20120435 Ver 1_Application_20120501

t — 9
BEVERLY EAVES PERDUE
GOVERNOR
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Apn120 2012
UAY ` 12012
LUD ANDS�hj iq
r
EUGENE A CONu, JR
SECRETARY
Ms Lon Beckwith NCDOT Regulatory Project Manager
U S Army Corps of Engineers _
151 Patton Avenue, Room 208
Asheville, NC 28801 -2714
Subject Nationwide 14 Permit Application
SR 1347 Foster Creek
Henderson County
State Project # 14C 045146 (DWQ Mmor Permit Fee $240)
Dear Ms Beckwith
The North Carolina. Department of Transportation ( NCDOT) is proposing to widen grade dram and
pave SR 1347 Foster Creek Road, in Henderson County for a distance of 5,350 feet This proposal
entails widening and paving the existing gravel road to a standard 20 -foot roadway Foster Creek
Road is a secondary gravel road which conveys local traffic
I am enclosing a typical section of the road drawings for pipe culvert replacements photographs a
marked county map and a USGS topographic map
The United States Fish and Wildlife Service list 32 species with federal status for Henderson County
that are known from current records or were known to occur in the county histoncally One species
white fringeless orchid (Platanthera integrilabia) is a candidate species and is known from historical
records The bog turtle (Glyptemys muhlenbergu) is listed as threatened due to similarity of
appearance with the listed northern bog turtle Six species Appalachian elktoe (Alasmidonta
ravenehana) swamp pink (Helonias bullata) small whorled pogonia (Isotna medeoloides)
bunched arrowhead (Sagittarca fasciculata) mountain sweet pitcher plant (Sarracenma jonesu) and
white insette (Sisynnchium dichotomum) are listed as threatened or endangered
There are records for the Appalachian elktoe within the Mills River watershed These records are for
Mills River approximately two miles downstream of the project The project is through relatively flat
terrain and only minimal cuts and fills will be required to complete construction BMPs for high
quality waters will further mmmuze the impacts to adjacent waters and to downstream habitat
a Division 14 District 1 - I
t A .� p `t
Phone [phone] ; ; ,, r 4142 Haywood Road Mt11s,Rwer North Carohna 28759 Fax [phone]

ASR 1347 Foster Creek Road 2
occupied by the Appalachian elktoe Foster Creek is a relatively small stream and does not provide
habitat that is characteristic of the Appalachian elktoe
There appear to be some wetlands within the maintained open field downslope of the road and off
the project These wetlands have been degraded by ditching and draining There are no wetlands or
habitat for the listed species within the footprint of the load -project There was no evidence of the
listed species observed in the project area BMP s will minimize any impact to habitat that is
downslope of the road project
It is not anticipated that the project will affect cultural resources The project was submitted to the
NCDOT Human Environment Unit for review for the potential to affect archaeological and
architectural resources It was determined by the Human Environment Unit that no further survey
work is required for architecture however a survey will be required for archaeology
The best management practices will be used to minimize and control sedimentation and erosion on
this project Water will be pumped around the work area to mmumnze erosion and sedimentation
from the pipe trench The construction foreman will review all sedimentation control measures
during installation to ensure sedimentation is controlled effectively If the planned devices are not
functioning as intended they will be replaced immediately with better devices The sedimentation
control devices will be in place prior to pipe culvert removal and remain in place until the new pipe is
installed
Impacts to Waters of the United States
Foster Creek (WS U, Tr HQW) is shown on the USGS topographic map as a perennial stream and
has sufficient flow to support fish and other aquatic life The unnamed tributaries of Foster Creek
(Sites 1 and 2) are not shown as perennial streams on the USGS topographic map The unnamed
tributaries are 1 -2 feet in width The channel at Site 1 is well - defined and lacks vegetation The
stream flows through a driveway pipe parallel to the road and then through a second pipe under the
road The plan is to route the stream directly across the road and eliminate the stream from flowing
through the driveway pipe The unnamed tributary at Site 1 flows approximately 60 feet to Foster
Creek The unnamed tributary of Foster Creek (Site 2) originates at a spring head at the inlet end of
the culvert, the channel below the outlet has been altered by ditching on the adjacent property This
tributary flows approximately 440 feet to Foster Creek Foster Creek (Site 3) is shown as a
perennial stream on the USGS topographic map Foster Creek flows approximately 14 miles from
the unnamed tributary to Mills River Mills River flows approximately 4 0 miles to the French Broad
River The French Broad River meets the definition of a Traditional Navigable Water For these
reasons we believe that the streams are Relatively Permanent Water and are under the jurisdiction of
the U S Army Corps of Engineers In order to replace and extend the culverts it will be necessary
to impact waters of the United States in the French Broad River Basin Specifically NCDOT is
requesting to replace and/or extend one CMP in Foster Creek and two CMPs in unnamed tributaries
to Foster Creek Listed below is a summary of the proposed impacts
Site No
Existing Condition
Proposed Condition
Net Impacts
Site 1
25' x 18 Driveway CMP
6 +57
30 x 18 Road CMP
40 x 18 CMP
15

