20120659 Ver 1_Application_20120705

i
STATE OF NORTH CAROLINA o DSq �� U12
DEPARTMENT OF TRANSPORTATION 6W�q1'8'?
BEVERLY EAVES PERDUE EUGENE A (tNTI JR
GOVERNOR SECRETARY
June 26 2012
U S Army Corps of Engineers
Regulatory Field Office
3331 Heritage Trade Drive, Suite 105
Wake Forest NC 27587
ATTN Mr John T Thomas Jr
NCDOT Coordinator
Dear Sir
120659
Subject Application for Section 404 Nationwide Permits 23 and 13 and Section 401
Water Quality Certification for the replacement of Bridge No 15 over Little
Yadkin River on SR 1604 (Spainhour Mill Road) in Forsyth County, Federal Aid
Project No BRZ- 1604(4), Division 9 T I P No B -4744
Debit $240 00 from WBS No 38517 1 1
The North Carolina Department of Transportation ( NCDOT) proposes to replace bridge No 15
over Little Yadkin Road on SR 1604 (Spainhour Mill Road) in Forsyth County
An onsite detour located west of existing bridge will be used There will be 423 feet of
permanent stream impacts due to replacement of the bridge and associated roadfill Bank
stabilization accounts for 21 linear feet of stream impacts requiring no mitigation whereas the
remaining 402 linear feet of stream impacts (two streams each at 215 feet and 187 feet
respectively) will require mrttgation at 1 1 ratio
Please see the enclosed copies of the Pre Construction Notification (PCN), USACE
Jurisdictional Determination Letter Ecosystem Enhancement Program (EEP) letter, stormwater
management plan, permit drawings, and design plans for the above - referenced project The
Categorical Exclusion (CE) for this project was completed in March 2010 Additional copies are
available upon request
This project let date for the project is February 19, 2013 with a review date of December 17,
2012 However the let date may advance as additional funds become available
MAILING ADDRESS
NC DEPARTMENT OF TRANSPORTATION TELEPHONE [phone] LOCATION
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS Century Center Building B
NATURAL ENVIRONMENT UNIT FAX [phone] Birch Ridge Drive
1598 MAIL SERVICE CENTER Raleigh NC 27610
RALEIGH NC 27699 1598 WEBSITE WWW NCDOT ORG

A copy of this permit application will be posted on the NCDOT Website at
http / /www ncdot ory./doh/preconstruct/pe /neu/permrt html
Thank you for your assistance with this project If you have any questions or need additional
information please contact Greg Price at gwpnce @ncdot gov or [phone]
Sincerely,
Gregory J Thorpe, Ph D , Manager
Project Development and Environmental Analysis Unit
cc NCDOT Permit Application Standard Distribution List
B 4744 Permit Application
Page 2 of 2

i •
W AT �
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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 El Section 10 Permit
lb Specify Nationwide Permit (NWP) number 23 and 13 or General Permit (GP) number
1c
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1 d
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
1 e
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 No 15 on SR 1604 (Spainhour Mill Road) over Little Yadkin
River
2b
County
Forsyth
2c
Nearest municipality / town
King
2d
Subdivision name
not applicable
2e
NCDOT only T I P or state
project no
B 4744
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
gwpnce @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
M
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 36 255996 Longitude 80 442683
(DD DDDDDD) (DD DDDDDD)
1 c Property size
4 5 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
Little Yadkin River
proposed project
2b Water Quality Classification of nearest receiving water
WS IV
2c River basin
Yadkin
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
Land use in the project vicinity is primanly agriculture interspersed with residential development and forestland
3b List the total estimated acreage of all existing wetlands on the property
No wetlands on property
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
520
3d Explain the purpose of the proposed project
To replace a structurally deficient bridge
3e Describe the overall project in detail including the type of equipment to be used
The project involves replacing a 3 span 136 foot bridge with a 3 span 177 5 foot bridge on the existing bridge location
with an onsite detour The new bridge will be of sufficient width to provide for two 10 foot lanes with 4 foot offsets on
each side The existing roadway will be widened to provide two 10 foot lanes with 6 foot shoulders (4 feet paved) on
each side to accommodate bicycles 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 /
® Yes ❑ No ❑ Unknown
project (including all prior phases) in the past?
Comments 1 perennial stream 2 intermittent streams
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 NCDOT
Name (if known) Greg Price
Other
4d If yes list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
September 14 2011
5 Project History
5a Have permits or certifications been requested or obtained for
❑ Yes ® No ❑ Unknown
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
❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g Total wetland impacts
2h Comments
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
Bank
stabilization
Little Yadkin River
® PER
❑ INT
® Corps
❑ DWQ
45
7
Site 2 ® P ❑ T
Bank
stabilization
Little Yadkin River
® PER
❑ INT
® Corps
❑ DWQ
45
7
Site 3 ® P ❑ T
Bank
stabilization
Little Yadkin River
® PER
❑ INT
® Corps
❑ DWQ
45
7
Site 4 ® P ❑ T
Roadway fill
UT to Little Yadkin
River
❑ PER
® INT
® Corps
❑ DWQ
1 5
215
Site 5 ® P ❑ T
Roadway fill
UT to Little Yadkin
❑ PER
® Corps
3
187
River
® INT
❑ DWQ
3h Total stream and tributary impacts
423 Perm
31 Comments

