20200520 Ver 1_PCN Form Submission_20200416

DWR
mrlslon of Water Resources
Pre -Construction Notification (PCN) Form
April 11, 2020 Ver 3.1
Initial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned * Version#*
20200520 1
Is a payment required for this project?*
r No payment required What amout is owed?*
r Fee received r $240.00
r Fee needed - send electronic notification IT $570.00
Reviewing Office *
Winston-Salem Regional Office - (336) 776- Select Project Reviewer*
9800 Stephanie Goss:eads\szgoss
Information for Initial Review
1a. Name of project:
Madison Fish Habitat Restoration Poject
1a. Who is the Primary Contact?*
Kris Bass
1b. Primary Contact Email:*
[e-mail]
Date Submitted
4/16/2020
Nearest Body of Water
Dan
Basin
Roanoke
Water Classification
WS-IV;CA
Site Coordinates
Latitude: Longitude:
36.3751-79.9936
A. Processing Information
County (or Counties) where the project is located:
Rockingham
Is this a NCDMS Project
r Yes IT No
Is this project a public transportation project?*
r Yes IT No
1a. Type(s) of approval sought from the Corps:
W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1c. Primary Contact Phone:*
[phone]
1b. What type(s) of permit(s) do you wish to seek authorization?

W Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
W Non-404 Jurisdictional General Permit
r Individual Permit
27 - Restoration
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
F- 401 Water Quality Certification - E)press
r Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
r Owner W Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Pine Hall Brick Co. Inc.
2b. Deed book and page no.:
1028,1560
2c. Responsible party:
2d.Address
Street Address
613 Lindsey Bridge Rd and 0 Teague Rd
Address Line 2
city
Madison
Postal / Zip Code
27025
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
Town of Madison
State / Rwince / Ifgion
NC
Country
Rockingham
2f. Fax Number:
r Yes r No
r Yes r No

2b. Deed book and page no.:
808,2006
2c. Responsible party:
2d.Address
Street Address
120 N. Market St
Address Line 2
aty
Madison
Postal / Zip Code
27025
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Kris Bass
3b. Business Name:
Kris bass Engineering
3c.Address
Street Address
7334 Chapel Hill Rd
Address Line 2
City
Raleigh
Postal / Zip Code
27607
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
State / Province / Region
NC
Country
Rockingham
2f. Fax Number:
State / Rovince / Region
NC
Country
Wake
3e. Fax Number:
4a. Name:
Kris Bass
4b. Business Name:
Iris Bass Engineering
4c.Address
Street Address
7334 Chapel Hill Rd
Address Line 2
City
State / Province / Region
Raleigh
NC
Postal / Zip (ode
Country
27607
Wake
4d. Telephone Number: 4e. Fax Number:
[phone]
0. Email Address:*
[e-mail]
Agent Authorization Letter*
Scan200320083408 (1).pdf
Scanned from a Xerox Multifunction Printer.pdf
F"Project Information and Prior Project History
1. Project Information
257.19KB
21.9KB