SR 1347 Foster Creek Road 3
Site IA
Free Flowing Channel
Flow Diversion
65
Site 2
25 x 18 CMP
40 x 18 CUT
15
41 +25
Site 2A
Free Flowing Channel
Flow Diversion
65
Site 3
25'x 42 CMP
40 x 95 x 67 Arched CMP
15
47 +58
Site 3A
Free Flowing Channel
Flow Diversion
65'
Total Impact in Linear Feet 15
Temporary Impact for Dikes and Flow Diversion in Linear Feet 195
Permits Requested
NCDOT is hereby requesting authorization under Section 404 of the Clean Water Act for the
construction project outlined above By copy of this letter I am asking Mr David McHenry
Mountain Region Coordinator of the North Carolina Wildlife Resources Commission ( NCWRC) to
comment directly to you concerning the 404 Nationwide Permit request
I am also requesting authorization under Section 401 of the Clean Water Act from the North
Carolina Department of Environment and Natural Resources (DENR), Division of Water Quality
(DWQ) In addition, I am asking Mr McHenry and Mr Ed Ingle Roadside Environmental Field
Operations Engineer ( NCDOT), to comment directly to me concerning this permit request
If you have any questions or need additional information, please contact Ms Lon Jones or me at
(828) 891 -7911
Sincerely
Steven L Cannon, P E
District Engineer
Enclosures
cc Mr Brian Wrenn DWQ DENR Raleigh (4 copies)
Mr David McHenry, Mountain Region Coordinator, NCWRC
Mr Mike Parker DWQ, Asheville
Mr Jason Mays Biologist U S Fish and Wildlife Service, Asheville
Mr Mark Gibbs P E Division Asset Maintenance Engineer
Mr Mark Davis Division Environmental Officer
Mr E L Ingle, Roadside Environmental Field Operations Engineer, NCDOT
Ms Lori M Jones P E , Henderson County Maintenance Engineer NCDOT
File

Corps Submittal Cover Sheet
Please provide the following info
1 Project Name _SR 1347 Foster Creek Road
2 Name of Property Owner /Applicant, NCDOT
3 Name of Consultant /Agent N/A
*Agent authorization needs to be attached
4 Related/Previous Action ID number(s)
5 Site Address Foster Creek Road Henderson County
6 Subdivision Name
7 City Mills River
8 County _Henderson
9 Lat 35 41060_ Long -82 60400 (Coordinates at Foster Creek Site 2) (Decimal Degrees Please )
10 Quadrangle Name _Skyland
11 Waterway Foster Creek & UT to Foster Creek
12 Watershed French Broad River
13 Requested Action
X Nationwide Permit # _14_
General Permit #
Jurisdictional Determination Request
Pre - Application Request
The following information will be completed by Corps office
AID
Prepare File Folder Assign number in ORM Begin Date
Authorization Section 10 Section 404
Project Description/ Nature of Activity/ Project Purpose
Site/Waters Name
Keywords

OFFICE USE ONLY
Date Received Fee Paid Permit Number
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
LINEAR ROADWAY PROJECT
This form may be photocopied for use as an onginal
DWO Stormwater Management Plan Review
A complete stormwater management plan submittal includes this application form, a supplement form for each BMP proposed
(see Section V) design calculations and plans and specifications showing all road and BMP details
PROJECT INFORMATION
NCDOT Project Number 14C 045146 County Henderson
Project Name SR 1347 (Foster Creek Road) Widen, grade dram and pave to NCDOT secondary road standards
Project Location _ SR 1347 (Foster Creek Road) located Wroxnnately 15 miles west of the intersection of SR 1345 (North
Mills River Road) and NC 280
Contact Person Steve Cannon, PE Phone [phone] Fax [phone]
Receiving Stream Name Foster Creek River Basin French Broad Class WS II, Tr, HQW
Proposed linear feet of project 5,327
Proposed Structural BMP and Road Station (attach a list of station and BMP type if more room is needed)
See attached Stormwater Management Plan
Type of proposed project (check all that apply)
❑ New ®Widening ®2 lane* 04 lane* ❑Curb and Gutter ❑Bndge Replacement
00ther (Describe) Widen, grade, drain and Dave to current NCDOT Secondary Road Standards
*2 lane and 4 lane imply that roadside ditches are used unless Curb and Gutter is also checked
II REQUIRED ITEMS CHECKLIST
Initial in the space provided below to indicate the following design requirements have been met and supporting documentation
is attached. Supporting documentation shall at a nummum, consist of a brief narrative description including (1) the scope of
the project, (2) how the items below are met (3) how the proposed best management practices numm,ze water quality
impacts and (4) any significant constraints and/or justification for not meeting a b c and d to the maximum extent
practicable
Des er s Initials
a The amount of impervious surface has been minimized as much as possible
b The runoff from the mTervious areas has been diverted away from surface waters as much as possible
C Best Management Practices are employed which minimize water quality impacts
d Vegetated roadside ditches are 3 1 slope or flatter

III OPERATION AND MAINTENANCE AGREEMENT
I acknowledge and agree by my initials below that the North Carolina Department of Transportation is responsible for the
implementation of the four maintenance items listed I agree to notify DWQ of any operational problems with the BMP s that
would impact water quality or prior to making any changes to the system or responsible party
Maintenance Engineer s Initials
a BMP s shall be inspected and maintained in good working order
b Eroded areas shall be repaired and reseeded as needed
�c Stormwater collection systems including piping inlets and outlets shall be maintained to insure proper
functioning
Maintenance Engineer s Name Lon Jones, PE
Title Henderson County Maintenance Engineer
IV APPLICATION CERTIFICATION
I (print or type name) Steve Cannon. PE of Division 14 District 1 Division of Highways Branch,
certify that the information included on this permit application form is to the best of my knowledge correct and that the
project will be constructed in conformance with the approved plans and that the proposed project complies with the
requirements of 15A NCAC 2H 1000
Title District Engineer
Address 4142 Haywood Rd Mills River, NC 28759
Signature cet - Date Y— Z S— Z 0/ Z-
V SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each BMP
specified for this project. Contact the Stormwater and General Permits Unit at [phone] for the status and availability
of these forms
Form SW401 Low Density
Form SW401 Curb Outlet System
Form SW401 Off Site System
Form SW401 Wet Detenhon Basin
Form SW401 Infiltration Basin
Form SW401 Infiltration Trench
Form SW401 Bioretention Cell
Form SW401 Level Spreader
Form SW401 Wetland
Form SW401 Grassed Swale
Form SW401 Sand Filter
Low Density Supplement
Curb Outlet System Supplement
Off Site System Supplement
Wet Detention Basin Supplement
Infiltration Basin Supplement
Underground Infiltration Trench Supplement
Bioretention Cell Supplement
Level Spreader /Filter Strip /Restored Riparian Buffer Supplement
Constructed Wetland Supplement
Grassed Swale Supplement
Sand Filter Supplement

