE Project No. 1357-09-027
Dawn Circle Sidewalk Project September 30, 2009
• Appendix IV: Site Photographs;
• Appendix V: Approved Jurisdictional Determination Form; and
• Appendix VI: U.S. Army Corps of Engineers (USACE) Stream Quality
Assessment Worksheet, N.C. Division of Water Quality (DWQ) Stream
Identification Form; and
• Check for $240 (DWQ processing fee).
The proposed project will occur largely within the footprint of an existing road crossing.
However, copies of this PCN, along with a check for the processing fee, are being
provided to DWQ for written concurrence because the proposed project will require an
additional 35 if of impact to jurisdictional waters of the U.S. (Stream 1) associated with
the culvert upgrade, sidewalk construction and placement of a riprap apron at the new
culvert outlet.
The location of the project area is depicted on the Site Vicinity Map (Figure 1), the
Derita, N.C (1993) USGS Topographic Map (Figure 2), a 2007 Aerial Photograph
(Figure 3), and the Mecklenburg County Soil Survey Map (Figure 4), included in
Appendix II.
BACKGROUND INFORMATION
The purpose of the proposed project is to install sidewalk along a pedestrian corridor and
to replace an undersized RCP that routes a jurisdictional stream under Dawn Circle and
eventually into Little Sugar Creek to the west. The proposed project entails replacing the
current 42-1f, 36-inch RCP with a 53-]f 66-inch RCP that will accommodate flow,
sidewalk improvements, and satisfy CDOT safety requirements associated with the
Hidden Valley NIP. The 66-inch RCP was designed to accommodate the 25-year storm
in accordance with the CDOT standards for residential neighborhood culverts. However,
the new culvert cannot be buried below the existing streambed, per USACE
requirements, due to the presence of an underlying sewer pipe beneath the culvert. In
addition to lengthening the new RCP, a 24 if riprap apron will also be installed at the
downstream portion of the RCP to reduce stormwater velocity.
FIELD OBSERVATIONS
On September 15, 2009 Mr. Joey Lawler with S&ME visited the project area and
conducted a jurisdictional delineation to determine the location of waters of the U.S.,
including wetlands. The project area was limited to approximately 50 feet upstream and
50 feet downstream of the existing road crossing on Dawn Circle. Representative
photographs of the project area are attached (Appendix IV).
The delineation was conducted utilizing currently accepted methods for wetland
determination, as set forth in the 1987 Corps of Engineers Wetlands Delineation Manual,
which states that under normal circumstances, an area must demonstrate the presence of
three components to be considered jurisdictional: 1) hydrophytic vegetation, 2) hydric
soils, and 3) wetland hydrology. Furthermore, stream assessments were conducted in
accordance with DWQ and USACE guidelines.
2
Nationwide Permit No.14/Request for Jurisdictional Determination SWE Project No. 1357-09-027
Dawn Circle Sidewalk Project September 30, 2009
Field review identified one relatively permanent water (Stream 1) that exhibited
perennial/year round flow within the project area. Stream 1 originates at a pond west of
Dawn Circle then flows through an existing 42 If, 36-inch RCP beneath the roadway.
The project area is comprised of a narrow, wooded area vegetated primarily with invasive
species. Figure 5, Appendix 11, depicts the delineated area within the project area. An
Approved Jurisdictional Determination form was prepared and is incorporated with this
PCN for verification (Appendix V). A completed DWQ Stream Identification Form and
USACE Stream Quality Assessment Worksheet are included in Appendix VI.
PROPOSED PROJECT IMPACTS
The proposed project will require a combined 35 if of permanent stream impact to the
portion of Stream 1 located downstream of the existing culvert footprint. The permanent
impact associated with replacing the existing 42 if culvert with a 53 if larger diameter
RCP is an additional 11 If that is necessary to effectively convey a 25-year storm event
and is in compliance with CDOT requirements. An additional 24 if of riprap will be
placed on the downstream portion of the new RCP to reduce stormwater velocity.
Temporary stream impacts of approximately 20 if upstream of the road crossing are
necessary for the temporary placement of a coffer dam, and a pump around and
temporary impacts of approximately 10 if downstream of the road crossing is necessary
for placement of a rock check dam. These temporary in-stream structures will divert
stream flow during construction.
Plan and profile details for the proposed project are included in Appendix III. The
location of Stream l is depicted on the attached Figure 5 (Appendix II). No jurisdictional
wetlands were identified in the project area.