1b. Subdivision name:
(d appropriate)
1c. Nearest municipality/ town:
Madison
2. Project Identification
2a. Property Identification Number:
790500347242,790500664907,
790500766703,790500765810
2c. Project Address
Street Address
Address Line 2
City
Postal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Dan
3b. Water Resources Classification of nearest receiving water:*
WS-IV;CA
3c. What river basin(s) is your project located in?*
Roanoke
3d. Please provide the 12-digit HUC in which the project is located.
030101030306
4. Project Description and History
2b. Property size:
6.6 acres (Phase 1 area: 1.0ac, Phase 2 area
5.6ac)
State / Rovince / Region
Country
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
3a. Describe the epsting conditions on the site and the general land use in the vicinity of the project at the time of this application:
The Lindsey Bridge Dam (LBD) was constructed in 1972; it is a low head, appropmately T, curvilinear sheet pile dam that is in disrepair and is a safety hazard to people and
recreational users on the Dan River. The dam is also a barrier to fish passage. The dam and impoundment are the primary water supply for the Town of Madison. The adjacent areas
surrounding the dam include farmland to the south and the industrial brick manufacturer, Pine Hall Brick to the north. An active freight railroad traverses the Pine Hall Brick property
bordering the project area. Just downstream of the LBD significant streambank erosion and washout occurs at high flows. The streambanks are bare, unstable, and over -steepened.
Upstream of the dam, within the impoundment area, the river bed substrate is homogeneous with few riffle features. The Upper Dan River contains substantial intact suitable habitat for
the Roanoke Logperch; however, at this time the fish are unable to pass the LBD.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
t^ Yes r No r Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
MFH_USGS Topo quad.pdf
589.79KB
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
MFH-Soils Map.pdf 823.53KB
4f. List the total estimated acreage of all existing wetlands on the property:
20.6
4g. List the total estimated linear feet of all existing streams on the property:
15,919
4h. Explain the purpose of the proposed project:*
The purpose of this project is to provide a passage for an endangered species and improve aquatic habitat along this reach of river. The completed project will also provide multiple
benefits for other aquatic species and improve stability of river banks.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
This project is a collaboration between the Piedmont Conservation Council, U.S. Fish and Wildlife Service, North Carolina Wildlife Resources Commission, and the Town of Madison.
The project seeks to be constructed in two phases.
Phase 1, will take place upstream of the dam, within the dam's impoundment, 3 constructed riffles are proposed. The constructed riffles will improve habitat for the endangered Roanoke
Logperch and increase the likelihood of safe passage through the impoundment to suitable habitat in the Upper Dan River. This phase is 1.0 Ac and will be constructed by offloading
stone along the stream bank and using a track excavator to place stone directly in the river and construct the proposed riffle. See Madison Fish Habitat Restoration Project - Phase 1
construction documents.
Phase 2, at the Lindsey Bridge Dam and appropmately 90OLF downstream, includes the fish passage structure which will create a pathway for the endangered Roanoke Logperch to
travel upstream of the existing Lindsey Bridge Dam on the Dan River. Seven boulder and stone weirs will be constructed in the Dan River to create the fish passage features. These
nature -like structures will improve hydraulics in the area and enable the movement offish species upstream. Structures will be constructed using boulders transported from an off -site
quarry and temporarily stockpiled in designated upland areas before being assembled in the river. This phase is 5.6 Ac and will be constructed using track excavators, bull dozers, and
off -road trucks to stockpile, stage, and construct these features. See Madison Fish Habitat Restoration Project- Phase 2 construction documents.
4j. Please upload project drawings for the proposed project.
Madison-NWP-Permit-Set-04092020.pdf 23.15MB
000-MFH-P1-PLAN SET.pdf 41.79MB

5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No r Unknown
Comments:
A PJD has been compiled by the agent and all pertaining information considered is included in the
application
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Kris Bass
Agency/Consultant Company: Kris Bass Engineering
Other:
5d1. Jurisdictional determination upload
MFH_PJD _200413.pdf
MFH_PJD-fillable-form2016-11 _signed.pdf
6. Future Project Plans
6a. Is this a phased project?*
r Yes C No
18.39MB
761.94KB
7b. If yes, explain.
This is a 2 Phase project that is complimentary of each other; however, the upper portion could stand alone providing functional uplift to a suite of aquatic species in the area. Phase 1
will take approximately 3-5 weeks. Phase 2 will take approximately 3-5 months. We understand the more complex permitting track of phase 2 and would like to seek the permits for both
phases on parallel tracks.
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands W Streams -tributaries F Buffers
W Open Waters r Pond Construction
2. Wetland Impacts
P1
2a1 Reason (?)
Temporary Construction
Access
2b. Impact type * (?)
T
2c. Type of W.*
Bottomland Hardwood Forest
2d. W. name *
Unnamed
2e. Forested*
Yes
2f. Type of
Jurisdicition*(?)
Both
2g. Impact
area*
0.040
(acres)
=�,nk
StabiliTation &
am Restoration
P
Bottomland Hardwood Forest
Unnamed
Yes
Both
0.060
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.040 0.060
2g. Total Wetland Impact
0.100
2h. Comments:
This preliminary jurisdictional determination (PJD) was completed through a desktop GIS analysis, utilizing all available forms of data to determine the
potential extent of existing wetlands within the site vicinity. Through a PJD, all features that may be wetlands are assumed to be wetlands for
jurisdictional purposes. Future field delineation of wetland areas may reveal some portions assumed to be wetlands based on NWI data do not exhibit
appropriate soils, vegetation, or hydrology to be considered jurisdictional wetlands or alternatively areas not assumed to be wetlands do exhibit
wetland characteristics. At the time these data become available, an amendment to the wetland impacts may be requested along with the submission
of wetland delineation data sheets.
3. Stream Impacts