STORMWATER MANAGEMENT PLAN
Project 14C 045146
Henderson County
Roadway Description
This project consists of improvement and paving of an existing gravel road SR 1347 Foster Creek Road
The total project length is 5 327 feet The project is located in the French Broad River Basin The project
drainage system consists of matted shoulders and ditches corrugated metal pipes with rip rap dissipater
pads at the pipe outfall
Jurisdictional Stream Foster Creek and Unnamed tributaries to Foster Creek
Environmental Description
The project is located within the French Broad River Basin in Henderson County The stream is classified
WS II Tr HQW Stormwater impacts to the stream will be minimized to the maximum extent
practicable by utilizing sheet flow on matting lined ditches along the roadway and using rip rap pads to
diffuse flow before entering the streams The existing drainage patterns will be maintained with the
hydraulic design of the project
Best Management Practices and Mayor Structures
The primary goal of Best Management Practices (BMPs) is to prevent degradation of the state s surface
waters by the location construction and operation of the highway system The BMPs are activities
practices and procedures taken to prevent or reduce Stormwater pollution The BMP measures used on
this project to reduce Stormwater impacts are
Matted Roadway Ditches
This will promote infiltration and filtration of construction runoff by directing water from L into a
matted roadway ditch The cut slope will be 11 to mimic the existing cut slope as well as to reduce cost
by minimizing excavation and R/W
Outlet protection with rip rap
Rip rap outlet protection is provided at all pipe outlets to dissipate energy from Stormwater runoff to
provide non erosive velocities for infiltration and filtration before entering the stream

APPROVED JURISDICTIONAL DETERMINATION FORM
U S Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook
SECTION I BACKGROUND INFORMATION
A REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD)
B DISTRICT OFFICE FILE NAME AND NUMBER
C PROJECT LOCATION AND BACKGROUND INFORMATION SR 1347 Foster Creek Road
State NC County /pansh/borough Henderson City Mills River
Center coordinates of site (lat/long in degree decimal format) Lat 35 40724 N Long 82 59845 W
Universal Transverse Mercator
Name of nearest waterbody Foster Creek and Unnamed Tributaries to Foster Creek
Name of nearest Traditional Navigable Water (TNW) Into which the aquatic resource flows French Broad River
Name of watershed or Hydrologic Unit Code (HUC) 06010105020020
® Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request
❑ Check if other sites (e g offsite mitigation sites disposal sites etc ) are associated with this action and are recorded on a
different JD foram.
D REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY)
® Office (Desk) Determination. Date February 16 2012
® Field Determination. Date(s) February 15 2012
SECTION H SUMMARY OF FINDINGS
A RHA SECTION 10 DETERMINATION OF JURISDICTION
There ne navigable waters of the US- within Rivers and Harbors Act (RIIA) junsdretron (as defined by 33 CFR part 329) in the
review area [Required]
❑ Waters subject to the ebb and flow of the tide
El Waters are presently used or have been used in the past or may be susceptible for use to transport interstate or foreign commerce
Explain
B CWA SECTION 404 DETERMINATION OF JURISDICTION
There Are waters of the US within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area [Required]
Waters of the U S
a Indicate presence of waters of U S in review area (check all that apply) r
❑ TNWs including territorial seas
❑ Wetlands adjacent to TNWs
® Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
❑ Non RPWs that flow directly or indirectly into TNWs
❑ Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to non RPWs that flow directly or indirectly into TNWs
❑ Impoundments of junsdtctronal waters
❑ Isolated (interstate or intrastate) waters including isolated wetlands
b Identify (estimate) size of waters of the U S in the review area
Non wetland waters 450 linear feet Unnamed Tributaries 1 and Foster Creek 6 width (fl) and/or acres
Wetlands acres
c Limits (boundaries) of jurisdiction based on Estabhshed by ---
Elevation of established OHWM (if known)
2 Non regulated waters/wetlands (check if applicable) 3
❑ Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not junsdretronal
Explain
t Boxes checked below shall be supported by completing the appropriate sections in Section III below
Y For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year round or has continuous flow at least seasonally
( v t— allv'3 month )

SECTIONIH CWAANALYSIS
A TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs If the aquatic resource is a TNW complete
Section III.A 1 and Section III D 1 only if the aquatic resource is a wetland adjacent to a TNW complete Sections III A.1 and 2
and Section III D 1 otherwise, see Section IILB below
1 TNW
Identify TNW
Summanze rationale supporting determination
2 Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is adjacent
B CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY)
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands if any and it helps
determine whether or not the standards for jurisdiction established Tinder Rapancir have been met
The agencies will assert jurisdiction over non navigable tributaries of TNWs where the tributaries are `relatively permanent
waters" (RPWs) i e tributaries that typically flow year round or have continuous flow at least seasonally (e g typically 3
months) A wetland that directly abuts an RPW is also jurisdictional If the aquatic resource is not a TNW but has year round
(perennial) flow slop to Section III D 2 If the aquatic resource is a wetland directly abutting a tributary with perennial flow
slop to Section IILD 4
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation Corps districts and
EPA regions will include in the record any available-information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water even
though a significant nexus finding is not required as a matter of law
If the waterbody4 is not an RPW or a wetland directly abutting an RPW a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands This significant nexus evaluation that combines, for
analytical purposes the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary or its adjacent wetlands, or both If the JD covers a tributary with adjacent wetlands, complete Section III B 1 for
the tributary Section III.B 2 for any onsite wetlands and Section III B3 for all wetlands adjacent to that tributary both onsite
and offsite The determination whether a significant nexus exists is determined in Section III C below
1 Characteristics of non TNWs that flow directly or indirectly into TNW
(i) General Area Conditions
Watershed size Pick —List
Drainage area Pick List
Average annual rainfall inches
Average annual snowfall inches
(u) Physical Characteristics
(a) Relationship with TNW
❑ Tributary flows directly into TNW
❑ Tributary flows through Pick List tributaries before entering TNW
Project waters are Puk List river miles from TNW
Project waters are Pick List river m les from RPW
Project waters are Pick List aerial (straight) miles from TNW
Project waters are Pick List aerial (straight) miles from RPW
Project waters cross or serve as state boundaries Explain
Identify flow route to TNV
Tnbutary stream order if known
Note that the Instructional Guidebook contains additional information regarding swales ditches washes and erosional features generally and in the and
West.
5 Flow route can be descnbed by identifjnng e g tnbutary a which flows through the review area to flow into tributary b which then flows into TNW

