20120535 Ver 1_Application_20120504

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STATE OF NORTH CAROLINA -"" ale
DEPARTMENT OF TRANSPORTATION °ST %441 ry
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BEVERLY EAVES PERDUE EUGENE A Co #'I JR
GOVERNOR SECRETARY
May 24, 2012
U S Army Corps of Engineers
Regulatory Field Office
69 Darlington Avenue
Wilmington NC 28402 1890
ATTN Mr Ronnie Smith
NCDOT Coordinator
r,- 0 5
2 0 Z) �J
Subject Application for Section 404 Nationwide Permits 23 and Section 401
Water Quality Certification for the proposed replacement of Bridge No 47
over the Lumber River on US 401 in Scotland and Hoke Counties Federal
Aid Project No BRNHS- 401(14) Division 8, TIP No B 4273
$240 00 debit WBS 33614 1 1
Dear Madam
The North Carolina Department of Transportation ( NCDOT) proposes to replace Bridge No
47 over the Lumber River on US 401 with a bridge The current structure is a six span
bridge approximately 240 feet in length The replacement structure will be a four -span
bridge approximately 260 feet in length An on -site detour will be used to control traffic
during construction There will be a total of 101 acres of permanent impact to wetlands for
the project The 10 1 acres of permanent impact to riparian wetlands are due to the
construction of the new bridge There will be 0 65 acres of temporary wetland impacts due
to fill for the on -site detour and use of a work bridge An additional 0 26 acres of impact
will occur due to hand clearing of wetlands in the vicinity of the temporary detour
Please see enclosed copies of the Pre Construction Notification (PCN), NCEEP acceptance
letter, jurisdictional determination forms, stormwater management plan, permit drawings
and design plans for the above mentioned project The Categorical Exclusion (CE) was
completed In January 2007 Copies were distributed shortly thereafter Additional copies are
available upon request
MAILING ADDRESS
NC DEPARTMENT OF TRANSPORTATION
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS
1598 MAIL SERVICE CENTER
RALEIGH NC 27699 1598
TELEPHONE [phone]
FAX [phone]
WEBSITE WWW NCDOT ORG
LOCATION
1020 BIRCH RIDGE DRIVE
RALEIGH NC 27610 -4328
�\l

This project calls for a letting date of November 20, 2012 and a review date of October 2
2012 however the let date may advance as additional funding becomes available
A copy of this permit application and its distribution list will be posted on the NCDOT
website at http / /www ncdot org /doh/preconstruct/pe /neu/permit html If you have any
questions or need additional information please call Jason Dilday at [phone]
Sincerely,
Gregory J Thorpe, PhD , Manager
Project Development and Environmental Analysis Branch
The "cc" List
NCDOT Permit Application Standard Distribution List
E

o�0F W A rF9o�
y
Office Use Only
Corps action ID no
DWQ project no
Form Version 1 3 Dec 10 2008
Pre - Construction Notification (PCN) Form
A
Applicant Information
1
Processing
la
Type(s) of approval sought from the
Corps
®Section 404 Permit E] Section 10 Permit
lb Specify Nationwide Permit (NWP) number 23 or General Permit (GP) number
1c
Has the NWP or GP number been verified by the Corps?
® Yes
❑ No
ld
Type(s) of approval sought from the DWQ (check all that apply)
0 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
le
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
1g
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
Replacement of Bridge 47 over the Lumber River on US 401
2b
County
Scotland /Hoke
2c
Nearest municipality / town
Wagram
2d
Subdivision name
not applicable
2e
NCDOT only T I P or state
project no
8-4273
3
Owner Information
3a
Name(s) on Recorded Deed
North Carolina Department of Transportation
3b
Deed Book and Page No
not applicable
3c
Responsible Party (for LLC if
applicable)
not applicable
3d
Street address
1598 Mail Service Center
3e
City state zip
Raleigh NC 27699 1598
3f
Telephone no
[phone]
3g
Fax no
[phone]
3h
Email address
lldilday @ncdot gov

