20111030 Ver 2_CAMA Application_20120302

NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue Braxton C Davis
Governor Director
February 29 2012
MEMORANDUM
TO
FROM
SUBJECT
Applicant
Project Location
Karen Higgins
Division of Water Quality
Doug Huggett
Mayor Permits Processing Coordinator
RE
MAR 2 2012
DIN wASaMn
"XMMn5T=n ERBRANCH
CAMA/DREDGE & FILL Permit Application Review
City of Havelock
Dee Freeman
Secretary
Craven County, MCAS Cherry Point and 304 Jackson Drive, on Slocum Creek
and Neuse River, in Havelock
Proposed Project Proposes to install a wastewater effluent pipe, which would cross Slocum
Creek and empty into the Neuse River The pipe would be 5 6 miles long and
empty 0 06 miles into the Neuse River
Please indicate below your agency's position or viewpoint on the proposed project and return this form by
March 20 2012 If you have any questions regarding the proposed protect please contact
Barry Guthrie Permit officer at [phone] When appropriate in depth comments with supporting
data is requested
REPLY This agency has no objection to the project as proposed
This agency has no comment on the proposed project
This agency approves of the project only if the recommended changes are
incorporated See attached
This agency objects to the project for reasons described in the attached comments
SIGNED DATE
400 Commerce Ave Morehead City NC 28557 None hCarohna
Phone [phone] FAX [phone] Internet www nccoastal management net
An Equal Opportunity 1 Affirmative Action Employer aturally

DIVISION OF COASTAL MANAGEMENT
FIELD INVESTIGATION REPORT
1 APPLICANT'S NAME City of Havelock
2 LOCATION OF PROJECT SITE MCAS Cherry Point and 304 Jackson Drive on Slocum
Creek and Neuse River in Havelock Craven County
Photo Index — NO HISTORIC AERIAL PHOTOGRAPHY FOR THIS AREA
State Plane Coordinates X 2779519 48 Y 425948 55
LAT 34 053 565N 34 053 269N LON 76 054 655W 76 054 557W
3 INVESTIGATION TYPE CAMA
4 INVESTIGATIVE PROCEDURE Dates of Site Visit — 12/13/11
Was Applicant Present —Yes
5 PROCESSING PROCEDURE Application Received — 11/28/11 cc 2/15/12
Office — Morehead City
6 SITE DESCRIPTION
(A) Local Land Use Plan — Havelock
Land Classification from LUP — Low density residential US military base
(B) AEC(s) Involved Public Trust Shoreline Estuarine Shoreline Estuarine Waters Public
Trust Waters
(C) Water Dependent No
(D) Intended Use Municipal
(E) Wastewater Treatment Existing — N/A
Planned — N/A
(F) Type of Structures Existing — Military base wastewater treatment plant
Planned — Wastewater effluent pipe /signage
(G) Estimated Annual Rate of Erosion N/A
Source — N/A
7 HABITAT DESCRIPTION
DREDGED G;
I jLLJW
Qom' $
(A) Highground Disturbance
N/A
N/A
15 3 acres
(B) Shallow Bottom
N/A
N/A
100 ft' diffuser head
(C) Open Water
N/A
N/A
100 ft' usurpation for
signs
(E) 404 Wetlands
N/A
N/A
38 400 ft2 open cut
(D) Total Area Disturbed 15 3 acres
(E) Primary Nursery Area Yes
(F) Water Classification SC Open No
8 PROJECT SUMMARY The applicant is proposing to install a wastewater effluent pipe which
would cross Slocum Creek and empty into the Neuse River The pipe would be 5 6 riles long and
empty 0 6 miles into the Neuse River