(b) General Tnbutary Characteristics (check all that amply)
Tributary is ❑ Natural
❑ Artificial (man made) Explain
❑ Manipulated (man altered) Explain
Tributary properties with respect to top of bank (estimate)
Average width feet
Average depth feet _
Average side slopes Pick List
Piimary tributary substrate composition (check all that apply)
❑ Silts ❑ Sands ❑ Concrete
❑ Cobbles ❑ Gravel ❑ Muck
❑ Bedrock ❑ Vegetation Type //o cover
[I Other Explain
Tributary condition/stability [e g ]uglily eroding sloughing banks] Explain
Presence of nm/nflle /pool complexes Explain
Tributary geometry Pic-01 L si t
Tributary gradient (approximate average slope) %
(c) Flow
Tributary provides for Pick L si t
Estimate average number of flow events in review area/year Pick List
Describe flow regime
Other information on duration and volume
Surface flow is Pick ListList Characteristics
Subsurface flow Pick "' st Explain findings
❑ Dye (or other) test performed
Tributary has (check all that apply)
❑ Bed and banks
❑ OHW vf' (check all indicators that apply)
❑ clear natural line impressed on the bank
❑
the presence of litter and debris
❑ changes in the character of soil
❑
destruction of terrestrial vegetation
❑ shelving
❑
the presence of wrack line
❑ vegetation matted down bent or absent
❑
sediment sorting
❑ leaf litter disturbed or washed away
❑
scour
❑ sediment deposition
❑
multiple observed or predicted flow events
❑ water staining
❑
abrupt change in plant community
❑ other (list)
❑ Discontinuous OHWM 7 Explain
If factors other than the OHWM were used to determ
❑ high Tide Line indicated by ❑
❑ oil or scum line along shore objects
❑ fine shell or debris deposits (foreshore)
❑ physical markings / charactenstics
❑ tidal gauges
❑ other (list)
me lateral extent of CWA]unsdiction (check all that apply)
Mean High Water Mark indicated by
❑ survey to available datum,
❑ physical markings
❑ vegetation Imes/changes in vegetation types
(m) Chemical Characteristics
Characterize tributary (e g water color is clear discolored oily film, water quality general watershed characteristics etc)
Explain
Identify specific pollutants if known
6A natural or man made discontinuity in the OHWM does not necessanly severjunsdiction (e g where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices) Where there is a break in the OHWM that is unrelated to the waterbody s flow
regime (e g flow over a rock outcrop or through a culvert) the agencies will look for indicators of flow above and below the break_
'Ibid

(w) Biological Characteristics Channel supports (check all that apply)
❑ Riparian corridor Characteristics (type average width)
❑ Wetland fringe Characteristics
❑ Habitat for
❑ Federally Listed species Explain findings
❑ Fish/spawn areas Explain findings
❑ Other environmentally sensitive species Explain findings
❑ Aquatic/wildhfe diversity Explain findings
2 Characteristics of wetlands adjacent to non TNW that flow directly or indirectly into TNW
(t) Physical Characteristics
(a) General Wetland Characteristics
Properties
Wetland size acres
Wetland type Explain
Wetland quality Explain
Project wetlands cross or serve as state boundaries Explain
(b) General Flow Relationship with Non TNW
Flow is Pick List Explain
Surface flow is Pick Li t
Characteristics
Subsurface flow Pickfist Explain findings
❑ Dye (or other) test performed
(c) Wetland Adjacency Determination with Non TNW
❑ Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection Explain
❑ Ecological connection Explain
❑ Separated by berm(bamer Explain
(d) Proximity (Relationship) to TNW
Project wetlands are Pick List river miles from TNW
Project waters are Pick List aerial (straight) miles from TNW
Flow is from Pick List
Estimate approximate location of wetland as within the Pick Li t floodplain
(u) Chemical Characteristics
Characterize wetland system (e g water color is clear brown oil film on surface water quality general watershed
characteristics etc ) Explain
Identify specific-pollutants if known
(m) Biological Characteristics Wetland supports (check all that apply)
❑ Riparian buffer Charactenshcs (type average width)
❑ Vegetation type /percent cover Explain
❑ Habitat for
❑ Federally Listed species Explain findings
❑
Fish/spawn areas Explain findings
❑ Other environmentally sensitive species Explain findings
❑
Aquatic/wildlife diversity Explain findings
3 Characteristics of all wetlands adjacent to the tributary (►f any)
All wetland(s) being considered in the cumulative analysis Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis

For each wetland specify the following
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological chemical and physical functions being performed
C SIGNIFICANT NEXUS DETERMNATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW For each of the following situations, a significant nexus exists if the tributary in combination with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical physical and/or biological integrity of a TNW
Considerations when evaluating significant nexus include, but are not limited to the volume duration and frequency of the flow
of water in the tributary and its proximity to a TNW and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e g between a
tributary and its adjacent wetland or between a tributary and the TNW) Similarly the fact an adjacent wetland hes within or
outside of a floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include for example
• Does the tributary in combination with its adjacent wetlands (if any) have the capacity to carry pollutants or flood waters to
TNWs or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary in combination with its adjacent wetlands (if any) provide habitat and hfecycle support functions for fish and
other species such as feedmg nesting spawning or rearing young for species that are present in the TNW9
• Does the tributary in combination with its adjacent wetlands (if any) have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary in combination with its adjacent wetlands (if any) have other relationships to the physical chemical or
biological integrity of the TNW?
Note the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below
1 Significant nexus findings for non RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below based on the tributary itself then go to Section III D
Significant nexus findings for non RPW and its adjacent wetlands where the non RPW flows directly or indirectly into
TNWs Explain findings of presence or absence of significant nexus below based on the tributary in combination with all of its
adjacent wetlands then go to Section III D
Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW Explain findings of
presence or absence of significant nexus below based on the tributary in combination with all of its adjacent wetlands then go to
Section IILD
D DETERMINATIONS OF JURISDICTIONAL FINDINGS THE SUBJECT WATERS /WETLANDS ARE (CHECK ALL
THAT APPLY)
TNWs and Adjacent Wetlands. Check all that apply and provide size eGttiinates in review area
❑ TNWs linear feet width (ft) Or acres
Q Wetlands adjacent to TNWs acres
RPWs that flow directly or indirectly into TNWs.
® Tributaries of TNWs where tributaries typically flow year round are jurisdictional Provide data and rationale indicating that
tributary is perennial Foster Creek is shown on the USGS topographic map as perennial The unnamed tributaries appear to
have good flow The tributary of site 1 is a short slow moving floodplain stream-within 60 feet of the confluence with Foster
Creek The unnamed tributary at site 2 has a spring head at the culvert inlet and has had good flow during site visits
❑ Tributaries of TNW where tributaries have continuous flow seasonally' (e g typically three months each year) are
jurisdictional Data supporting this conclusion is provided at Section III B Provide rationale indicating that tributary flows
seasonally

Provide estimates for jurisdictional waters in the review area (check all that apply)
® Tributary waters 450 linear feet unnamed tributaries 1 (ft) width Foster Creek 6 width (ft)
❑ Other non wetland waters acres
Identify type(s) of waters
Non RPWss that flow directly or indirectly into TNWs
❑ Waterbody that is not a TNW or an RPW but flows directly or indirectly into a TNW and it has a significant nexus with a
TNW is jurisdictional Data supporting this conclusion is provided at Section III C
Provide estimates for jurisdictional waters within the review area (check all that apply)
❑ Tributary waters linear feet width (ft)
❑ Other non wetland waters acres
Identify type(s) of waters
Wetlands directly abutting an RPW that flow directly or mdirectly into TNWs.
❑ Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands
❑ Wetlands directly abutting an RPW where tributaries typically flow year round Provide data and rationale
indicating that tributary is perennial in Section III D 2 above Provide rationale indicating that wetland is
directly abutting an RPW
❑ Wetlands directly abutting an RPW where tributaries typically flow seasonally Provide data indicating that tributary is
seasonal in Section III B and rationale in Section III D 2 above Provide rationale indicating that wetland is directly
abutting an RPW
Provide acreage estimates for jurisdictional wetlands in the review area acres
Wetlands adjacent to but not directly abutting an RPW that flow directly or -indirectly -into TNWs.
❑ Wetlands that do not directly abut an RPW but when considered in combination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands have a significant nexus with a TNW are junsidictional Data supporting this
conclusion is provided at Section IMC
Provide acreage estimates for junsdictional wetlands in the review area acres
Wetlands adjacent to non RPWs that flow directly or indirectly into TNWs.
Wetlands adjacent to such waters and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands have a significant nexus with a TNW are jurisdictional Data supporting this
conclusion is provided at Section III C
Provide estimates for jurisdictional wetlands in the review area acres
Impoundments of jurisdictional waters 9
Asa general rule the impoundment of a junsdictional tnbutary remains jurisdictional
❑ Demonstrate that impoundment was created from waters of the U S or
❑ Demonstrate that water meets the criteria for one of the categories presented above (1-6) or
® Demonstrate that water is isolated with a nexus to commerce (see E below)
ISOLATED [INTERSTATE OR INTRA- STATE] WATERS, INCLUDING ISOLATED WETLANDS THE USE
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY) "
❑ which are or could be used by tnterstate or foreign travelers for recreational or other purposes
❑ from which fish or shellfish are or could be taken and sold in interstate or foreign commerce
[] which are or could be used for industrial purposes by industries in interstate commerce
R Interstate isolated waters Explain
❑ Other factors Explain
'See Footnote # 3
s To complete the analysis refer to the key in Section III D 6 of the Instructional Guidebook.
10 Prior to asserting or declining CWA jurisdiction based solely on this category Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos

Identify water body and summarize rationale supporting determination
Provide estimates for Junsdictional waters in the revieNA area (check all that apply)
❑ Tributary waters linear feet width (ft)
❑ Other non wetland waters acres
Identify type(s) of waters
❑ Wetlands acres
NON4URISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY)
❑ If potential wetlands were assessed within the review area these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements
❑ Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce
❑ Prior to the Jan 2001 Supreme Court decision in SWANCC the review area would have been regulated based solel on the
Migratory Bind Rule (MBR)
❑ Waters do not meet the Significant Nexus standard where such a finding is required for Jurisdiction Explain
Other (explain, if not covered above)
Provide acreage estimates for non Junsdictional waters in the review area, where the sole potential basis of Junsdiction is the MBR
factors (i a presence of migratory buds presence of endangered species use of water for irrigated agriculture) using best professional
Judgment (check all that apply)
El Non wetland waters (i a rivers streams) linear feet width (ft)
❑ Lakes/ponds acres
❑ Other non wetland waters acres List type of aquatic resource
❑ Wetlands acres
Provide acreage estimates for non Jurisdictional waters in the review area that do not meet the Sigmficant Nexus standard, where such
a finding is required for Jurisdiction (check all that apply)
❑ Non wetland waters (i a nvers, streams) linear feet width (ft)
❑ Lakes/ponds acres
El Other non wetland waters acres List type of aquatic resource
❑ Wetlands acres
SECTION IV DATA SOURCES
A SUPPORTING DATA Data reviewed for JD (check all that apply checked items shall be included in case file and, where checked
and requested appropriately reference sources below)
® Maps plans plots or plat submitted by or on behalf of the applicant/consultant
❑ Data sheets prepared/submntted by or on behalf of the applicant/consultant
❑ Office concurs with data sheets/delmeatnon report
❑ Office does not concur with data sheets/delineation report
❑ Data sheets prepared by the Corps
❑ Corps navigable waters study
❑ U S Geological Survey Hydrologic Atlas
❑ USGS NHD data
❑ USGS 8 and 12 dtgnt HUC maps
❑ U S Geological Survey map(s) Cite scale & quad name
❑ USDA Natural Resources Conservation Service Soil Survey Citation
❑ National wetlands inventory map(s) Cite name
❑ State/Local wetland inventory map(s)
❑ FEMA/FIRM maps
❑ 100 year Floodplain Elevation is (National Geodectnc Vertical Datum of 1929)
® Photographs ❑ Aerial (Name & Date)
or ® Other (Name & Date) Culvert Site Jan. 2012
❑ Previous determmation(s) File no and date of response letter
❑ Applicable / supportmg case law
❑ Applicable /supporting scientific literature
❑ Other information (please specify)
13 ADDITIONAL COMMENTS TO SUPPORT JD

