20191744 Ver 1_2018-00874 NWP 3 Tearsheet_20200131

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2018-00874 County: Caswell U.S.G.S. Quad: NC -Ridgeville
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: NCDOT
Attn: Mike Mills, P.E.
Address: P O Box 14996
Greensboro, NC 27415
Size (acres) _2 Nearest Town Mebane
Nearest Waterway Lynch Creek River Basin Roanoke
USGS HUC 03010104 Coordinates 36.262431-79.223118
Location description: The site is located along SR 1771 Dave Smith Road) over Lynch Creek at NCDOT Bridge 19 in Caswell
County, North Carolina.
Description of projects area and activity: This verification authorizes the discharge of clean fill material associated with
replacing an existing bridge (Bridge 19 on SR 1771) in place. The project includes permanent impacts to 0.02 acre (0.01 acre
fill and 0.01 acre mechanized clearing) of riparian non-riverine wetlands. The project would also require hand clearing in an
additional 0.06 acre of riparian non-riverine wetlands.
Applicable Law(s): ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: NWP 3. Maintenance
SEE ATTACHED NW? GENERAL, REGIONAL, AND/OR SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the enclosed
Conditions, your application signed and dated 12/20/2019, and the enclosed plans Wetland and Surface Water Impacts Permit
Drawing Sheets 1 through 7. Any violation of the attached conditions or deviation from your submitted plans may subject the
permittee to a stop work order, a restoration order, a Class I administrative penalty, and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified, suspended
or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and/or modified, this
verification will remain valid until the expiration date identified below, provided it complies with all requirements of the modified
nationwide permit. If the nationwide permit authorization expires or is suspended, revoked, or is modified, such that the activity would
no longer comply with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are under construction)
or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the activity is completed
within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless discretionary authority has
been exercised on a case -by -case basis to modify, suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Resources (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA), prior
to beginning work you must contact the N.C. Division of Coastal Management.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal, State
or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory program,
please contact David E. Bailey at [phone] X 30or David.E.Bailey2(&usace.army.mil.
Date: 2020.01.3113:51:48
Corps Regulatory Official:-05'00' Date: 01/31/2020
Expiration Date of Verification: 03/18/2022

SAW-2018-00874
SPECIAL CONDITIONS
1. This USACE permit does not authorize you to take a threatened or endangered species, in
particular, the Northern Long-eared Bat (NLEB) (Myods septentrionalis). In order to legally take
a listed species, you must have separate authorization under the Endangered Species Act (ESA)
(e.g., a Biological Opinion (BO) under the ESA, Section 7, with "incidental take" provisions with
which you must comply). The U.S. Fish and Wildlife Service's (USFWS's) Programmatic BO
titled "Northern Long-eared Bat (NLEB) Programmatic Biological Opinion for North Carolina
Department of Transportation (NCDOT) Activities in Eastern North Carolina (Divisions 1-8),"
dated March 25, 2015, and adopted on May 4, 2015, contains mandatory terms and conditions to
implement the reasonable and prudent measures that are associated with "incidental take" that
are specified in the BO. Your authorization under this USACE permit is conditioned upon your
compliance with all the mandatory terms and conditions (incorporated by reference into this
permit) associated with incidental take of the BO. Failure to comply with the terms and conditions
associated with incidental take of the BO, where a take of the listed species occurs, would
constitute an unauthorized take, and would also constitute non-compliance with your USACE
permit. The USFWS is the appropriate authority to determine compliance with the terms and
conditions of its BO and with the ESA.
Date:
2020.01.31
Corps Regulatory Official: 13:51:27-05'00' Date: 1/31/2020
Expiration Date of Verification: 3/18/2022
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we continue to do so,
please complete the Customer Satisfaction Survey located at http://corpsmapu.usace.army.mil/cm_apex/Pp=136:4:0.
Copy furnished:
April Norton, NCDEQ-DWR, 1617 Mail Service Center, Raleigh, NC 27699
Nicole J. Thomson, PWS, Division Environmental Supervisor Assistant, NCDOT, PO Box 14996 Greensboro, NC 27415-4996