9 NARRATIVE DESCRIPTION
The City of Havelock project is located at 304 Jackson Drive adjacent to Slocum Creek in Havelock
Craven County To reach the project site travel on Hwy 70 and turn north onto Jackson Drive The
project site will be approximately 0 25 miles down Jackson Drive and be located on the right (east)
side of the street
The 19 1 acre project site has a highground elevation ranging from +5 to +15 above NWL The
Havelock LUP classifies this area as low density residential and US Military Base The project site is
a 20 wide easement granted to the City of Havelock to cross through the MCAS Cherry Point with
the pipeline The project area is both wooded and developed The 5 6 rule route of the proposed
pipeline crosses expanses of forest as well as portions of developed sections of the MCAS Cherry
Point Coastal wetlands exist on site consisting mainly of Juncus roemerianus The easement also
has a recent jurisdictional determination on January 11 2012 Action ID 201200078 The project site
consists of approximately 20 feet of shoreline frontage on Slocum Creek and the Neuse River
The project site currently consists of a wastewater treatment plant on Jackson Drive and the MCAS
Cherry Point located on the eastern side of the Slocum Creek crossing
The Division of Water Quality classifies this area of Slocum Creek and Neuse River as SC waters
This area is an Inland Primary Nursery Area as classified by the Division of Wildlife Resource
Commission The area is closed to the harvesting of shellfish by the Division of Marine Fisheries
Shellfish Sanitation
10 PROJECT DESCRIPTION
The applicant is proposing to place a wastewater effluent pipeline starting at the City of Havelock
wastewater treatment plant and ending 0 6 mmles into the Neuse River The pipeline would be 5 3
miles in length and 24 in diameter The pipe would cross all waterbodies by means of directional
drilling The first directional boring would be under the East prong of Slocum Creek At the location
of the crossing Slocum Creek is approximately 70 in width The boring would have a 1200 radius
and be approximately 25 beneath the bed of Slocum Creek The second waterbody body would be
approximately 40 in width and be located approximately 35 beneath the bed of the waterbody The
pipeline would extend 0 6 miles into the Neuse River where the outfall would occur The pipeline
would be buried 20 25 beneath the bed of the Neuse River before making a 1200 radial turn
towards the riverfloor The terminus of the pipeline would consist of a discharge header and be
anchored to the seafloor in approximately 10 NWL of water The anchoring technique will be by
means of two pilings extending to above the surface with signage warning of the submerged pipe
In transit from the wastewater treatment station to the Neuse River approximately 15 3 acres (667 339
ft') of highground would be disturbed by (25 000 yd') the installation of the pipe The pip would be
installed by open cut not trenching A majority of the area is developed and will be located within the
MCAS Cherry Point Areas of Section 404 wetlands would also be impacted during the installation of
the pipeline Approximately 38 400 ft' (0 88 acres) of 404 wetlands would be disturbed during the
clearing of the work corridor No coastal wetlands would be impacted as proposed

11 ANTICIPATED IMPACTS
The proposed project would result in the disturbance of 15 3 acres of highground by the installation
of the proposed pipeline Proper sedimentation and erosion control measures would prevent any
significant runoff into the adjacent waterbodies A majority of the pipeline will be placed by an
open cut with the portions lying beneath waterbodies being installed by directional boring thus
causing no direct impact to coastal wetlands or shallow bottom habitats Section 404 wetlands
would be disturbed by the trenching in of the proposed pipeline Approximately 38 400 ftz (0 88
acres) of 404 wetlands would be impacted by this project Two piling will be used to anchor the
diffuser head into place at the terminus of the pipeline 0 6 miles into the Neuse River and in 10
NWL of water The pilings will have signs warning of the submerged pipe Approximately 100 ftz
of open water and shallow bottom would be usurped by the placement of both the diffuser head at
the terminus of the outfall pipe and the signage These pilings and signs should be marked or lit in
accordance with conditions from the appropriate agency to prevent the structures from becoming a
hazard to navigation
�l at