PROTECTED SPECIES AND CULTURAL RESOURCES
Protected Species
S&ME's review of potential protected species habitat entailed a literature review of
existing records obtained from federal and state sources to identify documented records
of protected species. The USFWS list of federally protected species (updated May 10,
2007) was consulted for a listing of protected species documented within Mecklenburg
County, North Carolina. This review identified three protected plant species and one
animal species. Listed fauna and flora and their federal status are identified in Table 1.
Explanations of rankings are included at the end of the table.
Nationwide Permit No.14/Request for Jurisdictional Determination SWE Project No. 1357-09-027
Dawn Circle Sidewalk Project September 30, 2009
Table 1: Federally Protected Flora and Fauna Summary
Species Federal Rank' County Status Habitat Present
Helianthus schweinitzii

Schweinitz's sunflower E Current No
Lasmigona decorata

Carolina heelsplitter E Historical No
Echinacea laevigata

Smooth coneflower E Current No
Rhus michauxii
Michaux's sumac
? r E Historical No
C = Enuan9ereu
As part of the literature review, S&ME also consulted the North Carolina Natural
Heritage Program NCNHP Geographic Information Systems (GIS) database Virtual
Workroom and Element Occurrence (EO) Database for a listing of EO's of endangered or
threatened species within or near the project area. This review did not identify EO's
pertaining to federally protected species within a two-mile radius of the project area.
S&ME completed a field reconnaissance for jurisdictional features on September 17,
2009. This effort revealed the project area consists of forested and residential areas along
Stream 1. Based on the urban nature of the project area and continued disturbance, the
project area was not considered to provide potential habitat for protected terrestrial
species with a likelihood of occurring in Mecklenburg County.
The proposed project affects Stream 1, an unnamed tributary of Little Sugar Creek, and
will not impact streams that drain to known populations of Carolina heelsplitter or its
designated Critical Habitat. No documented occurrences of Carolina heelsplitter are
known for Little Sugar Creek or its tributaries. Accordingly, the proposed project is not
anticipated to impact this species or its designated Critical Habitat.
A copy of this NWP No. 14 application will be provided to the NCNHP and the U.S. Fish
and Wildlife Service (USFWS), Asheville Field Office on September 30, 2009 requesting
their review of records they may have in regards to the proposed project and to provide
comments regarding agency interests.
Cultural Resources
A copy of this NWP No. 14 application will be provided to the North Carolina State
Historic Preservation Office (SHPO) on September 30, 2009 requesting their review of
records regarding cultural, archaeological, or historical resources in or near the project
area and to provide written comments regarding the interests of their agency.
Nationwide Permit No.14/Request for Jurisdictional Determination SWE Project No. 1357-09-027
Dawn Circle Sidewalk Project September 30 2009
AVOIDANCE AND MINIMIZATION
The proposed project involves impacts to less than 150 if of stream. The new culvert will
be placed at the same angle as the existing culvert. Except for an additional I I If, the
culvert replacement and road and sidewalk improvements will occur within the footprint
of the existing road crossing and will improve current stream function. An additional 24
If of riprap will be located on the downstream portion of the 66-inch RCP replacement.
Placement of riprap is necessary to reduce velocity of stormwater during high flow events
and help prevent downstream erosion of the stream bed due to high velocity water. To
prevent sedimentation of downstream portions of Stream 1, construction will be
conducted in the dry through the use of a coffer dam, a pump around, and a rock check
dam. Original grades and contours will be restored and disturbed areas seeded. Impacts
have been avoided and minimized to the extent practicable and have been limited to the
minimum necessary to facilitate sidewalk improvements and satisfy CDOT requirements
for the Hidden Valley NIP.
REGULATORY CONSIDERATIONS
Following construction, temporarily disturbed areas will be restored to original grade and
elevation. The proposed project should not result in permanent changes in pre-
construction elevation contours or stream dimension, pattern or profile beyond those
described in this application. Excess material will be removed to a high ground disposal
area.
Appropriate sediment and erosion control practices outlined in the most recent version of
the "North Carolina Sediment and Erosion Control Planning and Design Manual" and
approved by the local governing authority will be in compliance with specifications
governing the proper design, installation, operation and maintenance of such Best
Management Practices (BMP's) to comply with the appropriate turbidity water quality
standard. Sediment and erosion control measures placed in waters will be removed and
the original grade restored within two months after the Division of Land Resources has
released the project. Impacts have been avoided and minimized, and appropriate
measures will be taken during construction to allow flow and circulation patterns of
waters of the U.S. to remain unaffected. After construction, disturbed areas will be
seeded and restored. No permanent or temporary impacts to wetlands are anticipated.