4 Applicant Information (if different from owner)
4a Applicant is
❑ Agent ❑ Other specify
4b Name
not applicable
4c Business name
(if applicable)
4d Street address
4e City state zip
4f Telephone no
4g Fax no
4h Email address
5 Agent/Consultant Information (if applicable)
5a Name
not applicable
5b Business name
(if applicable)
5c Street address
5d City state zip
5e Telephone no
5f Fax no
5g Email address

B Project Information and Prior Project History
1 Property Identification
la Property identification no (tax PIN or parcel ID)
not applicable
1 b Site coordinates (in decimal degrees)
Latitude 34 900180 Longitude 79 349092
(DD DDDDDD) ( DD DDDDDD)
1 c Property size
10 0 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
Lumber River
proposed project
2b Water Quality Classification of nearest receiving water
WS IV B Sw HQW
2c River basin
Lumber
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
US 401 is a major highway route serving overweight traffic Land use within the project vicinity consists of forested
wetlands Also included is the vicinity is are lands owned by NC Parks and Recreation and a NC Wildlife Resource
Commission boat ramp
3b List the total estimated acreage of all existing wetlands on the property
8
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
200
3d Explain the purpose of the proposed project
To replace a structurally deficient and functionally obsolete bridge
3e Describe the overall project in detail including the type of equipment to be used
The project involves replacing a six span 240 foot bridge with a four span 260 foot bridge on the existing alignment with
an on site detour Standard road budding equipment such as trucks dozers and cranes will be used
4 Jurisdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property
/ project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
Comments A final JD is anticipated to be issued at
permitting
4b If the Corps made the jurisdictional determination what
Preliminary ina
❑ Prelim Final
type of determination was made?
4c If yes who delineated the jurisdictional areas?
Agency /Consultant Company
Name (if known)
Other
4d If yes list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
5 Project History
5a Have permits or certifications been requested or obtained
❑Yes ®No El Unknown
for this project (including all prior phases) in the past?
5b If yes explain in detail according to help file instructions
6 Future Project Plans
6a Is this a phased project?
❑ Yes ® No
6b If yes explain

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
Site 1 ® P ❑ T
Proposed
Rivenne Swamp
® Yes
® Corps
064
bridge /Fill
Forest
❑ No
❑ DWQ
Site 1 ® P ❑ T
Proposed
bridge /Mech
Rivenne Swamp
Forest
® Yes
❑ No
® Corps
❑ DWQ
037
Clearing
Site 1 ❑ P ® T
Detour/Temp
Rivenne Swamp
® Yes
® Corps
0 50
Fill
Forest
❑ No
❑ DWQ
Site 1 ❑ P ® T
Work
Bndge/Temp
Rivenne Swamp
Forest
® Yes
❑ No
® Corps
❑ DWQ
015
Fill
❑ Yes
❑ Corps
Site 1 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
Site 1 ❑ P ❑ T
❑ No
❑ DWQ
1 01 ac
2g Total wetland impacts
Permanent
0 65 ac
Temporary
2h Comments 0 26 acres of wetland impact will occur due to hand clearing in the vicinity of the on site detour
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
Average
Impact length
number
(PER) or
jurisdiction
stream
(linear feet)
Permanent (P) or
intermittent
(Corps 404 10
width
Temporary (T)
(INT)?
DWQ — non 404
(feet)
other)
Site 1 ® P ❑ T
Bridge bents
® PER
❑ INT
❑ Corps
❑ DWQ
<0 01 ac
❑ PER
❑ Corps
Site 2 ❑ P ❑ T
❑ INT
❑ DWQ
❑ PER
❑ Corps
Site 3 ❑ P ❑ T
❑ INT
❑ DWQ
❑ PER
❑ Corps
Site 4 ❑ P ❑ T
❑ INT
❑ DWQ
Site 5 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
❑ PER
❑ Corps
Site 6 ❑ P ❑ T
❑ INT
❑ DWQ