HAZEN AND SOM
Environmental Engineers & Scientists
February 15 2012
Mr Barry Guthrie
NC Division of Coastal Management
400 Commerce Avenue
Morehead City NC 28557 3421
Hazen and Sawyer F C
4011 WestChase Blvd
Raleigh NC 27607
919 833 7152
Fax [phone]
Re Additional Information
Mayor Permit Application for City of Havelock North Carolina — Havelock VWVTP
Expansion and Neuse River Outfall
Dear Mr Guthrie
Enclosed are documents providing additional information as requested relative to the Mayor
Permit Application that was originally submitted on behalf of the City of Havelock on November
22 2011 Included in this submittal are
1 Signed Return Receipt postcard
2 Revised MP 1 form
3 Jurisdictional Determination issued by U S Army Corps of Engineers on January 11
2012
4 Revised plan sheets showing additional details as requested and areas of coastal
wetlands
We appreciate your attention to this project If you have any questions regarding this
application please contact me at 919 863 9350 We look forward to working with you on this
important project for the City of Havelock
Sincerely
HAZEN AND SAWYER, P C
Keven Arrance
Scientist
CC James Freeman City of Havelock
Attachments
New York NY Armonk NY Woodbury NY Detroit MI Raleigh NC Charlotte NC Atlanta GA Fairfax VA Hollywood FL Boca Raton FL Fort Pierce FL Sarasota FL Miami FL Philadelphia PA

DCM MP 1
APPLICATION for
Mayor Development Remit
(last revised 12/27/06)
North Carolina DIVISION OF COASTAL MANAGEMENT
1 Primary Applicant/ Landowner Information
Business Name
Project Name (if applicable)
City Of Havelock
Havelock WWTP Expansion and Neuse River Outfall
Applicant 1 First Name
MI
Last Name
James
Keven
Freeman
Applicant 2 First Name
MI
Last Name
If additional applicants please attach an additional page(s) with names listed
Mailing Address
Mailing Address
PO Box
City
City
State
4011 WestChase Boulevard Suite 500
368
Havelock
NC
ZIP
Country
Phone No
Phone No 1
FAX No
28532
USA
252 444
6401 ext
252 444 2616
Street Address (if different from above)
City
State
ZIP
1 Governmental Avenue
Havelock
NC
28532
Email
State
ZIP
JFreeman @havelocknc us
2 Agent/Contractor Information
Business Name
Hazen And Sawyer P C
Agent/ Contractor 1 First Name
MI
Last Name
Keven
Arrance
Agent/ Contractor 2 First Name
MI
Last Name
Mailing Address
PO Box
City
State
4011 WestChase Boulevard Suite 500
Raleigh
NC
ZIP
Phone No 1
Phone No 2
27607
919 863
9350 ext
ext
FAX No
Contractor #
919 833 1828
Street Address (if different from above)
City
State
ZIP
Email
KArrance @hazenandsawyer com
<Form continues on back>
7 acs 2808 1 8 s 4 < rAS' WVJN i� - mot` I6 s I - t