E li�;tlwy North Carolina Department of Transportation
Storill'Yva#er Highway Stormwater Program*
STORMWATER MANAGEMENT PLAN
(Version 2.08; Released April 2018) FOR NCDOT PROJECTS
WBS Element: 17BP.7.R.110 TIP No.: SF-160019 County(ies): Caswell Page 1 of 1
General Project Information
WBS Element:
17BP.7.R.110
ITIP Number: SF-160019
Project Type: Bridge Replacement
Date: 7/10/2018
NCDOT Contact:
Galen Cail, PE
Contractor / Designer:
Kyle Stoffer
Address:
NCDOT Hydraulics Unit
Address:
HDR Engineering, Inc. of the Carolinas
1590 Mail Services Unit
555 Fayetteville Street, Suite 900
Raleigh, NC 27560
Raleigh, NC 27601
Phone:
[phone]
Phone:
[phone]
Email:
[e-mail]
Email:
I [e-mail]
City/Town:
Prospect Hill
County(ies):
Caswell
River Basin(s):
Roanoke
CAMA County?
No
Wetlands within Project Limits?
Yes
Project Description
Project Length (lin. miles or feet):
0.104 miles Surrounding Land Use: Low Residential, Wooded
Proposed Project
Existing Site
Project Built -Upon Area (ac.)
0.4 ac.
0.3 ac.
Typical Cross Section Description:
Dave Smith Road (SR 1771): 2 paved lanes (total 20' wide), 4' shoulder on each side (7'
Dave Smith Road (SR 1771): 2 paved lanes (total 20' wide), 2' shoulder on each side.
with guardrail).
Annual Avg Daily Traffic (veh/hr/day):
Design/Future: 520 Year: 2025
Existing: 260 Year: 2009
General Project Narrative:
The North Carolina Department of Transportation (NCDOT) has proposed to replace Caswell County Bridge #19 on Dave Smith Road (SR 1771) over Lynch Creek. The
(Description of Minimization of Water
existing structure is a three span bridge (1 @30'4, 1 @30'0, 1 @30'4) and timber deck on I -Beams. The end and interior bents are steel caps and piles. The proposed structure
Quality Impacts)
is a single span (1 @100'), 39" box beam with 4' deep caps. This structure has been designed to have as little environmental, wetland, and surface water impacts as possible.
2:1 roadway fill slope will be used in the wetland areas to minimize wetland impacts. Permanent drainage easement (PDE) will be set to have as little wetland impacts as
possible.
Deck drains are required for the proposed bridge. There is no direct discharge of bridge storm water into the receiving water. The deck drains discharge into the Class II Rip
Rap sloping abutments. Storm water impacts to the stream have been minimized by utilizing grated inlets and pipes to collect bridge storm water and use rip rap outlet
protection at 14+70 RT to dissipate energy to provide a diffuse flow (non -erosive sheet flow) in a wooded area. This diffused flow will run for a distance of 16'+/- before
entering the wetland. In the northwest quadrant an existing roadside ditch outlets at 13+38 LT with Class B Rip Rap outlet protection and becomes non -erosive sheet flow
126'+/- before entering the wetland. In the northeast quadrant an existing roadside ditch outlets at 18+52 LT and becomes non -erosive sheet flow 112'+/- before entering the
wetland. In the southeast quadrant an existing roadside ditch outlets at 17+30 RT and becomes non -erosive sheet flow 32'+/- before entering the wetland. In the southwest
quadrant an existing roadside ditch outlets at 14+43 RT and becomes non -erosive sheet flow 75'+/- before entering the stream. Due to the nature of low impact bridge
replacement, the increases in stormwater discharges (post vs pre condition) are insignificant and the existing ditches do not need to be modified. Therefore, additional
stormwater measures are not required.
Waterbody Information
Surface Water Body (1): Lynch Creek
NCDWR Stream Index No.:
22-58-1-2
NCDWR Surface Water Classification for Water Body
Primary Classification:
Class C
Supplemental Classification:
None
Other Stream Classification:
None
Impairments:
None
Aquatic T&E Species?
No Comments:
NRTR Stream ID:
Buffer Rules in Effect: N/A
Project Includes Bridge Spanning Water Body?
Yes
Deck Drains Discharge Over Buffer?
N/A Dissipator Pads Provided in Buffer?
N/A
Deck Drains Discharge Over Water Body?
INo
(If yes, provide justification in the General Project Narrative) (If yes, describe in the General Project Narrative; if no, justify in the
General Project Narrative)
(If yes, provide justification in the General Project Narrative)