3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name*
3e. Stream Type *
3f. Type of
3g. S. width *
3h. Impact
(?)
Jurisdiction*
length*
S1
Placement of stone on river
Permanent
Fill
Dan River
Perennial
Both
150
41
bottom; Weir 1
Average (feet)
(linearfeet)
S2
Placement of stone on river
Permanent
Fill
Dan River
Perennial
Both
150
39
bottom; Weir
Average (feet)
(linearfeet)
S3
Placement of stone on river
Permanent
Fill
Dan River
Perennial
Both
150
34
bottom, Weir
Average (feet)
(lir�rfeet)
S4
Placement of stone on river
Permanent
Fill
Dan River
Perennial
Both
150
27
bottom; Weir
Average (feet)
(linearfeet)
S5
Placement of stone on river
Permanent
Fill
Dan River
Perennial
Both
150
29
bottom; Weir 5
Average (feet)
(lirearfeet)
�]E
ent of stone on river
Permanent
Fill
Dan River
Perennial
Both
Weir
Average (feet)
(lirrfeet)
S7
Placement of stone on river
Permanent
Fill
Dan River
Perennial
Both
150
24
bottom; Weir?
Average (feet)
(lir�rfeel)
31. Total jurisdictional ditch impact in square feet:
3i. Total permanent stream impacts:
221
3i. Total stream and ditch impacts:
221
3i. Total temporary stream impacts:
3j. Comments:
These impacts are associated with Phase 2. The project takes place over 90OLF of stream corridor; however, the areas of permeant fill, where the
rock and weir structures will be built account for 221 LF. Each of the 7 weirs is specified above as a stream impact above with its corresponding LF of
impact. The Areas of Impact per weir are as follows: Weir 1 = 0.2AC; Weir 2 = 0.2AC; Weir 3 = 0.1AC; Weir 4 = 0.1AC; Weir 5 = 0.1AC; Weir 6 =
0.1AC; Weir 7 = 0.1AC. The total area of permanent stream fill, where the 7 rock weirs will be constructed is MAC.
4. Open Water Impacts
4a. Site #
4a1. Impact Reason
4b. Impact type _114c.
Name of waterbody
4d. Activity type :114e.
Waterbody type
4f. Impact area
01
Placement of stone on
P
Dan River
Fill
Lake
0.12
bottom of impoundment
water
02
Placement of stone on
P
Dan River
Fill
Lake
0.12
bottom of impoundment
water
Placement of stone on
P
Dan River
Fill
Lake
E:1
bottom of impoundment
r:1-
water
4g. Total temporary open water Impacts: 4g. Total permanent open water impacts:
0.00 0.36
4g. Total open water impacts:
0.36
4h. Comments:
These impacts are associated with Phase 1 and are representative of the 3 constructed riffle habitat improvement areas. The areas will be temporarily
disturbed as machines place stone on the bottom of the dam impoundment to build the riffles.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The goal of this project is to improve aquatic habitats for endangered species and provide for safer recreational use. Extensive hydraulic modeling
was conducted to design instream structures that make biological sense for the Roanoke Logperch. The velocities produced will be suitable for
logperch passage while minimizing material use and surface impacts within the channel. Design consideration was made to limit unnecessary impacts
in the upland areas associated with stockpiles, staging, and material handling; however, due to the project goals impacts to the stream are necessary
to achieve functional uplift in this area. Additionally, to stabilize eroding river banks and reduce future sediment export bank sloping and reconstruction
is required in several areas. This will result in minimal impacts to adjacent wetland areas where no alternative was available. In the long term, these
efforts will result in more stable and healthy riparian areas.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Where possible pumps and diversion will be used to work in the dry. Furthermore, construction will occur during the annual lowwater months. Efforts
will be made to work when weather is favorable and to stabilize and limit work onsite and in -channel if inclement weather is forecast or expected.