The proposed project will result in additional impervious surface; however, the project is
a linear transportation corridor and amounts of impervious surface should not exceed
24% of the project area.
Note: Because a sewer main is located directly beneath the existing CMP, the project
cannot comply with USACE regional condition 3.6. (Safe Passage Requirements for
Culvert Placement) and general condition 14 (Placement of Culverts and other Structures
in Waters and Wetlands) of DWQ WQC 3704, which specify that new culverts be buried
one foot beneath the existing streambed. Accordingly, CSWS requests that a waiver
from the aforementioned depth specifications be granted, and seeks authorization for the
invert of the new culvert to be placed at the bottom elevation of the existing streambed.
Nationwide Permit No.14/Request for Jurisdictional Determination SWE Project No. 1357-09-027
Dawn Circle Sidewalk Project September 30, 2009
MITIGATION
Based on conversations with the USACE for similar projects, we anticipate that
appropriate mitigation for the proposed project can be satisfied by the avoidance and
minimization procedures implemented during the design phase of the proposed project.
Impacts to Stream 1 will be minimized by implementing the sidewalk improvements
within the footprint of the existing stream crossing. BMP's will be utilized during
construction to prevent sedimentation and the channel slope will be restored upon project
completion.
CLOSING
By copy of this correspondence and completed PCN, we are requesting your written
concurrence with this NWP No. 14 permit application. If we can provide additional
information or answer questions you may have, please feel free to contact us at
704.523.4726.
Sincerely,
S&ME
--) 4-v&? ) 4 ???
Isaac Hinson, P.W.S.
Wetland Specialist
Charlo e Storm Water Services
Michael Wolfe
Natural Resources Department Manager
4 Z
?oey VLaer,.W.S.
Natural Resources Project Manager
Senior Reviewed by Neal McElveen, P.E.
Attachments
cc: Mr. Isaac Hinson, Charlotte Storm Water Services
Mr. Peter Sandbeck, State (North Carolina) Historic Preservation Office
Mr. Brian Cole, U.S. Fish and Wildlife Service, Asheville Field Office
Mr. Harry LeGrand, Jr., North Carolina Natural Heritage Program
cjf/JOL S:\1357\PROJECTS\2009\09-027 Dawn Circle Sidewalk Project
6
APPENDIX 1
Pre-Construction Notification
09'1068
TFRQG
?0? IN A
O
6
1 1 >
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification C Form
A. Applicant Information
1. Processing
1 a . Type(s) of approval sought from the
Corps:
® Section 404 Permit ? Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: NWP No. 14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

? Yes ® No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes ® No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below. ? Yes ® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Dawn Circle Sidewalk Project
2b. County: Mecklenburg
2c. Nearest municipality / town: Charlotte
2d. Subdivision name: Hidden Valley
2e. NCDOT only, T.I.P. or state
project no: N/A
3. Owner Information
3a. Name(s) on Recorded Deed: Addams, LLC and Mr. John Kirk Killian
3b. Deed Book and Page No. 22449-743 and 04030-423
3c. Responsible Party (for LLC if
applicable): Unknown
3d. Street address: 701 Dawn Circle
3e. City, state, zip: Charlotte, North Carolina 28205
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page I of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ® Other, specify: Storm Water Utility
4b. Name: Isaac Hinson, PWS
4c. Business name
(if applicable): Charlotte Storm Water Services
4d. Street address: 600 East Fourth Street
4e. City, state, zip: Charlotte, NC 28202
4f. Telephone no.: 704-336-4495
4g. Fax no.: 704-336-6586
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: Joey Lawler, PWS
5b. Business name
(if applicable): S&ME, Inc.
5c. Street address: 9751 Southern Pine Blvd.
5d. City, state, zip: Charlotte, NC 28273
5e. Telephone no.: 704-523-4726
5f. Fax no.: 704-525-3953
5g. Email address: [e-mail]
Page 2 of 11
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a . Property identification no. (tax PIN or parcel ID): 08921109 and 08921201
1b. Site coordinates (in decimal degrees): Latitude: 35.26566 Longitude: - 80.77593
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: Project Area = 1.06 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Little Sugar Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: 11-137-8, Class C
2c. River basin: Lower Catawba River Basin
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The project area is primarily wooded. Surrounding landuse is largely residential.