69
aLl
1771
1767
17BP.7.R.110
68
PROJECT
°
1771LIMITS
100
1773
— — — —
CASWELL COUNTY
— — — —
1004
— — — -r—-----------
O{ANGE COUNTY
---
\
1369 ,\
1367
"J
1366
/ 1368
1368
1361
I
—
1422
/
1004
1371
13 1
VICINITY MAP
(NOT TO SCALE)
OFF -SITE DETOUR
TO SR 1004
(CORBETT RIDGE ROAD)
DESIGN DATA
ADT 2009 = 260
ADT 2025 = 520
V = 55 MPH
SUB REGIONAL TIER
LOCAL
STATE OF NORTH CAROLINA
DIVISION OF HIGHWAYS
CASWELL COUNTY
LOCATION: BRIDGE NO. 19 OVER LYNCH CREEK ON SR 1771 (DAVE SMITH ROAD)
TYPE OF WORK: GRADING, PAVING, DRAINAGE AND STRUCTURE
WETLAND AND SURFACE WATER IMPACTS PERMIT
-G/ PROJECT 17BP.7RJ/0 --LV Sta.15+12.70 ��� ��
- POT Sta.13+00.00 /� END BRIDGE
1
I* �
y /
-L-
-----------------------------
----------------
-----------
*1 SR (DAVE SMITH ROAD)
-L- POT Sta.
BEGIN APPROACH
-L- Sta. 15+02DO / * `1 i * N6,VPROACH SLAB
* Sta.16+26.00
PROJECT LENGTH
LENGTH ROADWAY TIP PROJECT = 0.085 MILES
LENGTH STRUCTURE TIP PROJECT = 0.019 MILES
TOTAL LENGTH TIP PROJECT = 0.104 MILES
Prepared In the Office of Mott MacDonald for
DIVISION 7
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2018 STANDARD SPECIFICATIONS
TIMRDJORDAN, PE
LETTING DATE:
DAVID FUH PE
HYDRAULICS ENGINEER
NCDOT CONTACT. • TIM POWERS, PE
DIVISION BRIDGE
PROGRAM MANAGER
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Faq-y-Vari-, NC 27526
t9191512-2253
MOTT 1919) 552-2254 (Fax)
MACDONALD www.mottmac.com/americas
LICENSE NO. F-0669
1 HDR Engineering, Inc. O the Carolinas
�� ♦ 555 Fayetteville St, Suite 900 Raleigh, N.C. 27601
N.C.B.E.L.S. License Number: F-0116

PROJECTRUERIENU SHEET NO.
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ROADWAY DESIGN HYDRAULICS
ENGINEER ENGINEER
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NO. F-0669 LICENSE N. F-0116
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UNLESS ALL SIGNATURES COMPLETED
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DENOTES MECHANIZED
CLEARING
DENOTES HAND
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PROJECTRUERENU SHEET NO.
176P.7.R.110 - CASWELL 19 4.
ROADWAY DESIGN HYDRAULICS
ENGINEER ENGINEER
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PROJECT REFERENCE SHEET NO.
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PRELIMINARY PLAN$
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WETLAND PERMIT IMPACT SUMMARY
WETLAND IMPACTS SURFACE WATER IMPACTS
Site
No.
Station
(From/To)
Structure
Size / Type
Permanent
Fill In
Wetlands
(ac)
Temp.
Fill In
Wetlands
(ac)
Excavation
in
Wetlands
(ac)
Mechanized
Clearing
in Wetlands
(ac)
Hand
Clearing
in
Wetlands
(ac)
Permanent
SW
impacts
(ac)
Temp.
SW
impacts
(ac)
Existing
Channel
Impacts
Permanent
(ft)
Existing
Channel
Impacts
Temp.
(ft)
Natural
Stream
Design
(ft)
1
-L- 15+14 to 16+14
SINGLE SPAN 39" BOX BEAK/
0.01
0.01
0.06
TOTALS*:
1 0.01
1
1
0.01
F 0.06
*Rounded totals are sum of actual impacts
NOTES:
September 2014