i 7
OF
Pre - Construction Notification (PCN) Application Form
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
SR 1347 Foster Creek Road
Henderson County
OQ µOaiH C4Q�'!
y�
0 2
99r�FNT OF TS ANSQO�c
NCDOT Division 14

oaoF w A
rF9oc
r
Office Use Only
Corps action ID no
DWQ project no
Form Version 1 3 Dec 10 2008
Page I of 11
PCN Form — Version 1 3 December 10 2008 Version
Pre - Construction Notification PCN Form
A Appheant Information
1
Processing
1a
Type(s) of approval sought from the
Corps
® Section 404 Perm it ❑ Section 10 Permit
1b Specify Nationwide Permit (NWP) number NW 14 or General Permit (GP) number
1 c
Has the NW P or GP number been verified by the Corps?
❑ Yes
® No
1d
Type(s) of approval sought from the DWQ (check all that apply)
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1e
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification
❑ Yes ® No
For the record only for Corps Permit
❑ Yes ® No
1f
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so attach the acceptance letter from mitigation bank or in -lieu
fee program
❑ Yes
❑ No
1 g
Is the project located in any of NC s twenty coastal counties If yes answer 1 h
below
❑ Yes
® No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2
Project Information
2a
Name of project
SR 1347 Foster Creek Road
2b
County
Henderson
2c
Nearest municipality / town
Mills River
2d
Subdivision name
N/A
2e
NCDOT only T I P or state
project no
14C 045146
3
Owner Information
3a
Name(s) on Recorded Deed
North Carolina Department of Transportation
3b
Deed Book and Page No
N/A
3c
Responsible Party (for LLC if
applicable)
N/A
3d
Street address
N/A
3e
City state zip
N/A
3f
Telephone no
N/A
3g
Fax no
N/A
3h
Email address
N/A
Page I of 11
PCN Form — Version 1 3 December 10 2008 Version

4
Applicant Information (if different from owner)
4a
Applicant is
❑ Agent ® Other specify District Engineer
0
Name
Steven L Cannon
4c
Business name
(if applicable)
North Carolina Department of Transportation
4d
Street address
4142 Haywood Road
4e
City state zip
Mills River NC 28759
4f
Telephone no
828 891 7911
4g
Fax no
828 891 5026
4h
Email address
slcannon @ncdot gov
5
Agent/Consultant Information (if applicable)
5a
Name
N/A
5b
Business name
(if applicable)
N/A
5c
Street address
N/A
5d
City state zip
N/A
5e
Telephone no
N/A
5f
Fax no
N/A
5g
Email address
N/A
Page 2 of 11
PCN Form — Version 1 3 December 10 2008 Version

B Project Information and Prior Project History
1 Property Identification
la Property identification no (tax PIN or parcel ID)
N/A
lb Site coordinates (in decimal degrees) Approximate Project
Latitude 35 40724 Longitude 8259845
Center
(DD DDDDDD) ( DD DDDDDD)
1 c Property size
N/A acres
2 Surface Waters
2a Name of nearest body of water (stream river etc) to
Foster Creek
proposed project
2b Water Quality Classification of nearest receiving water
WS II Tr HQW
2c River basin
French Broad River
3 Project Description
3a Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application
Landscape is mostly deciduous forest and open grassed areas Area is rural with limited single family residences
3b List the total estimated acreage of all existing wetlands on the property
N/A
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
N/A
3d Explain the purpose of the proposed project
To upgrade the existing gravel road to current NCDOT secondary road standards
3e Describe the overall project in detail including the type of equipment to be used
Widen grade dram and pave The area will be cleared and grubbed Culverts will be replaced /extended with the water
diverted around the site during installation The road bed will be graded and fill material added as needed The road will
be paved Track hoes dump trucks bulldozers water pumps diversion pipe various hand tools will be used to
accomplish the work
4 Jurisdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
❑ Yes ® No ❑ Unknown
project (including all prior phases) in the past?
Comments N/A
4b If the Corps made the jurisdictional determination what type
❑ Preliminary ❑ Final
of determination was made?
4c If yes who delineated the jurisdictional areas?
Agency /Consultant Company N/A
Name (if known) N/A
Other N/A
4d If yes list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
N/A
5 Project History
5a Have permits or certifications been requested or obtained foTE]Yes
® No ❑ Unknown
this project (including all prior phases) in the past?
5b If yes explain in detail according to help file instructions
N/A
Page 3 of 11
PCN Form — Version 1 3 December 10 2008 Version

6 Future Project Plans
6a Is this a phased project? ❑ Yes ® No
6b If yes explain
N/A
Page 4 of 11
PCN Form — Version 1 3 December 10 2008 Version