3b. List the total estimated acreage of all existing wetlands on the property:
No wetlands were identified in the study area.
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
Stream 1 extended for approximately 153 If in the study area.
3d. Explain the purpose of the proposed project:
The project will involve replacement of a 42 linear foot, (If) 36-inch reinforced concrete pipe (RCP) with a 53 If, 66-inch
RCP to accommodate sidewalk construction and Charlotte Department of Transportation (CDOT) safety requirements for
residential roads. Proposed construction of the sidewalk and upgrading the existing RCP are associated with the Hidden
Valley Neighborhood Improvement Project (NIP), in Charlotte, North Carolina.
3e. Describe the overall project in detail, including the type of equipment to be used:
The proposed project will require a combined 35 If of permanent stream impact to the portion of Stream 1 located
downstream of the existing culvert footprint. The permanent impact associated with replacing the existing 42 If culvert
with a 53 If larger diameter RCP is an additional 11 If that is necessary to effectively convey a 25-year storm event and is
in compliance with CDOT requirements. An additional 24 If of riprap will be placed on the downstream portion of the new
RCP to reduce stormwater velocity.
Temporary stream impacts of approximately 20 If upstream of the road crossing are necessary for the temporary
placement of a coffer dam, and a pump around and temporary impacts of approximately 10 If downstream of the road
crossing is necessary for placement of a rock check dam. These temporary in-stream structures will divert stream flow
during construction and will be removed following completion of the RCP installation.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
t
i
? Yes ? No ® Unkno
n
projec
(
ncluding all prior phases) in the past? w
Comments:
4b. If the Corps made the jurisdictional determination, what type
f
? Preliminary ? Final
o
determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Page 3 of 11
PCN Form - Version 1.3 December 10, 2008 Version
5. Project History
5a. Have permits or certifications been requested or obtained for ? Yes ® No ? Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ®Yes ? No
6b. If yes, explain.
This is Phase 6 of the Hidden Valley Neighborhood Improvement Project. Other activities have included transportation
and drainage infrastructure improvements.
Page 4 of 11
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
? Wetlands ® Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
W1 ? P ? T ? Yes ? Corps
? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? PEI T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts
2h. Comments: No wetlands identified in the study area.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ®P ? T RCP extension UT to Little Sugar
Creek, Stream 1 ® PER
? INT ® Corps
® DWQ
5-6
11
S2 ® P ? T Riprap apron UT to Little Sugar ® PER ® Corps 5-6 24
Creek, Stream 1 ? INT ® DWQ
S3 ? P ? T Coffer dam, UT to Little Sugar ® PER ® Corps 5-6 30
Checkdam Creek, Stream 1 ? INT ® DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3b. Total stream and tributary impacts 65
3i. Comments: 11 linear feet of impact is associated with the installation of the longer RCP, 24 If is due to the placement of
riprap at the RCP outlet to reduce stormwater velocity. Temporary stream impacts of approximately 20 If upstream of the road
crossing are necessary for the temporary placement of a coffer dam, and a pump around and temporary impacts of
approximately 10 If downstream of the road crossing is necessary for placement of a rock check dam. These temporary in-
stream structures will divert stream flow during construction and will be removed followinq completion of the RCP installation.
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary T
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments: No open waters are located within the study area.
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose (acres)
number of pond
Flooded Fitted Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWO)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary T impact required?
B1 ?P?T ?Yes
? No
B2 ?P?T ?Yes
? No
B3 ? P ? T ? Yes
? No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed project involves impacts to less than 150 If of stream. The new culvert will be placed at the same angle as the
existing culvert. Except for an additional 11 If, the culvert replacement and road and sidewalk improvements will occur within
the footprint of the existing road crossing and will improve current stream function. An additional 24 If of riprap will be located
on the downstream portion of the 66-inch RCP replacement. Placement of riprap is necessary to reduce velocity of
stormwater during high flow events and help prevent downstream erosion of the stream bed due to high velocity water. To
prevent sedimentation of downstream portions of Stream 1, construction will be conducted in the dry through the use of a
coffer dam, a pump around, and a rock check dam. Original grades and contours will be restored and disturbed areas seeded.
Impacts have been avoided and minimized to the extent practicable and have been limited to the minimum necessary to
facilitate sidewalk improvements and satisfy CDOT requirements for the Hidden Valley NIP.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
.