Action ID Number: SAW-2018-00874
Permittee: NCDOT, Attn: Mike Mills, P.E.
County: Caswell
Project Name: SAW-2018-00874 (NCDOT Div. 7 Bridge 19 / SR 1771 / Lynch Creek / David Smith Road
/ Caswell County
Date Verification Issued: 01/31/2020
Project Manager: David E. Bailey
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn: David E. Bailey
Raleigh Regulatory Office
U.S Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
or
[e-mail]
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee
Date

Determination of Jurisdiction:
A. ® There are waters, including wetlands on the above described project area that may be subject to Section 404 of the
Clean Water Act (CWA) (33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). This
preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
(Reference 33 CFR Part 331). However, you may request an approved JD, which is an appealable action, by contacting
the Corps district for further instruction. Please note, if work is authorized by either a general or nationwide permit, and
you wish to request an appeal of an approved JD, the appeal must be received by the Corps and the appeal process
concluded prior to the commencement of any work in waters of the United States and prior to any work that could alter
the hydrology of waters of the United States.
B. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements of
Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403) and Section 404 of the Clean Water Act (CWA) (33 USC §
1344). Unless there is a change in the law or our published regulations, this determination may be relied upon for a period not to
exceed five years from the date of this notification.
C. ❑ There are waters, including wetlands within the above described project area that are subject to the permit requirements of
Section 404 of the Clean Water Act (CWA) (33 USC § 1344). Unless there is a change in the law or our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
D. ❑ The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued DATE. Action ID: FILE NUMBER.
Basis For Determination: See the preliminary jurisdictional determination form dated 01/31/2020.
Remarks: None.
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdiction determinations as indicated in B and C
above).
This correspondence constitutes an approved jurisdiction determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Phillip Shannin, Review Officer
60 Forsyth Street SW, Room 10M15
Atlanta, Georgia 30303-8801
Phone: [phone]
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by Not applicable.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
Date:2020.01.31
Corps Regulatory Official:
13:50:30-05'00'
David E. Bailey
Date of JD: 01/31/2020 Expiration Date of JD: Not applicable

SAW-2018-00874
NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: NCDOT (Attn: Mike Mills, P.E.) File Number: SAW-2018-00874 Date: 01/31/2020
Attached
is:
See Section below
PROFFERED PERMIT Standard Permit or Letter of ermission
A
RED PERMIT Standard Permit or Letter of ermission
B
DENIAL
LAPPROVED
C
JURISDICTIONAL DETERMINATION
D
INARY JURISDICTIONAL DETERMINATION
E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or http://www.usace.q=.mil/Missions/CivilWorks/Re ugulatoryProgramandPermits.aspx
or the Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.

SAW-2018-00874
SECTION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division
Mr. Phillip Shannin, Administrative Appeal Review Officer
Attn: David E. Bailey
CESAD-PDO
Raleigh Regulatory Office
U.S. Army Corps of Engineers, South Atlantic Division
U.S Army Corps of Engineers
60 Forsyth Street, Room 10M15
3331 Heritage Trade Drive, Suite 105
Atlanta, Georgia 30303-8801
Wake Forest, North Carolina 27587
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investigation, and will have the opportuni to participate in all site investi ations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: David E. Bailey, 69 Darlington Avenue, Wilmington, North Carolina
28403
For Permit denials, Proffered Permits and Approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Phillip Shannin, Administrative
Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]