<0 01 ac
3h Total stream and tributary impacts
Permanent
31 Comments Bent 1 impact =8 4 sq ft Bent 2 impact =11 2 sq ft Bent 3 1mpact =11 2 sq ft Total impact =30 8 sq ft
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 indi idually list all open water impacts below
4a
4b
4c
4d
4e
Open water
Name of
impact number —
waterbody
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P)
(if applicable)
or Temporary
T
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
0 Total open water impacts
0 Permanent
0 Temporary
4g Comments
5 Pond or Lake Construction
If pond or lake construction propose d then complete the chart below
5a
5b
5c
5d
5e
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or
(acres)
number
purpose of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes permit ID no
51 Expected pond surface area (acres)
5j Size of pond watershed (acres)
5k Method of construction

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 El Tar Pamlico El Other
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
will occur to the Lumber River In areas where temporary fill will occur in wetlands fiber coir matting will be placed
between wetland materials and fill materials After construction fill material and fiber coir matting will be removed
1 b
number —
Reason for impact
NCDOT Best Management Practices for Bridge Demolition and Removal will be implemented during the removal of the
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
2
Stream name
mitigation
(square feet)
(square feet)
Temporary
impacts to Waters of the U S or Waters of the State?
If no explain
required?
If yes mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
❑ Mitigation bank
El Yes
If yes which mitigation option will be used for this
® Payment to in lieu fee program
B1 ❑P ❑T
project?
❑ No
❑ Permittee Responsible Mitigation
El Yes
B2 ❑ PEI T
❑ No
❑Yes
B3 ❑P ❑T
❑ No
6h Total buffer impacts
61 Comments
D
Impact Justification and Mitigation
1
Avoidance and Minimization
1a
Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
The proposed bridge replaces a 6 span bridge with a 4 span bridge meaning less bents in the water The bridge will be
replaced at its existing location The bridge will be replaced at approximately the same grade and footprint as the original
bridge Replacement of the bridge will use a temporary work bridge Design was modified to minimize impact to NC
Department of Parks and Recreation land and the NCWRC boat ramp No impacts causing loss of Waters of the US
will occur to the Lumber River In areas where temporary fill will occur in wetlands fiber coir matting will be placed
between wetland materials and fill materials After construction fill material and fiber coir matting will be removed
1 b
Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
NCDOT Best Management Practices for Bridge Demolition and Removal will be implemented during the removal of the
existing bridge Best Management Practices for the Protection of Surface Waters will be employed Design Standards in
Sensitive Watersheds will be employed
2
Compensatory Mitigation for Impacts to Waters of the U S or Waters of the State
2a
Does the project require Compensatory Mitigation for
® Yes ❑ No
impacts to Waters of the U S or Waters of the State?
If no explain
2b
If yes mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
❑ Mitigation bank
2c
If yes which mitigation option will be used for this
® Payment to in lieu fee program
project?
❑ Permittee Responsible Mitigation

3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank not applicable
3b Credits Purchased (attach receipt and letter)
Type
Quantity
3c Comments
4 Complete if Making a Payment to In lieu Fee Program
4a Approval letter from in lieu fee program is attached
® Yes
4b Stream mitigation requested
0 linear feet
4c If using stream mitigation stream temperature
❑ warm ❑ cool ❑cold
4d Buffer mitigation requested (DWQ only)
square feet
4e Riparian wetland mitigation requested
2 02 acres
4f Non riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments
5 Complete if Using a Permittee Responsible Mitigation Plan
5a If using a permittee responsible mitigation plan provide a description of the proposed mitigation plan
6 Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ® No
6b If yes then identify the square feet of impact to each zone of the riparian buffer that requires mitigation Calculate the
amount of mitigation required
Zone
6c
Reason for impact
6d
Total impact
(square feet)
Multiplier
6e
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1 5
6f Total buffer mitigation required
0
6g If buffer mitigation is required discuss what type of mitigation is proposed (e g payment to private mitigation bank
permittee responsible riparian buffer restoration payment into an approved in lieu fee fund)
6h Comments