C Proposed Impacts Inventory
1 Impacts Summary
la Which sections were completed below for your project (check all that apply)
❑ Wetlands ® Streams tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2 Wetland Impacts
If there are wetland impacts proposed on the site then complete this question for each wetland area impacted
2a
2b
2c
2d
2e
2f
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps 404 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404 other)
(acres)
Temporary T
W1 ❑ P ❑ T
N/A
N/A
❑ Yes
El No
❑ Corps
[I DWQ
N/A
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ PEI T
El Yes
El Corps
❑ No
❑ DWQ
W6 ❑ P [IT
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g Total wetland impacts
N/A
2h Comments N/A
3 Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site then complete this
question for all stream sites impacted
3a
3b
3c
3d
3e
3f
3g
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number
(PER) or
(Corps 404 10
stream
length
Permanent P
( ) or
intermittent
DWQ —non -404
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ®P ❑ T
Culvert
UT to Foster
® PER
® Corps
1
15
Creek
[I INT
® DWQ
S1A ❑ P ®T
Flow Diversion
UT to Foster
® PER
® Corps
1
65
Creek
❑ INT
® DWQ
S2 ® P ❑ T
Culvert
UT to Foster
® PER
® Corps
1
15
Creek
❑ INT
® DWQ
S2A ❑ P ® T
Flow Diversion
UT to Foster
® PER
® Corps
1
65
Creek
❑ INT
® DWQ
S3 ® P ❑ T
Culvert
Foster Creek
® PER
❑ INT
® Corps
® DWQ
6
15
SM ❑ P ® T
Flow Diversion
Foster Creek
® PER
❑ INT
® Corps
® DWQ
6
65
3h Total stream and tributary impacts
15
31 Comments Total Temporary Impact for Impervious Dikes and Flow Diversion is 195 feet
Page 5 of 11
PCN Form — Version 1 3 December 10 2008 Version

4 Open Water Impacts
If there are proposed impacts to lakes ponds estuaries tributaries sounds the Atlantic Ocean or any other open water of
the U S then individually list all open water impacts below
4a
4b
4c
4d
4e
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑ P ❑ T
N/A
N/A
N/A
N/A
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
N/A
4g Comments N/A
5 Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below
5a
5b
5c
5d
5e
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
P2
5f Total
N/A
N/A
N/A
N/A
N/A
N/A
N/A
5g Comments N/A
5h Is a dam high hazard permit required?
❑ Yes ❑ No If yes permit ID no N/A
51 Expected pond surface area (acres)
N/A
5j Size of pond watershed (acres)
N/A
5k Method of construction
N/A
6 Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer then complete the chart below If yes then individually list all buffer impacts
below If any impacts require mitigation then you MUST fill out Section D of this form
6a
❑ Neuse ❑ Tar Pamlico ❑ Other
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
B1 ❑ P ❑ T
N/A
-required
N/A
Nos
N/A
N/A
B2 ❑P ❑T
es
B3 ❑P ❑T
7E]No
es
o
6h Total buffer impacts
N/A
NIA
61 Comments N/A
Page 6 of 11
PCN Form — Version 1 3 December 10 2008 Version

D Impact Justification and Mitigation
1 Avoidance and Minimization
1 a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
The culverts are being extended in length only to provide the sufficient width needed to bring this road up to current secondary
road standards The undersized round pipe at Foster Creek site will be replaced with a larger arched pipe to reduce potential
for overwidening channel at outlet
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Impervious dikes will be installed in the channel to minimize the water flowing into the work area Then water will be diverted
around the site during pipe installation to limit downstream habitat and water quality degradation Appropriate BMPs
according to the approved erosion and sedimentation control plan will be installed on the project prior to culvert installation
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?
❑ Yes ❑ No
2b If yes mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
2c If yes which mitigation option will be used for this
project?
❑ Mitigation bank
❑Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank N/A
3b Credits Purchased (attach receipt and letter)
Type N/A
Quantity N/A
3c Comments WA
4 Complete if Making a Payment to In lieu Fee Program
4a Approval letter from in -lieu fee program is attached
❑ Yes
4b Stream mitigation requested
4c If using stream mitigation stream temperature
❑ warm ❑ cool ®cold
4d Buffer mitigation requested (DWQ only)
N/A square feet
4e Riparian wetland mitigation requested
N/A acres
4f Non - riparian wetland mitigation requested
N/A acres
4g Coastal (tidal) wetland mitigation requested
N/A acres
4h Comments N/A
5 Complete if Using a Permittee Responsible Mitigation Plan
5a If using a permittee responsible mitigation plan provide a description of the proposed mitigation plan
N/A
Page 7 of 11
PCN Form — Version 1 3 December 10 2008 Version

6 Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires
❑ Yes ® No
buffer mitigation?
6b If yes then identify the square feet of impact to each zone of the riparian buffer that requires mitigation Calculate the
amount of mitigation required
6c
6d
6e
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
N/A
N/A
3 (2 for Catawba)
N/A
Zone 2
15
6f Total buffer mitigation required
N/A
6g If buffer mitigation is required discuss what type of mitigation is proposed (e g payment to private mitigation bank
permdtee responsible riparian buffer restoration payment into an approved in lieu fee fund)
N/A
6h Comments N/A
Page 8 of 11
PCN Form — Version 1 3 December 10 2008 Version