To prevent sedimentation of downstream portions of Stream 1, construction will be conducted in the dry through the use of a
coffer dam, a pump around, and rock check dams. Following construction, disturbed areas outside of the bank stabilization
area will be restored to original grade and elevation. The proposed project should not result in permanent changes in pre-
construction elevation contours or stream dimension, pattern or profile beyond those described in this application. Excess
material will be removed to a high ground disposal area.
Appropriate sediment and erosion control practices outlined in the most recent version of the "North Carolina Sediment and
Erosion Control Planning and Design Manual" and approved by the local governing authority will be in compliance.. With.
specifications governing the proper design, installation, operation and maintenance of such Best Management Practices
(BMP's) to comply with the appropriate turbidity water quality standard. Sediment and erosion control measures placed in
waters will be removed and the original grade restored within two months after the Division of Land Resources has released
the project. Impacts have been avoided and minimized, and appropriate measures will be taken during construction to allow
flow and circulation patterns of waters of the U.S. to remain unaffected. After construction, disturbed areas will be seeded and
restored. No permanent or temporary impacts to wetlands are anticipated.
The proposed project will result in additional impervious surface; however, the project is a linear transportation corridor and
amounts of impervious surface should not exceed 24% of the project area.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for ? Yes ® No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps
? Mitigation bank
2c. If yes, which mitigation option will be used for this
El P
t t
i
li
project? aymen
o
n-
eu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
Page 7 of 11
PCN Form - Version 1.3 December 10, 2008 Version
3c . Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a . Approval letter from in-lieu fee program is attached. ? Yes
4b . Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 8 of 11
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a . Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b . If yes, then is a diffuse flow plan included? If no, explain why.
El Yes No
?
Comments:
2. Stormwater Management Plan
2a . What is the overall percent imperviousness of this project? 0%
2b . Does this project require a Stormwater Management Plan? ? Yes ® No
2c . If this project DOES NOT require a Stormwater Management Plan, explain why: The proposed project is a municipal
improvement project that will not result impervious surface exceeding 24% of the proj ect area.
2d . If this project DOES require a Stormwater Management Plan, then provide a brief, na rrative description of the plan:
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
? Phase If
3b. Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties

4a.
Which of the following state-implemented stormwater management programs apply ? HQW
? ORW
(check all that apply): ? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No
Page 9 of 11
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the ® Yes ? No
use of public (federal/state) land?
1b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ? Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ? Yes ? No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer 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 of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
The proposed project will not generate wastewater.
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version
S. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or El Yes ® No
habitat .
5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes
No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted. El Raleigh
® Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
A copy of this PCN will be provided to USFWS Asheville Field Office. A literature review of the study area and are
professional experience did not indicate the presence of endangered species listed for Mecklenburg County. The study
area and vicinity are not located in a Designated Critical Habitat. Review of EOs on the North Carolina Natural Heritage
Program Geographic Information Systems (GIS) Virtual Workroom did not reveal occurrences of federally-listed species
within a two-mile radius from the project area.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http://ocean.floridamarine.org/efh_coraI/ims/viewer.htm
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
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 ? Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
A copy of this PCN will be provided to SHPO on September 30, 2009.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? http://polaris.mecklenburgcountync.gov

Isaac Hinson, PWS Ci 9/30/2009
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant
is rovided.
Page 1 I of 11
PCN Form - Version 1.3 December 10, 2008 Version
APPENDIX II
Figure 1 - Site Vicinity Map
Figure 2 - USGS Topographic Map
Figure 3 - Aerial Photograph
Figure 4 - Mecklenburg County Soil Survey Map
Figure 5 - Approximate Waters of the U.S. Map
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REFERENCE: USGS 1993 DERITA [NC] QUAD SHEET v, a
THE ABOVE INFORMATION WAS OBTAINED FROM THE MECKLENBURG COUNTY GEOGRAPHIC INFORMATION �_ 0
SYSTEM (GIS) DEPARTMENT WEB SITE. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL PURPOSES ONLY. IT
IS NOT MEANT FOR DESIGN, LEGAL, OR ANY OTHER USES. THERE ARE NO GUARANTEES ABOUT ITS '3} r,0 500 0-1 000 ) 1,500 -.
ACCURACY. S&ME, INC. ASSUMES NO RESPONSIBILITY FOR ANY DECISION MADE OR ANY ACTIONS TAKEN BY
THE USER BASED UPON THIS INFORMATION.