E
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1
Diffuse Flow Plan
la
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
lb
if yes then is a diffuse flow plan included? If no explain why
® Yes ❑ No
Comments See attached permit drawings
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
2d
If this project DOES require a Stormwater Management Plan then provide a brief narrative
description of the plan
See attached permit drawings
❑ 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?
not applicable
❑ Phase II
❑ NSW
3b
Which of the following locally implemented stormwater management programs
❑ 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
(check all that apply)
❑ ORW
❑ Session Law 2006 246
❑ Other
4b Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
5
DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No NA
5b Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No NA

F Supplementary Information
1 Environmental Documentation (DWQ Requirement)
la Does the project involve an expenditure of public (federal /state /local) funds or the
® Yes ❑ No
use of public (federal /state) land?
lb If you answered yes to the above does the project require preparation of an
environmental document pursuant to the requirements of the National or State
® Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c If you answered yes to the above has the document review been finalized by the
State Clearing House? (If so attach a copy of the NEPA or SEPA final approval
letter)
® Yes ❑ No
Comments
2 Violations (DWQ Requirement)
2a Is the site in violation of DWQ Wetland Rules (15A NCAC 2H 0500) Isolated
Wetland Rules (15A NCAC 2H 1300) DWQ Surface Water or Wetland Standards
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b Is this an after the fact permit application?
❑ Yes ® No
2c If you answered yes to one or both of the above questions provide an explanation of the violation(s)
3 Cumulative Impacts (DWQ Requirement)
3a Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
additional development which could impact nearby downstream water quality?
® No
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
Due to the minimal transportation impact resulting from this bridge replacement this project will neither influence nearby
land uses nor stimulate growth Therefore a detailed indirect or cumulative effects study will not be necessary
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
not applicable

5
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a
Will this project occur in or near an area with federally protected species or
® Yes ❑ No
habitat?
5b
Have you checked with the USFWS concerning Endangered Species Act
® Yes ❑ No
impacts?
® Raleigh
5c
If yes Indicate the USFWS Field Office you have contacted
❑ Asheville
5d
What data sources did you use to determine whether your site would Impact Endangered Species or Designated Critical
Habitat?
N C Natural Heritage Heritage Program database USFWS Raleigh Field Office website biological surveys for protected
species listed for Scotland /Hoke Counties which include American alligator red cockaded woodpecker Michaux s
sumac Saint Francis satyr rough leaved loosestrife Canby s dropwort and American chaffseed All species received a
Biological Conclusion of No Effect No habitat is present in the study area for Saint Francis satyr rough leaved
loosestrife American chaffseed or red cockaded woodpecker Habitat is present for Michaux s sumac and Canby s
dropwort but surveys conducted of the study area resulted in no specimens being found American alligator does not
require surveys
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?
NMFS County Index
7
Historic or Prehistoric Cultural Resources (Corps Requirement)
7a
WIII 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?
NEPA Documentation
8
Flood Zone Designation (Corps Requirement)
8a WIII this project occur in a FEMA designated 100 year floodplain?
® Yes ❑ No
8b
If yes explain how project meets FEMA requirements NCDOT Hydraulics Unit coordination with FEMA
8c What source(s) did you use to make the floodplain determination? FEMA Maps
Dr Grego1y f Thorpe, Ph D
A plic t/Agent s Signature
Date
Applicant/Agent s Printed Name
(Agents signature is valid only if an authorization letter from the applicant
is provided
10