E Stormwater Management and Diffuse Flow Plan (required by DWQ)
1 Diffuse Flow Plan
1a Does the project include or is it adjacent to protected riparian buffers identified
El Yes No
within one of the NC Riparian Buffer Protection Rules
1 b If yes then is a diffuse flow plan included*7 If no explain why
❑ Yes No
❑
Comments N/A
2 Stormwater Management Plan
2a What is the overall percent imperviousness of this project?
N/A %
2b Does this project require a Stormwater Management Plan
® Yes ❑ No
2c If this project DOES NOT require a Stormwater Management Plan explain why N/A
2d If this project DOES require a Stormwater Management Plan then provide a brief narrative description of the plan
Project is covered by individual NPDES Permit NCS000250
❑ Certified Local Government
2e Who will be responsible for the review of the Stormwater Management Plan
® DWQ Stormwater Program
❑ DWQ 401 Unit
3 Certified Local Government Stormwater Review
3a In which local government s jurisdiction is this project?
N/A
❑ Phase II
3b Which of the following locally implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
❑ Other
3c Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4 DWQ Stormwater Program Review
❑ Coastal counties
4a Which of the following state implemented stormwater management programs apply
❑ HQW
❑ ORW
(check all that apply)
❑ Session Law 2006 -246
❑ Other
4b Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
5 DWQ 401 Unit Stormwater Review
5a Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 9 of 11
PCN Form — Version 1 3 December 10 2008 Version

F Supplementary Information
1 Environmental Documentation (DWQ Requirement)
1a Does the project involve an expenditure of public (federal/state /local) funds or the
® Yes ❑ No
use of public (federal/state) land?
1 b If you answered yes to the above does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c If you answered yes to the above has the document review been finalized by the
State Clearing House? (If so attach a copy of the NEPA or SEPA final approval
letter)
❑ Yes ❑ No
Comments N/A
2 Violations (DWQ Requirement)
2a Is the site in violation of DWQ Wetland Rules (15A NCAC 2H 0500) Isolated
Wetland Rules (15A NCAC 2H 1300) DWQ Surface Water or Wetland Standards
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b Is this an after the fact permit application?
❑ Yes ® No
2c If you answered yes to one or both of the above questions provide an explanation of the violation(s) N/A
3 Cumulative Impacts IDWQ Requirement)
3a Will this project (based on past and reasonably anticipated future impacts) result in
Yes No
additional development which could impact nearby downstream water quality?
3b If you answered yes to the above submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy If you answered no provide a short narrative description
This project involves the widening and paving of an existing secondary dead -end gravel road to current secondary road
standards The existing road is of good quality and would not be expected to limit residential development therefore
access to this area does not appear to be the limiting factor for development of this rural area The pave road is not
expected to be a significant contributor to secondary development and cumulative impact
4 Sewage Disposal (DWQ Requirement)
4a Clearly detail the ultimate treatment methods and disposition (non discharge or discharge) of wastewater generated from
the proposed project or available capacity of the subject facility
N/A
Page 10 of 11
PCN Form — Version 1 3 December 10 2008 Version

5 Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this project occur in or near an area wdh federally protected species or
❑ yes 0 N
habitat
5b Have you checked with the USFWS concerning Endangered Species Act
❑Yes ®No
impacts?
5c If yes indicate the USFWS Field Office you have contacted
❑ Raleigh
❑ Asheville
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program Database
6 Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitats
❑ Yes ® No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
N/A —There are no marine or estuarine habitats in the Blue Ridge Physiographic Province
7 Historic or Prehistoric Cultural Resources (Corps Requirement)
7a Will this project occur in or near an area that the state federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e g National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
The project has been submitted to the NCDOT Human Environment for Screening for arcaeology and historical
structures An archaeological survey is pending for this project
8 Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA- designated 100 year floodplain?
❑ Yes ® No
8b If yes explain how project meets FEMA requirements N/A
8c What source(s) did you use to make the floodplain determination? NC Floodplain Mapping Program
Steven L Cannon P E
20 Apnl 2012
Applicant/Agent s Printed Name
Applicant/Agent s Signature
Date
(Agents signature is valid only if an authorization letter from the applicant
is provided
Page 11 of 11
PCN Form — Version 1 3 December 10 2008 Version

#1 Sta 6 +54
1347 Foster Creek Rd
iderson County
Existing & Prop Center Line
40301 °N 82
1 ---------------- - - 2
--------------- - - - - -- - -..
Inlet Invert Elev Replace Existing Perched Oulet Invert Elev
9975 30x18 CMP with 50x18 CMP 9956
Thalwegs Approximately 20 from shoulder of existing road
1 9981
2 9972 Outlet is heavily silted
See plans for erosion control ' Drawing not to scale
Site # 2 Sta 41 +25 Coordinates 35 410110 N / 82 602030 W
SR 1347
Foster Creek Road
Henderson County
2
Existing & Prop Center Line
------------------------------------------
1
Oulet Invert Elev Replace Existing Inlet Invert Elev
9938 25x18 CMP 9947
with 40x18 CMP
)gs Approximately 20 from shoulder of existing road
1 9953
2 9936
See plans for erosion control * Drawing not to scale

Site # 3 Sta 47 +58 Coordinates 35 41060 N / 82 60400 W
SR 1347
Foster Creek Road
Henderson County
Existing & Prop Center Line
2 1
Oulet Invert Elev Replace Existing Inlet Invert Elev
9940 25x42 CMP 9947
with 40x60 CMP
Thalwegs Approximately 20 from shoulder of existing road
1 9953
2 9937

SR 1347 Foster Creek Road NW 14
Site 1 Inlet 35 40309 °N 8259475 0W Station 06 +57
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Site 3 Outlet

N C DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
SECONDARY ROAD SURVEY
SUBJECT SR 1347 Foster Creek Road
LOCATION Begin at the end of pavement on SR 1345 and SR 1347 and continue
in a northerly direction for a total distance of 5 327 feet to the end of project
WORK TYPE Grade, Drain, Base, Pave & Erosion Control
WORK ORDER 14C 045068 (Temp)
COUNTY Henderson TOWNSHIP Mills River
DATE 8/4/2011 (Revised 412512012) SCALE I"=50'
Current ADT Bracket 0 -360 Design ADT Bracket 0 -600
Water Foster Creek (Class WS -II, Tr, HQW)
NOTES 50' R/W EC PREPARED BY BA/BT
50' 0"
RIGHT OF WAY
CENTERLINE
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6' 10' 10' 4' L 3'
ASPHALT PAVEMENT
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