Form DCM MP 1 (Page 2 of 4)
APPLICATION for
Major Development Permit
3 Project Location
County (can be multiple)
Street Address
State Rd #
Craven
Jackson Drive
20
Subdivision Name
City
State
Zip
Havelock
NC
28532
Phone No
Lot No (s) (if many attach additional page with list)
252 444 6401 ext
n/a
a In which NC river basin is the project located?
b Name of body of water nearest to proposed project
Neuse
East Prong of Slocum Creek
c Is the water body identified in (b) above natural or manmade?
d Name the closest major water body to the proposed project site
❑Natural ❑Manmade ❑Unknown
Neuse River
e Is proposed work within city limits or planning jurisdiction?
f If applicable list the planning jurisdiction or city limit the proposed
®Yes ❑No
work falls within
City of Havelock
4
Site Description
a
Total length of shoreline on the tract (ft)
b Size of entire tract (sq ft )
20
832 431
c
Size of individual lot(s)
d Approximate elevation of tract above NHW (normal high water) or
n/a
NWL (normal water level)
(If many lot sizes please attach additional page with a list)
5 15 ft ❑NHW or ®NWL
e
Vegetation on tract
Vegetation includes grass along the roadside dirt running path and pockets of forested wetlands
f
Man made features and uses now on tract
The project is located within existing maintained roadway or utility easements or within the existing City of Havelock
Wastewater Treatment Plant (WWTP) property
g
Identify and describe the existing land uses adiacent to the proposed project site
Existing land uses adjacent to the proposed project include the City of Havelock WWTP Marine Corps Air Station (MCAS)
Cherry Point and associated infrastructure and uses
h
How does local government zone the tract?
i Is the proposed project consistent with the applicable zoning?
federal land
(Attach zoning compliance certificate if applicable)
®Yes ❑No DNA
I
Is the proposed activity part of an urban waterfront redevelopment proposal? ❑Yes NNo
k
Hasa professional archaeological assessment been done for the tract? If yes attach a copy ®Yes ❑No DNA
If yes by whom? The project was reviewed by the
North Carolina Division of Cultural
Resources
I
Is the proposed project located in a National Registered Historic District or does it involve a ❑Yes NNo DNA
National Register listed or eligible property?
<Form continues on next page>

Form DCM MP 1 (Page 3 of 4)
APPLICATION for
Major Development Permit
m (i) Are there wetlands on the site? ®Yes []No
(u) Are there coastal wetlands on the site? ®Yes []No
(ui) If yes to either (i) or (ii) above has a delineation been conducted? ®Yes ❑No
(Attach documentation if available)
n Describe existing wastewater treatment facilities
The City of Havelock operates the City of Havelock WWTP which currently discharges into East Prong of Slocum Creek
The effluent pipeline and outfall are proposed to be relocated to discharge Into Nuese River All wastewater treatment
services for MCAS Cherry Point are provided by the MCAS Cherry Point WWTP
o Describe existing drinking water supply source
Havelock s water source is the Castle Hayne aquifer which is accessed by groundwater wells Raw water Is then treated at
and distributed from the City of Havelock Water Treatment Plant (WTP)
p Describe existing storm water management or treatment systems
No storm water management or treatment systems are located within the proposed project footprint
5 Activities and Impacts
a Will the project be for commercial public or private use? ❑Commercial ®Public/Government
❑Private /Community
b Give a brief description of purpose use and daily operations of the project when complete
The purpose of the project is to relocate the existing discharge from the City s WWTP to accommodate anticipated growth
and connection by residents who are currently served by septic or community treatment facilities to the City s sewer services
The use and daily operations of the project is discharge of treated wastewater effluent
c Describe the proposed construction methodology types of construction equipment to be used during construction the number of each type
of equipment and where it is to be stored
Installation of the proposed effluent pipeline and outfall will be conducted via directional drill bore and jack or subaqueous
techniques at the crossings of all blueline streams and the adjacent wetlands The remainder of the pipeline will be installed
via open cut techniques Equipment anticipated to be used includes one each of the following items dozer front end loader
and horizontal directional drill Equipment will be stored along the corridor in upland areas
d List all development activities you propose
The City of Havelock proposes to install a new effluent pipeline across MCAS Cherry Point to connect the City of Havelock
WWTP to the proposed new effluent outfall in Neuse River
e Are the proposed activities maintenance of an existing protect new work or both? Both the proposed activities are new
work associated with maintaining
services currently provided by existing
development
f What is the approximate total disturbed land area resulting from the proposed protect? 153 ❑Sq Ft or ®Acres
g Will the proposed protect encroach on any public easement public accessway or other area ®Yes []No ❑NA
that the public has established use of?
h Describe location and type of existing and proposed discharges to waters of the state
The existing discharge from the WWTP is to East Prong of Slocum Creek and is proposed to be relocated to Neuse River as
depicted on attached figures and design drawings All jurisdictional waters of the state that will be disturbed will be returned
to original grade and elevation during installation of the pipeline These areas will be replanted as appropriate
i Will wastewater or stormwater be discharged into a wetland? ❑Yes ®No ❑NA
If yes will this discharged water be of the same salinity as the receiving water? []Yes ❑No ®NA
t Is there any mitigation proposed? ❑Yes ®No ❑NA
If yes attach a mitigation proposal
2� Boo 23 - 4 0 �� 1� %r �i r � rs ~u�� VlDp a cArl 4 't