r4d�ji
Eco�ystem
PROGRAM
May 3 2012
Mr Gregory J Thorpe PhD
Manager Project Development and Environmental Analysis Unit
North Carolina Department of Transportation
1548 Mail Service Center
Raleigh North Carolina 27699 1548
Dear Dr Thorpe
Subject EEP Mitigation Acceptance Letter
B 4273, Replace Bridge Number 47 over the Lumber River on US 401 Scotland County
The purpose of this letter is to notify you that the Ecosystem Enhancement Program (EEP) will provide the
compensatory riparian wetland mitigation for the subject project Based on the information supplied by you on
April 26 2012 the impacts are located in CU 03040203 of the Lumber River basin in the Southern Inner Coastal
Plain (SICP) Eco Region and are as follows
Lumber
Stream
Wetlands
Buffer (Sq Ft )
03040203
Cold
Cl
oop
Warm
Riparian
Non
Coastal
Zone 1
Zone 2
SICP
Riparian
Marsh
Impacts
0
0
0
101
0
0
0
0
feet /acres
EEP commits to implementing sufficient compensatory riparian wetland mitigation credits to offset the
impacts associated with this project as determined by the regulatory agencies in accordance with the N C
Department of Environment and Natural Resources Ecosystem Enhancement Program In Lieu Fee Instrument
dated July 28 2010 If the above referenced Impact amounts are revised then this mitigation acceptance letter will
no longer be valid and a new mitigation acceptance letter will be required from EEP
1929
If you have any questions or need additional information please contact Ms Beth Harmon at 919 715
Sincerely
MI Ellison
EEP Deputy Director
cc Mr Ronnie Smith USACE — Wilmington Regulatory Field Office
Mr Brian Wrenn Division of Water Quality Wetlands /401 Unit
File B 4273
R."-tortAg Protie" ow J-tA&
� I
NCDETdR
North Carolina Ecosystem Enhancement Program 1652 Mall Service Center Raleigh NC 27699 1652 / 919 715 0476 / www nceep net

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 B4273 (Bridge No 47 over Lumber River on US 401)
C PROJECT LOCATION AND BACKGROUND INFORMATION
State NC County/pansh/borough Scotland/Hoke City Wagram
Center coordinates of site (]at/long in degree decimal format) Lat 34 900180 LI Long 79 349092 W
Universal Transverse Mercator
Name of nearest waterbody Lumber River
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows Lumber River
Name of watershed or Hydrologic Unit Code (HUC) 03040203
® Check if map /diagram of review area and/or potential jurisdictional areas is/are available upon request
E] Check if other sites (e g offsite mitigation sites disposal sites etc ) are associated with this action and are recorded on a
different JD form
D REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY)
Office (Desk) Determination Date
Field Determination Date(s)
SECTION II SUMMARY OF FINDINGS
A RHA SECTION 10 DETERMINATION OF JURISDICTION
There flip' , at o bee o navigable waters of the US within Rivers and Harbors Act (RHA) Jurisdiction (as defined by 33 CFR part 329) in
the review area [Required]
E] 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 ON waters of the US within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area [Required]
1 Waters of the U S
a Indicate presence of waters of U S in review area (check all that apply) i
® TNWs including territorial seas
19 Wetlands adjacent to TNWs
Q Relatively permanent waters 2 (RPWs) that flow directly or indirectly into TNWs
F4 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
0 Impoundments of junsdictional waters
SMI 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 600 linear feet 50 100 width (ft) and/or acres
Wetlands 3 00 acres
c Limits (boundaries) of Jurisdiction based on Established bj,C)I yiM
Elevation of established OHWM (►f 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 jurisdictional
Explain
i Boxes checked below shall be supported by completing the appropriate sections in Section III below
2 For purposes of this form an RPW is defined as a tributary that is not a TNW and that typically flows year round or has continuous flow at least seasonally
(e g typically 3 months)
Supporting documentation is presented in Section III F