2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Wetland impacts are perceived to be minimal at 0.1 Ac and will provide much greater benefits in functional uplift for the aquatic and riparian environments.
F. Stormwater Management and Diffuse Flow Plan (required by DWR) u
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes r No
If no, explain why:
There are not buffer rules on this area of the Roanoke River and no impervious surfaces are proposed
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15ANCAC 02H .1003(2)?
r Yes r No
Comments:
No impervious surfaces are proposed
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
r Yes r No
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 (North Carolina)
Environmental Policy Act (NEPA/SEPA)?*
r Yes
r No
1c. If you answered "yes" to the above, has the document review been finalized bythe State Clearing House?*
r Yes r No
NEPAor SEPA Final Approval Letter
3-2185 NEPA Yellow Brick Road.signed.pdf
2. Violations (DWR Requirement)
199.1 KB
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
This project is restoration within the proposed project area. No additional work is proposed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r NIA
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No

5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
r Yes r No
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?'
r Yes r No
r Unknown
51. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Emily Wells, USFWS; Thomas Russ, NC Wildlife Resources Commission
Consultation Documentation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA Essential Fish Habitat Mapper, NOAA Habitat Conservation website
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 status?*
r Yes
r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NC State Historic Preservation Office; See attached explanatory document
7c. Historic or Prehistoric Information Upload
ER_20-0591.pdf
ER_20-0592.pdf
MadisonFishHabitatRestorationPhase2_NCSHPOReview. pdf
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?*
r Yes r No
8b. If yes, explain how project meets FEMA requirements:
Detailed flood study has been conducted and a No Rise Certification has been submitted
8c. What source(s) did you use to make the floodplain determination?*
FRIS Map
Miscellaneous
Comments
96.27KB
96.27KB
8.69MB
Miscellaneous attachments not previously requested.
MFH_PJD_200413.pdf 18.39MB
MFH_FIRM Panel.pdf 2.17MB
MFH_PJD-fillable-form2016-11_signed.pdf 761.94KB
Signature u
*
W By checking the box and signing below, I certify that:
I have given true, accurate, and complete information on this form;
. I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");

• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Simon Gregg
Signature
Date
4/16/2020

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID: 790500664907, 790500347242
STREET ADDRESS: 613 Lindsey Bridge Rd and 0 Teague Rd
Madison, NC 27025
Please print: Property Owner: Pine Hall Brick Cc Inc
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Kristopher Bass of
(Contractor / Agent)
Kris Bass Engineering
(Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Telephone: 334- 3t2
336-5y�-Goo? e t<
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Author#dignature
Date: 31 / 4 �42. 0
r
Authorized Signature
Date:

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO.
PLAN NO.
PARCEL ID: 790500766703
STREET ADDRESS: 640 Lindsey Bridge Rd, Madison, NC 27025
Please print: Town of Madison
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Kristopher Bass of Kris Bass Engineering
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
120 N Market St, Madison NC 27025
Telephone:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Signature Authorized Signature
Date: 3- a `1— A u a Date:

Topography Map
G/B
Phase 1
Airport
o
�O 4�
v-
V
Legend 0 500 1000 1500 2000ft
Q Project Area
USGS 7.5-minute Quadrangle
Mayodan, Ellisboro, Ayersville and Belews Lake Quadrangles
Kris Bass Engineering Madison Fish Habitat Restoration Project
www.kbeng.org KRIS BASS
919.960.1552 Rockingham County, NC E N G I N E E R I N G

Hydric Soils
Kris Bass Engineering Madison Fish Habitat Restoration Project
www.kbeng.org KRIS BASS
919.960.1552 Rockingham County, NC E N G I N E E R I N G

Appendix 2 - PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: 4/10/2020
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: Kris Bass, 7334 Chapel Hill Rd. Raleigh, NC 27606
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: Wilmington
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT SITES)
State: NC County/parish/borough: Rockingham City: Madison
Center coordinates of site (lat/long in degree decimal format):
Lat.: 36.3751 Long.:-79.9936
Universal Transverse Mercator:
Name of nearest waterbody: Dan River
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑■ Office (Desk) Determination. Date: 4/10/2020
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES IN REVIEW AREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Site
number
Latitude
(decimal
degrees)
Longitude
(decimal
degrees)
Estimated amount
of aquatic resource
in review area
(acreage and linear
feet, if applicable)
Type of aquatic
resource (i.e., wetland
vs. non -wetland
waters)
Geographic authority
to which the aquatic
resource "may be"
subject (i.e., Section
404 or Section 10/404)
1
36.3751
-79.9936
20.6Ac
wetland
Section 404
1
36.3751
-79.9936
15,919 LF
non -wetland
Section 404