Form DCM MP 1 (Page 4 of 4)
<Form continues on back>
APPLICATION for
Major Development Permit
6 Additional Information
In addition to this completed application form (MP 1) the following items below if applicable must be submitted �Inlorder�for the application
package to,be compeeeel Items (a) -, (0 are always applicable to any major development application Please consult the application
instruction booklet on how to properly prepare the required items below l l
a A project narrative
b An accurate dated work plat (including plan view and cross sectional drawings) drawn to scale Please give the present status of the
proposed project Is any portion already complete? If previously authorized work clearly indicate on maps plats drawings to distinguish
between work completed and proposed
c A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site
d A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties
e The appropriate application fee Check or money order made payable to DENR
f A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management
Name Carmen Lombardo EAD i f i2 ) I `'f � I Phone No 252 466 58
170 f
Address Budding 4223 MCAS Cherry Point NC 27533 0006 f I I s X
Name Phone No
Address
Name q Phone No i
r
Address 3f ;r p(#`
g A list of previous state or federal permits issued for work on the project tract Include permit numbers permittee and issuing dates
No other permits have been issued to date for the proposed
project
h Signed consultant or agent authorization form if applicable
i Wetland delineation if necessary
j A signed AEC hazard notice for projects in oceanfront and inlet areas (Must be signed by property owner)
k A statement of compliance with the N C Environmental Policy Act (N C G S 113A 1 10) if necessary If the project involves expenditure
of public funds or use of public lands attach a statement documenting compliance with the North Carolina Environmental Policy Act
7 Certification and Permission to Enter on Land
I understand that any permit issued in response to this application will allow only the development described in the application
The project will be subject to the conditions and restrictions contained in the permit
I certify that I am authorized to grant and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow up
monitoring of the project
I further certify that the information provided in this application is truthful to the best of my knowledge
Date / - 141-1 L Print Name
Signature v
Please indicate application attachments pertaining toy proposed project
®DCM MP 2 Excavation and Fill Information ❑DCM MP 5 Bridges and Culverts
NDCM MP 3 Upland Development
NDCM MP 4 Structures Information
,a a- ; T'I° 3 —5°-1 -�c " -. 0 a7� ?r a

U S ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
04
Action Id 201200078 County Craven U S G S Quad Havelock
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Property Owner /Agent James Freeman, City Manager
Address City of Havelock
1 Government Avenue
Havelock, NC 28532
Telephone No
Property description
Size (acres) existing utility corridor Nearest Town Havelock
Nearest Waterway Slocum Creek River Basin Neuse
USGS HUC 03020204 Coordinates N 34 923413 W 76 901442
Location description The existina utility corridor beams at the Havelock Wastewater Treatment Plant on Jackson
Drive, crosses Slocum Creek to Marine Coras Air Station Cherry Point, parallels existing roads and then discharges
into the Neuse haver at a new location
Indicate Which of the Following Apply
A Preliminary Determination
X Based on preliminary information there may be waters of the U S including wetlands on the above described project area
We strongly suggest you have this property inspected to determine the extent of Department of the Army (DA)
,jurisdiction To be considered final a Jurisdictional determination must be verified by the Corps This preliminary
determination is not an appealable action under the Regulatory Program Administrative Appeal Process ( Reference 33
CFR Part 33 1)
B Approved Determination
_ There are Navigable Waters of the United States within the above described property subject to the permit requirements of
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act 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
_ There are wetlands on the above described project area 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
_ We strongly suggest you have the wetlands on your property delineated Due to the size of your property and/or our
present workload the Corps may not be able to accomplish this wetland delineation in a timely manner For a more timely
delineation you may wish to obtain a consultant To be considered final any delineation must be verified by the Corps
_ The wetland on your property have been delineated and the delineation has been verified by the Corps We strongly
suggest you have this delineation surveyed Upon completion this survey should be reviewed and verified by the Corps
Once verified this survey will provide an accurate depiction of all areas subject to CWA,jurisdiction on your property
which provided there is no change in the law or our published regulations may be relied upon for a period not to exceed
five years
_ The wetlands have been delineated and surveyed and are accurately depicted on the plat signed by the Corps
Regulatory Official identified below on 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
_ There are no waters of the U S to include wetlands present on the above described property which are subject to the
permit requirements of Section 404 of the Clean Water Act (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
Page 1 of 2