SECTION III CWA ANALYSIS
A TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs If the aquatic resource is a TNW complete
Section III A I 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 III B below
1 TNW
Identify TNW Lumber River
Summarize rationale supporting determination South Fork Catawba River is 50-100 feet wide NCWRC maintains a boat ramp
adjacent to bridge No 47 for recreational users
2 Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is adjacent The Lumber River at Bridge No 47 is classified by
NCDWQ as swamp waters (Sw) The wetlands at this area are contiguous and connected directly to the Lumber River
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 under Ropanos have been met.
The agencies will assert jurisdiction over non navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i e tributaries that typically flow year round or have continuous flow at least seasonally (e g typically 3
months} A wetland that directly abuts an RPW is also jurisdictional If the aquatic resource is not a TNW but has year round
(perennial) flow skip to Section III D 2 If the aquatic resource is a wetland directly abutting a tributary with perennial flow
skip to Section III D 4
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water even
though a significant nexus finding is not required as a matter of law
If the waterbody' is not an RPW or a wetland directly abutting an RPW a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands This significant nexus evaluation that combines for
analytical purposes the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is
the tributary or its adjacent wetlands, or both If the JD covers a tributary with adjacent wetlands, complete Section III B I for
the tributary Section III B 2 for any onsite wetlands and Section III B.3 for all wetlands adjacent to that tributary, both onsite
and offsite The determination whether a significant nexus exists is determined in Section Ill C below
1 Characteristics of non -TNWs that flow directly or indirectly into TNW
(i) General Area Conditions
Watershed size PlchJUR
Drainage area 1
Average annual rainfall inches
Average annual snowfall inches
(u) Physical Characteristics
(a) Relationship with TNW
® Tributary flows directly into TNW
❑ Tributary flows through #W st tributaries before entering TNW
Project waters are PiWlit river miles from TNW
Project waters are i"11 river miles from RPW
Project waters are Picic%.isst aerial (straight) miles from TNW
Project waters are lPk,LAO aerial (straight) miles from RPW
Project waters cross or serve as state boundaries Explain
'Note that the Instructional Guidebook contains additional information regarding swales ditches washes and erosional features generally and in the and
West

Identify flow route to TNW5
Tributary stream order if known
(b) General Tnbutary Characteristics (check all that apply)
Tnbutary 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 lE 1C�
Primary tributary substrate composition (check all that apply)
❑ Silts ❑ Sands ❑ Concrete
❑ Cobbles ❑ Gravel ❑ Muck
❑ Bedrock ❑ Vegetation Type/% cover
❑ Other Explain
Tributary condition/stability [e g highly eroding sloughing banks] Explain
Presence of run/niile/pool complexes Explain
Tributary geometry Kiaut
Tributary gradient (approximate average slope) %
(c) Flow
Tributary provides for
Estimate average number of flow events in review area/year 1P k�
Describe flow regime
Other information on duration and volume
Surface flow is iW17a . Characteristics
Subsurface flow Explain findings
❑ Dye (or other) test performed
Tnbutary has (check all that apply)
❑ Bed and banks
❑ OHWM6 (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 determine lateral extent of CWA jurisdiction (check all that apply)
❑ High Tide Line indicated by El Mean High Water Mark indicated by
❑ oil or scum line along shore objects ❑ survey to available datum
❑ fine shell or debris deposits (foreshore) ❑ physical markings
❑ physical markings/charactenstics ❑ vegetation lines/changes in vegetation types
❑ tidal gauges
❑ other (list)
(in) 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
i Flow route can be described by identifying e g tributary a, which flows through the review area, to flow into trbutary b which then flows into TNW
6A natural or man -made discontinuity in the OHWM does not necessarily sever jurisdiction (e g where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices) Where there is a break in the OHWM that is unrelated to the waterbody s flow
regime (e g flow over a rock outcrop or through a culvert) the agencies will look for indicators of flow above and below the break
'Ibid