1) The Corps of Engineers believes that there may be jurisdictional aquatic resources in
the review area, and the requestor of this PJD is hereby advised of his or her option
to request and obtain an approved JD (AJD) for that review area based on an
informed decision after having discussed the various types of JDs and their
characteristics and circumstances when they may be appropriate.
2) In any circumstance where a permit applicant obtains an individual permit, or a
Nationwide General Permit (NWP) or other general permit verification requiring "pre -
construction notification" (PCN), or requests verification for a non -reporting NWP or
other general permit, and the permit applicant has not requested an AJD for the
activity, the permit applicant is hereby made aware that: (1) the permit applicant has
elected to seek a permit authorization based on a PJD, which does not make an
official determination of jurisdictional aquatic resources; (2) the applicant has the
option to request an AJD before accepting the terms and conditions of the permit
authorization, and that basing a permit authorization on an AJD could possibly result
in less compensatory mitigation being required or different special conditions; (3) the
applicant has the right to request an individual permit rather than accepting the terms
and conditions of the NWP or other general permit authorization; (4) the applicant can
accept a permit authorization and thereby agree to comply with all the terms and
conditions of that permit, including whatever mitigation requirements the Corps has
determined to be necessary; (5) undertaking any activity in reliance upon the subject
permit authorization without requesting an AJD constitutes the applicant's acceptance
of the use of the PJD; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps permit
authorization based on a PJD constitutes agreement that all aquatic resources in the
review area affected in any way by that activity will be treated as jurisdictional, and
waives any challenge to such jurisdiction in any administrative or judicial compliance
or enforcement action, or in any administrative appeal or in any Federal court; and (7)
whether the applicant elects to use either an AJD or a PJD, the JD will be processed
as soon as practicable. Further, an AJD, a proffered individual permit (and all terms
and conditions contained therein), or individual permit denial can be administratively
appealed pursuant to 33 C.F.R. Part 331. If, during an administrative appeal, it
becomes appropriate to make an official determination whether geographic
jurisdiction exists over aquatic resources in the review area, or to provide an official
delineation of jurisdictional aquatic resources in the review area, the Corps will
provide an AJD to accomplish that result, as soon as is practicable. This PJD finds
that there "may be"waters of the U.S. and/or that there "may be" navigable waters of
the U.S. on the subject review area, and identifies all aquatic features in the review
area that could be affected by the proposed activity, based on the following
information:

SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources
below where indicated for all checked items:
❑ Maps, plans, plots or plat submitted by or on behalf of the PJD requestor:
Map:
❑ Data sheets prepared/submitted by or on behalf of the PJD requestor.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report. Rationale:
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑■ U.S. Geological Survey Hydrologic Atlas:
❑m USGS NHD data.
❑ USGS 8 and112 digit HUC maps.
U.J. Geological Survey map(s). Cite Scale p quad name: 7.5-min, Mayodan, Ellisboro, Ayersville, and Belews Lake Quad
❑■ Natural Resources Conservation Service Soil Survey. Citation: USGS Web Soil Survey
❑■ National wetlands inventory map(s). Cite name: USFWS National Wetland Inventory
❑ State/local wetland inventory map(s):
❑■ FEMA/FIRM maps: FEMA Firm Map Panel 7905
❑■ 100-year Floodplain Elevation is: 583.8-582.2feet Datum NAV88 .(National Geodetic Vertical Datum of 1929)
❑■ Photographs: ❑■ Aerial (Name & Date): 2018, 2014, 2010
or ❑ Other (Name & Date):
❑ Previous determination (s). File no. and date of response letter:
❑■ Other information (please specify): LIDAR
IMPORTANT NOTE: The information recorded on this form has not necessarily
been verified by the Corps and should not be relied upon for later jurisdictional
determinations.
Signature and date of
Regulatory staff member
completing PJD
Signature and date of
person requesting PJD
(REQUIRED, unless obtaining
the signature is impracticable)'
1 Districts may establish timeframes for requestor to return signed PJD forms. If the requestor does not respond
within the established time frame, the district may presume concurrence and no additional follow up is
necessary prior to finalizing an action.