Action ID
X The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act
(CAMA) You should contact the Division of Coastal Management in Morehead City NC at [phone] to
determine their requirements
Placement of dredged or fill material within waters of the US and/or wetlands without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311) If you have any questions regarding this
determination and/or the Corps regulatory program please contact William Wescott at 910 251 4629
C Basis For Determination
The subiect area exhibits the three parameters identified in the Regional Supplement to the 1987 Corps of Engineers
Wetlands Delineation Manual
D Remarks
Site visit conducted on January 4, 2012 to verify the presence and boundaries of wetlands 1 through 9 and streams 1
through 11
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 jurisdictional determinations as indicated in
B above)
This correspondence constitutes an approved Jurisdictional 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
District Engineer Wilmington Regulatory Division
Attn William Wescott Protect Manager
Washington Regulatory Field Office
Post Office Box 1000
Washington North Carolina 27889
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 3315 and that it has been received by the District 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
* *It is not necessary to submit an RFA form to the District Office if you do not object to the determination in this
correspondence **
Corps Regulatory Official ��' 1 L "" S
Date 01/1112012
Expiration Date 01/11/2017
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 our website at htty / /regulatory usacesurvey com/ to
complete the survey online
Copy furnished
Hazen and Sawyer attn Keven Arrance
Page 2 of 2

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w NOTIFICATION OF ADMINISTRATIVE APPEAL O TIONI ANDTAOCESS',AND
�3 --�Y
t;—iF C' .�+`°'`rrj_E +A'
REQUEST FOR APPEAL R FAT
—M
Applicant City of Havelock attn James Freeman
File Number 201200078
Date 1/11/2012
Attached is Preliminary Jurisdictional Deterinination
See Section below
INITIAL PROFFERED PERMIT Standard Permit or Letter of permission)
A
PROFFERED PERMIT (Standard Permit or Letter of permission)
B
PERMIT DENIAL
C
APPROVED JURISDICTIONAL DETERMINATION
D
PRELIMINARY 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
h / /www usace army mil/CECW/Pages/reg_materials as x or 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 Pernssion (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 Admimstrative 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 division 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 i eevaluate the JD

SECTION H - 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 admuustratrve record Neither the appellant nor the Comps may add new information or analyses to the record However
you may rovide additional information to clan the location of information that is alreaL in the administrative record
POINT OF CONTACT FOR QUESTIONS OR INFORMATION
If you have questions regarding this decision and/or the appeal
If you only have questions regarding the appeal process you may
process you may contact
also contact
U S Army Comps of Engineers
Jason Steele
Attn William Wescott
Administrative Appeals Review Officer
Post Office Box 1000
60 Forsyth Street SW (Room 9M10)
Washmgton North Carolina 27889
Atlanta GA 30303 8801
404 562 5137
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 opporhinity to participate in all site investigations
Date
Telephone number
Signature of appellant or a ent

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