(iv) Biological Characteristics Channel supports (check all that apply)
❑ Riparian corridor Characteristics (type average width)
❑ Wetland fringe Characteristics
❑ Habitat for
❑ Federally Listed species Explain findings
❑ Fish/spawn areas Explain findings
❑ Other environmentally sensitive species Explain findings
❑ Aquatic/wildlife diversity Explain findings
2 Characteristics of wetlands adjacent to non TNW that flow directly or indirectly into TNW
(i) Physical Characteristics
(a) General Wetland Characteristics
Properties
Wetland size acres
Wetland type Explain
Wetland quality Explain
Project wetlands cross or serve as state boundaries Explain
(b) General Flow Relationship with Non TNW
Flow is Explain
Surface flow is
Characteristics
Subsurface flower Explain findings
❑ Dye (or other) test performed
(c) Wetland Adjacency Determination with Non TNW
❑ Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection Explain
❑ Ecological connection Explain
❑ Separated by berm/barrier Explain
(d) ProxumtY(Relationshtn) to TNW
Project wetlands area river miles from TNW
Protect waters are aerial (straight) miles from TNW
Flow is from
Estimate approximate location of wetland as within the t41UR floodplain
(u) Chemical Characterutus
Characterize wetland system (e g water color is clear brown oil film on surface water quality general watershed
characteristics etc ) Explain
Identify speck pollutants, if known
(m) Biological Characteristics Wetland supports (check all that apply)
❑ Riparian buffer Characteristics (type average width)
❑ Vegetation type/percent cover Explain
❑ Habitat for
❑ Federally Listed species Explain findings
❑ Fish/spawn areas Explain findings
❑ Other environmentally sensitive species Explain findings
❑ Aquatic/wildlife diversity Explain findings
3 Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis SckIrst
Approximately ( ) acres in total are being considered in the cumulative analysis

For each wetland specify the following
Directly abuts9 (Y/N Size (nn acres) Directly abuts9 ( Size (in acres)
Summarize overall biological chemical and physical functions being performed
C SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical and biological integrity
of a TNW For each of the following situations, a significant nexus exists of the tributary in combination with all of its adjacent
wetlands has more than a speculative or insubstantial effect on the chemical, physical and /or biological integrity of a TNW
Considerations when evaluating significant nexus include but are not limited to the volume duration and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands It is not appropriate to determine significant nexus based solely on any specific threshold of distance (e g. between a
tributary and its adjacent wetland or between a tributary and the TNW) Similarly the fact an adjacent wetland lies within or
outside of a floodplam 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 tnbutary 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 TNW9
• Does the tributary in combination with its adjacent wetlands (if any) provide habitat and Infecycle support functions for fish and
other species, such as feeding, nesting spawning or rearing young for species that are present in the TNW?
• Does the tributary in combination with its adjacent wetlands (if army) 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
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
3 Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW Explain findings of
presence or absence of significant nexus below based on the tributary in combination vwth all of its adjacent wetlands, then go to
Section III D
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 estimates in review area
TNWs 600 linear feet 50 100 width (ft) Or acres
{ Wetlands adjacent to TNWs 3 00 acres
RPWs that flow directly or indirectly into TNWs
Q Tributaries of TNWs where tributaries typically flow year round are jurisdictional Provide data and rationale indicating that
tributary is perennial Hardin Creek and its UTs have NCDWQ stream rating scores greater than 30
El 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)
El Tributary waters linear feet width (ft)
Q Other non wetland waters acres
Identify type(s) of waters
Non RPWss that flow directly or indirectly into TNWs
Q Waterbody that is not a TNW or an RPW but flows directly or indirectly into a TNW and it has asignificant 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 indirectly into TNWs
ZI 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 junsdictional wetlands in the review area acres
Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs
El 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 III C
Provide acreage estimates for jurisdictional 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
As a general rule the impoundment of a junsdictional tributary remains jurisdictional
Demonstrate that impoundment was created from `waters of the U S or
Demonstrate that water meets the criteria for one of the categories presented above (1-6) or
Demonstrate that water is isolated with a nexus to commerce (see E below)
ISOLATED [INTERSTATE OR INTRA- STATE] WATERS INCLUDING ISOLATED WETLANDS THE USE
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY) 10
0 which are or could be used by interstate or foreign travelers for recreational or other purposes
from which fish or shellfish are or could be taken and sold in interstate or foreign commerce
which are or could be used for industrial purposes by industries in interstate commerce
[] Interstate isolated waters Explain
[� Other factors Explain
Identify water body and summarize rationale supporting determination
'See Footnote tl 3
' To complete the malysis 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 Junsdredon Following Rapano&

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

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