FLOOD HAZARD INFORMATION NOTES TO USERS SCALE
SEE HE REPORT FORZONE DESCRIPTIONS AND INDUMAP
THE INFORMATION DEPICTED ON THIS MAP AND SUPPORTING
DOCUMENTATION ARE ALSO AVAILABLE IN DIGITAL FORMAT AT
HTTP://FRIS.NC.GOV/FRIS
-Without Base Rood Elevation (BFE)
Wit, BFE cr Depth zone AE. Ao. AK v An
HAZAPOAREAS
SPECIAL FLOOD — Regulatory Roodway
0.2%Annual Chance Field Hazard Areas
of 1%Annual Chance Flood with Average
Depth Less Than One Foot or With Drainage
Areas of Less Than One Square Mlle —A
— FUWre Conditions 1%Annual
Chance Flood Hazard — x
OTHER AREAS OF —Area with Reduced Flood Risk due to Levee
ROOD HAZARD See Notes Zonex
DTHER — Areas Determin.d.b.O.daid.th.
AREAS 0.2% Annual Chance Floodplaln—o
Channel, Culvert, or Storm Sewer
Accredited or Provisional' Accredhed
GENERAL Levee, Gike,ar Floodwall
STRUCTURES ............. Non- nedhed Levee, Dike, or Flaodwall
ems North Canalna Galahad, Survey bench mark
ems ® NaUonal Geodetic Surveybench mrk a
sc® Contractor Est. NCFMP Survey bench mark
o�i -tier— Cross Sections With 1%Annual Chance
Water Surface Elevation (BFE)
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- ProRle Baseline
Hyda graphic Feature
OTHER Unnitof Study
FEATURES -- e_.._.__.
Umhof Moderate Wave Act..0JMWA)
C— BARRIER RESOURCES EM s(CBRS) NOTE
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. Us
®pCBRSAIea ss1e11M1Se � tlOWernel ¢Protected Area
I inch = 500 feet
0 250 500 1,000
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0 75 150 300
PANEL LOCATOR
NORTH CAROLINA FLOODPLAIN MAPPING PROGRAM
NATIONAL FLOOD INSURANCE PROGRAM
Ca FLOOD INSURANCE RATE MAP
c NORTH CAROLINA 1�J
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07/03/07

NEPA COMPLIANCE CHECKLIST

State: Federal Financial Assistance Grant/Agreement/Amendment Number:
Grant/Project Name:

This proposal  is;  is not completely covered by categorical exclusion _____ in 516 DM 2, Appendix _____; and/or 516 DM 6,
Appendix _____.
(check ( 7 ) one) (Review proposed activities. An appropriate categorical exclusion must be identified before completing the remainder of
the Checklist. If a categorical exclusion cannot be identified, or the proposal cannot meet the qualifying criteria in
the categorical exclusion, or an extraordinary circumstance applies (see below), an EA must be prepared.)
Extraordinary Circumstances:
Will This Proposal (check ( 7 ) yes or no for each item below): Yes No
  1. Have significant adverse effects on public health or safety.   2. Have significant adverse effects on such natural resources and unique geographic characteristics as historic or cultural resources; park, recreation or refuge lands; wilderness areas; wild or scenic rivers; national natural landmarks; sole or principal drinking water aquifers; prime farmlands; wetlands (Executive Order 11990); floodplains (Executive Order
11988); national monuments; migratory birds (Executive Order 13186); and other ecologically significant or critical areas under Federal ownership or jurisdiction.   3. Have highly controversial environmental effects or involve unresolved conflicts concerning alternative uses of available resources [NEPA Section 102(2)(E)].
  4. Have highly uncertain and potentially significant environmental effects or involve unique or unknown environmental risks.   5. Have a precedent for future action or represent a decision in principle about future actions with potentially significant environmental effects.
  6. Have a direct relationship to other actions with individually insignificant but cumulatively significant environmental effects.   7. Have significant adverse effects on properties listed or eligible for listing on the National Register of Historic Places as determined by either the bureau or office, the State Historic Preservation Officer, the Tribal Historic Preservation
Officer, the Advisory Council on Historic Preservation, or a consulting party under 36 CFR 800.   8. Have significant adverse effects on species listed, or proposed to be listed, on the List of Endangered or Threatened Species, or have significant adverse effects on designated Critical Habitat for these species.   9. Have the possibility of violating a Federal law, or a State, local, or tribal law or requirement imposed for the
protection of the environment.   10. Have the possibility for a disproportionately high and adverse effect on low income or minority populations (Executive Order 12898).   11. Have the possibility to limit access to and ceremonial use of Indian sacred sites on Federal lands by Indian religious
practitioners or significantly adversely affect the physical integrity of such sacred sites (Executive Order 13007).   12. Have the possibility to significantly contribute to the introduction, continued existence, or spread of noxious weeds or non-native invasive species known to occur in the area or actions that may promote the introduction, growth, or expansion of the range of such species (Federal Noxious Weed Control Act and Executive Order 13112).

(If any of the above extraordinary circumstances receive a AYes@ check (7) , an EA must be prepared.)
 Yes  No This grant/project includes additional information supporting the Checklist.