Feet
SCALE: AS SHOWN FIGURE
DATE: 09.14.09 USGS TOPOGRAPHIC MAP NO,
S&MEDRAWN BY: Dawn Circle Sidewalk Project
CJF Charlotte, NC 2
CHECKED BY: EMW PROJECT NO:
1357-09-027

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REFERENCE: SOIL SURVEY GEOGRAPHIC (SSURGO) DATASET FOR MECKLENBURG COUNTY
THE ABOVE GIS DATA WAS OBTAINED FROM USDA GEOSPATIAL DATA GATEWAY WEB SITE. PLEASE NOTE THIS
MAP IS FOR INFORMATIONAL PURPOSES ONLY. IT IS NOT MEANT FOR DESIGN, LEGAL. OR ANY OTHER USES.
THERE ARE NO GUARANTEES ABOUT ITS ACCURACY. S&ME,INC. ASSUMES NO RESPONSIBILITY FOR ANY
DECISION MADE ORANY ACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION.
"ALE
Old Concord Rd
0 250 500
1" = 500' MECKLENBURG COUNTY FIGURE
ATE: 09.14.09 S&ME SOIL SURVEY MAP NO.
RAWN BY: Dawn Circle Sidewalk Project
CJF may' Charlotte, NC
4
IECKED BY. EIUIW PROJECT NO: 1357_09-027
APPENDIX 111
Stream Crossing Plan and Profile
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APPENDIX IV
Site Photographs
Taken by: JOL
Checked by: EMW tS
SITE PHOTOGRAPHS
Dawn Circle Sidewalk Project
Charlotte, North Carolina
Photo 1: View of existing 36-inch culvert facing downstream
Photo 3: View facing south along project corridor (09.15.09)
APPENDIX V
Approved Jurisdictional Determination Form
APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION 1: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:ASHEVILLE FIELD REGULATORY OFFICE
C. PROJECT LOCATION AND BACKGROUND INFORMATION: STREAM 1
State:NORTH CAROLINA County/parish/borough: MECKLENBURG City: CHARLOTTE
Center coordinates of site (lat/long in degree decimal format): Lat. 35.26566° N, Long. 80.77593° W.
Universal Transverse Mercator:
Name of nearest waterbody: LITTLE SUGAR CREEK
Name of nearest Traditional Navigable Water (TNW) Into which the aquatic resource flows: CATAWBA RIVER
Name of watershed or Hydrologic Unit Code (HUC): 03050103 (LOWER CATAWBA RIVER)
® Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
? Check if other sites (e.g., offsite mitigation sites, disposal sites, etc... ) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
? Office (Desk) Determination. Date:
? Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RIIA SECTION 10 DETERMINATION OF JURISDICTION.
There Are no "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
? Waters subject to the ebb and flow of the tide.
? Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Are "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): '
? TNWs, including territorial seas
? Wetlands adjacent to TNWs
® Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
? Non-RPWs that flow directly or indirectly into TNWs
? Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
? Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
? Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
? Impoundments of jurisdictional waters
? Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: 153 linear feet: 5-6 width (ft) and/or acres.
Wetlands: acres.
c. Limits (boundaries) of jurisdiction based on: 1987 Delineation Manual
Elevation of established OHWM (if known):
2. Non-regulated waters/wetlands (check if applicable):;
? Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section 111 below.
For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months) -
3 Supporting documentation is presented in Section III.F.
SECTION ID: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section HI.A.1 and Section II1.D.l. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections M.A.] and 2
and Section ID.D.1.; otherwise, see Section II1.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT 1S NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section II1.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section M.B.1 for
the tributary, Section HI.B.2 for any onsite wetlands, and Section IH.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section M.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: Pick List
Drainage area: Pick List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
? Tributary flows through Pick List tributaries before entering TNW.
Project waters are Pick List river miles from TNW.
Project waters are Pick List river miles from RPW.
Project waters are Pick List aerial (straight) miles from TNW.
Project waters are Pick List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW5:
Tributary stream order, if known
Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the arid
west.
s Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.

(b) General Tributary Characteristics (check all that apply):
Tributary is: ? Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick List.
Primary tributary substrate composition (check all that apply):
? Silts ? Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/% cover:
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks). Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry: Pick List
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for: Pick List
Estimate average number of flow events in review area/year: Pick List
Describe flow regime:
Other information on duration and volume:
Surface flow is: Pick List. Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
Tributary has (check all that apply):
? Bed and banks
? OHWM6 (check all indicators that apply):
? clear, natural line impressed on the bank ?