Concurrences/Approvals:
Project Leader: ______________________________________________ Date: _______________________

State Authority Concurrence: _____________________________________ Date: _______________________
(with financial assistance signature authority, if applicable)
Within the spirit and intent of the Council of Environmental Quality's regulations for implementing the National Environmental Policy Act
(NEPA) and other statutes, orders, and policies that protect fish and wildlife resources, I have established the following administrative record
and have determined that the grant/agreement/amendment:
 is a categorical exclusion as provided by 516 DM 6, Appendix 1 and/or 516 DM 2, Appendix 1. No further NEPA
documentation will therefore be made.
 is not completely covered by the categorical exclusion as provided by 516 DM 6, Appendix 1 and/or 516 DM 2, Appendix 1.
An EA must be prepared.

Service signature approval:

RO or WO Environmental Coordinator: ________________________________ Date: ________________________
Staff Specialist, Division of Federal Assistance: __________________________ Date:_________________________
(or authorized Service representative with financial assistance signature authority)

FWS Form 3-2185
Revised 02/2004
North Carolina F19AC00670
USFWS Partners for Fish and Wildlife/The Yellow Brick Road for Roanoke Logperch
✔B3
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
4/14/20

North Carolina Department of Natural and Cultural Resources
State Historic Preservation Office
Ramona M. Bartos, Administrator
Governor Roy Cooper Office of Archives and History
Secretary Susi H. Hamilton Deputy Secretary Kevin Cherry
Location: 109 East Jones Street, Raleigh NC 27601 Mailing Address: 4617 Mail Service Center, Raleigh NC 27699-4617 Telephone/Fax: [phone]-6599

April 13, 2020

Katie Lokey [e-mail]
Kris Bass Engineering
7334 Chapel Hill Road
Raleigh, NC 27606

Re: Create fish habitat in Dan River, south of 350 Teague Road, Madiso n, ER 20-0591

Dear Ms. Lokey,
Thank you for your email of March 6, 2020, concerning the above project.
We have conducted a review of the project and are aware of no historic resources which would be affected by
the project. Therefore, we have no comment on the project as proposed.

The above comments are made pursuant to Section 106 of the National Historic Preservation Act and the
Advisory Council on Historic Preservation’s Regulations for Compliance with Section 106 codified at 36 CFR
Part 800.

Thank you for your cooperation and consideration. If you have questions concerning the above co mment,
contact Renee Gledhill-Earley, environmental review coordinator, at 919-814-6579 or
[e-mail]. In all future communication concerning this project, please cite the above
referenced tracking number.
Sincerely,

Ramona Bartos, Deputy
State Historic Preservation Officer

North Carolina Department of Natural and Cultural Resources
State Historic Preservation Office
Ramona M. Bartos, Administrator
Governor Roy Cooper Office of Archives and History
Secretary Susi H. Hamilton Deputy Secretary Kevin Cherry
Location: 109 East Jones Street, Raleigh NC 27601 Mailing Address: 4617 Mail Service Center, Raleigh NC 27699-4617 Telephone/Fax: [phone]-6599

April 13, 2020

Katie Lokey [e-mail]
Kris Bass Engineering
7334 Chapel Hill Road
Raleigh, NC 27606

Re: Create fish habitat, Dan River, 642 Lindsey Bridge Road, Madison, ER 20-0592

Dear Ms. Lokey,
Thank you for your email of March 6, 2020, concerning the above project.
We have conducted a review of the project and are aware of no historic resources which would be affected by
the project. Therefore, we have no comment on the project as proposed.

The above comments are made pursuant to Section 106 of the National Historic Preservation Act and the
Advisory Council on Historic Preservation’s Regulations for Compliance with Section 106 codified at 36 CFR
Part 800.

Thank you for your cooperation and consideration. If you have questions concerning the above co mment,
contact Renee Gledhill-Earley, environmental review coordinator, at 919-814-6579 or
[e-mail]. In all future communication concerning this project, please cite the above
referenced tracking number.
Sincerely,

Ramona Bartos, Deputy
State Historic Preservation Officer

North Carolina State Historic Preservation Office’s
Project Review
Project Name: Madison Fish Habitat Restoration Project Phase 2
Project Location:
• 1.5 miles southwest of Madison, NC in Rockingham County
• 642 Lindsey Bridge Rd, Madison NC
• Latitude = 36.3751, Longitude = -79.9936
Project Contact Information
• Kris Bass
• Kris Bass Engineering
• 7334 Chapel Hill Rd, Ste 104
• Phone: [phone]; Email: [e-mail]
Project Description
The Madison Fish Habitat Restoration Project Phase 2 will create a pathway for small fish, such
as the endangered Roanoke logperch, to travel upstream of the existing Lindsey Bridge Dam on
the Dan River. This dam, constructed in 1972, is in disrepair and is a barrier to fish passage as
well as a safety hazard to recreational users of the Dan. Seven weirs will be constructed in the
Dan River to create a whitewater kayak park and fish passage. These boat and fish passages, in
addition to partial removal of the dam, will improve the safety of the area and enable the
movement of fish species upstream.
Each of the seven weirs will span the width of the river and include separate passages for fish
and small boats such as kayaks. There are three openings in each weir – two designed for fish
and one for boats. Each opening is roughly 20 feet wide, for a total width of 60 feet. Deeper
pools are located between each weir and are approximately 100 feet in length. Structures will
be constructed using boulders transported from an off-site quarry and temporarily stockpiled in
designated areas before being assembled in the river. In addition to the weirs, a center section
of the dam will be lowered by approximately 2 feet. During weir installation, currently eroding
banks will be regraded and stabilized with native plantings.
The project area is approximately 3.5 acres along the Dan River, from slightly upstream of the
Lindsey Bridge Dam to about 450 feet downstream of Lindsey Bridge Road. The disturbed area
is primarily the river bed, but includes some land on either side of the river channel.
Dimensions of disturbed area are approximately 900 feet in length and 150 feet in width. The
reach of river is bordered by farmland to the south and an industrial brick manufacturing plan t
to the north.
No historic buildings or structures occur on the project site. The Pine Hall Brick Plant 3A parcel,
which contains one or more historic buildings, is adjacent to the northern boundary of the
project area, located on the opposite side of the railroad tracks. Portions of the Pine Hall Brick
Plant 3A facility were constructed in 1947 and are more than 50 years old. An evaluation of the
facility’s eligibility for the National Register of Historic Places was completed in 2016 in relation
to the proposed replacement of Lindsey Bridge, but a final determination of the facility’s status
on the Register does not appear to have been made.
The Madison Fish Habitat Restoration Phase 2 Project has received funding and assistance from
multiple agencies, including grants from the North Carolina Division of Water Resources and the
Clean Water Management Trust fund and is being completed with assistance from the US F ish
and Wildlife Service, the North Carolina Wildlife Resources Commission and the Town of
Madison. Nationwide Permit 27 and Section 404 Permits are sought from the US Army Corps of
Engineers.

Site Photographs
Photo 1. Lindsey Bridge Dam facing upstream.

Photo 2. Lindsey Bridge Dam facing downstream.

Photo 3. Water intake structure and Lindsey Bridge Dam facing south.

Photo 4. Downstream of Lindsey Bridge Dam.

Photo 5. Impoundment upstream of Lindsey Bridge Dam.

Photo 6. Draft schematic of Madison Fish Habitat Restoration Project Phase 2.
Location Map
Upper Yadkin
03040101
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03040103
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03030003
High Point `"
Legend 0 5 10 15 20 mi
8-Digit Sub -Basins I{
• Lindsey Bridge Dam
Kris Bass Engineering M adison Fish Habitat Restoration Project Phase 2
www.kbeng.org KRIS BASS
919.960.1552 Rockingham County, N E R G I R E E R I a G

Kris Bass Engineering
www.kbeng.org
919.960.1552
Madison Fish Habitat Restoration Project Phase 2
Rockingham County, NC
Project Area
2018 Orthoimagery
Legend
Project Area
Lindsey Bridge Dam
Lindsey Bridge Road
SR 1138
Kris Bass Engineering
www.kbeng.org
919.960.1552
Madison Fish Habitat Restoration Project Phase 2
Rockingham County, NC
Project Area
USGS 7.5-minute Quadrangle
Mayodan and Ellisboro Quadrangles
Legend
Topography Map
Fish Passage
Weirs
Lindsey Bridge Road
SR 1138
Kris Bass Engineering
www.kbeng.org
919.960.1552
Madison Fish Habitat Restoration Project Phase 2
Rockingham County, NC
Project Area
2018 Orthoimagery
Legend
Historic Buildings Map
Lindsey Bridge Dam
Lindsey Bridge Road
SR 1138
Pine Hall Brick Plant 3A
RK1648