? changes in the character of soil ?
? shelving ?
? vegetation matted down, bent. or absent ?
? leaf litter disturbed or washed away ?
? sediment deposition ?
? water staining ?
? other (list):
? Discontinuous OHWM.7 Explain:
If factors other than the OHWM were used to determ
High Tide Line indicated by: ?
? oil or scum line along shore objects
? fine shell or debris deposits (foreshore)
? physical markings/characteristics
? tidal gauges
? other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
ine lateral extent of CWA jurisdiction (check all that apply)
Mean High Water Mark indicated by:
? survey to available datum;
? physical markings;
? vegetation lines/changes in vegetation types.
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain:
Identify specific pollutants, if known:
°A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground; or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert); the agencies will look for indicators of flow above and below the break.
'Ibid
(iv) Biological Characteristics. Channel supports (check all that apply):
? Riparian corridor. Characteristics (type, average width):
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Pick List. Explain:
Surface flow is: Pick List
Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width): .
? Vegetation type/percent cover. Explain: .
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis.

For each wetland, specify the following:
Directly abuts? (YIN) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section I11.D:
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
? TNWs: linear feet width (11), Or, acres.
? Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
® Tributaries ofTNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: STREAM 1 POSSESSED GEOMORPHIC FEATURES, FLOW. AND BIOTA CONSISTENT WITH
A PERENNIAL CHANNEL (SEE ATTACHED NC DWQ STREAM CLASSIFICATION FORM FOR STREAM 1).
? Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section II1.B. Provide rationale indicating that tributary flows
seasonally:

Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 153 linear feet 5-6 width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWss that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section II1.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non-wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section I11.B and rationale in Section 111.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
? Demonstrate that impoundment was created from "waters of the U.S.," or
? Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
? Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED ]INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):10
? which are or could be used by interstate or foreign travelers for recreational or other purposes.
? from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
Other factors. Explain:
'See Footnote N 3.
9 To complete the analysis refer to the key in Section 111.D.6 of the Instructional Guidebook.
70 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction FoAawing Rapanos.

Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
? Tributary waters: linear feet width (ft).
? Other non-wetland waters: acres.
Identify type(s) of waters:
? Wetlands: acres.
F. NON-JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
? If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
? Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
? Prior to the Jan 2001 Supreme Court decision in "SWANCC." the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
? Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
? Other: (explain, if not covered above):
Provide acreage estimates for non-jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds. presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
? Non-wetland waters (i.e., rivers, streams): linear feet width (ft).
? Lakes/ponds: acres.
? Other non-wetland waters: acres. List type of aquatic resource:
? Wetlands: acres.
Provide acreage estimates for non-jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
? Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
? Lakes/ponds: acres.
? Other non-wetland waters: acres. List type of aquatic resource:
? Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall 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 applicantJconsultant:S&ME, INC.
® Data sheets prepared/submitted by or on behalf of the applicant/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: 1993 DERITA 1:24,000 QUAD SHEET (FIGURE 2).
® USDA Natural Resources Conservation Service Soil Survey. Citation: USDA SSURGO DATASET FOR MECKLENBURG
COUNTY (FIGURE 4).
? 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: ® Aerial (Name & Date):2007 AERIAL PHOTOGRAPH (FIGURE 3).
or ® Other (Name & Date):SITE PHOTOGRAPHS (9-15-09).
? Previous determination(s). File no. and date of response letter:
? Applicable/supporting case law:
? Applicable/supporting scientific literature:
? Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD: SEE ATTACHED USACE STREAM QUALITY FORM AND DWQ STREAM
IDENTIFICATION FORM.
. I
APPENDIX VI
USACE Stream Quality Assessment Worksheet
DWQ Stream Identification Form
• ?iJSACOL Aid # DWQ # Site # (indicate on attached map)
STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
1. Applicant's name: Charlotte Stormwater Services 2. Evaluator's name: SBME (Joey Lawler)
3. Date of Evaluation: 9/15/2009 4. Time of Evaluation: 09:46:48am
5. Name of stream: 1 6. River basin: Lower Catawba
7. Approximate drainage area: 50 acres 8. Stream order: 1
9. Length of reach evaluated: 100 feet 10. County: Mecklenburg
11.Site coordinate(if known): prefer in decimal degrees 11. Subdivision name (if any): Hidden Valley
Latitude (ex. - 34.872312) 35.26566°N Longitude (ex. - 77.55661) 80.77593°W
Method location determined ? GPS ?Topo Sheet /Ortho (Aerial Photo/GIS) /Other GIS Other
13. Location of reach under evaluation (note the nearby roads and landmarks and attach a map identifying stream's location)
701 Dawn Circle, Charlotte, N.C. 28205. Urban stream.
14. Proposed channel work (if any): Culvert replacement
15. Recent weather conditions: dry
16. Site conditions at time of visit: dry
17.Identify any special waterway classification known: Section 10 Tidal Waters Essential Fisheries Habitat
Trout Waters _ Outstanding Resource Waters Nutrient Sensitive Waters Water Supply Watershed ([-IV)
18. Is there a pond or lake located upstream of the evaluation reach? YES If yes, estimate the water surface area: 1.36 acre
19. Does the channel appear on a USGS quad map? YES 20. Does channel appear on USDA Soil Survey: YES
50 % Residential 10 % Commercial 0 % Industrial 0 % Agricultural
21. Estimated watershed land use: 40 % Forested 0 % Cleared/Logged 0 % Other
22. Bankfull width: 5 23. Bankfull height (from bed to top of bank): 1
24. Channel slope down center of stream: Flat (0-2%) X Gentle (24%) Moderate (4-10%) Steep (>10%)
25. Channel sinuosity: Straight X Occasional bends Frequent meander Very sinuous Braided channel
Instruction for completion of worksheet (located on page 2):
Begin by determining the most appropriate ecoregion based on location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the
same ecoreg ion. Assign points to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics
identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If characteristic cannot be evaluated due to site or
weather conditions, enter 0 in the scoring box and provide an explanation in the comment section. Where there are obvious changes in the character of a stream under
review (e.g., the stream flows from the pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to
evaluate each reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the highest quality.
Total Score (from reverse): 38 Comments: RPW, Year-Round
Evaluators Signature:
Date: 9/15/2009
This channel evaluation form is intended to a used only as a guide to assist landowners and environmental professionals in gathering
the data required by the United States Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting
from the completion of this form is subject to USACE approval and does not imply a particular mitigation ratio or requirement.
Form subject to change - version 06/03. To comment, please call 919-876-8441 x 26
1
r . •
North Carolina Division of Water Quality - Stream Identification Form; Version 3.1
Date: 9/15/2009 Project Dawn Circle Sidewalk Project Latitude: 35.26566°N
Evaluator: S&ME (Joey Lawler) Site: 1 Longitude: 80.77593°W
Total Points
Stream is at least intermittent 35.5
it 2 19 or perennial if z 30 County: Mecklenburg Other

e. g. Quad Name:
A. Geomorphology (subtotal = 15.5) Absent Weak Moderate Strong
1a. Continuous bed and bank 3
2. Sinuosity 2
3. In-channel structure: riffle-pool sequence
Soil texture or stream substrate sorting 2
Active/relic oo p aln 1 --
Depositional bars or benches
- - - 2 - - -
Braided channel 0
8. Recent alluvial deposits
a. Natural levees _ i
10. emits 0
11. Grade controls
12. Natural valley or drainageway 1.5
13. Second or greater order on existing
USGS or NRCS map or other documented
evidence.
No = 0
a. man-made ditches are not rated: see discussions in manual
B. HArolow (Subtotal = 8.5 )
14. Groundwater flow/discharge 2
15. Water in channel and > 48 hours since rain or
Water in channel -- dry or growing season 3
16. Leaflitter 1
1
7. Sediment on plants or debris
0.5
18.
Organic debris lines or piles (Wrack lines)
0.5 _
1 Y. y ric soils re oxlmorp is features) present . Yes = 1.5
C. BioloQV (Subtotal = 11.5 )
20b. Fibrous roots in channel 2
21 b. Rooted plants in channel _ 3
22. Crayfish 1.5
23. Bivalves 0
24. Fish 0.5
25. Amphibians 1
26. Macrobenthos (note diversity and abundance) 1
27. Filamentous algae; periphyton 1 _-
28. Iron bacteria/fungus 1
29b. Wetland plants in streambed FAC = 0.5;
o. Items /u ana zi tocus on the presence or upland plants- Item 29 focuses on the presence of aquatic or wetland plants
Notes: (use back side of this form for additional notes) Sketch:
RPW,_Year-Round