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 indiv ually 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) or
(if applicable)
Temporary T
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
X Permanent
X Temporary
4g Comments
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
(acres)
number
purpose of pond
Excavat
Flooded
Filled
ed
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
❑ Tar Pamlico ❑ Other
Project is in which protected basin?
❑ Catawba
❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number —
Reason for impact
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
Stream name
mitigation
(square feet)
(square feet)
Temporary
required?
131 ❑P ❑T
El Yes
❑ No
B2 ❑P ❑T
❑Yes
❑ No
B3 ❑ PEI T
El Yes
❑ 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 replacement will take place on existing alignment and is longer completely spanning Little Yadkin
River The number of bents in water will be reduced from 2 bents to 0 bents Temporary access in Little Yadkin River is
not necessary to remove existing bridge or to construct the proposed bridge
1 b
Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
NCDOT will use Best Management Practices for Bridge Demolition and Removal as well as Best Management Practices
for the Protection of Surface Waters
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
If no explain
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 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
402 linear feet at 1 1 mitigation ratio per discussion with
USACE from JD visit
4c
If using stream mitigation stream temperature
® warm ❑ cool ❑cold
4d
Buffer mitigation requested (DWQ only)
4e
Riparian wetland mitigation requested
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
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?
1 b
If yes then is a diffuse flow plan included? If not explain why
❑ Yes ❑ No
Comments
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 N/A
5b Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No N/A

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)?
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
® Yes ❑ No
letter)
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
11111

5 Endangered Species and Designated Critical Habitat (Corps Requirement)
5a WIII 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? No habitat for any of the listed species
El 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?
USFWS county list and NCNHP database along with field surveys
6 Essential Fish Habitat (Corps Requirement)
6a WIII 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
6 z�
Dr Grew J Thorpe, PhD
Date
Applicant/Agent s Printed Name
Al!iblicantVgent s Signature
(Agent s signature is valid only if an authorization letter from the applicant
is provided
11

I&
Ft at - - It
WILMINGTON DISTRICT oibr 7 � C;'yJJ
Action Id 201101703 County Forsyth U S G S Quad Pinna le DIVISI i J' lkjhk�'
NOTIFICATION OF JURISDICTIONAL DETERMINAT & OFFICE U� tin I"441 `
Property Owner /Agent Greg Price
Address NC DOT
1598 Mail Service Center
Raleigh, NC 27699 -1598
Telephone No 919 715 7217
Property description
Size (acres) Nearest Town King
Nearest Waterway Little Yadkin River River Basin Yadkin River
USGS HUC 03040101 Coordinates N 36 2558419 W 80 4428897
Location description Bridge #15 on SR 1604 adiacent to Little Yadkin River, west of King, in Forsyth County,
North Carolina TIP B 4744
Indicate Which of the Following Apply
A Preliminary Determination
_ Based on preliminary information, there may be wetlands on the above described property We strongly suggest you have
this property inspected to determine the extent of Department of the Army (DA) jurisdiction To be considered final a
jurisdictional determination must be verified by the Corps This prelimmary determination is not an appealable action
under the Regulatory Program Administrative Appeal Process ( Reference 33 CFR Part 33 1)
B Approved Determination
_ There are Navigable Waters of the United States within the above described property subject to the permit requirements of
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act Unless there is a change in the law or
our published regulations this determination may be relied upon for a period not to exceed five years from the date of tlus
notification.
X There are waters of the U S including wetlands on the above described project area subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344) Unless there is a change in the law or our published
regulations this determination may be relied upon for a period not to exceed five years from the date of this notification
_ We strongly suggest you have the wetlands on your property delineated Due to the size of your property and/or our
present workloau the Corps may not be able to accomplish this wetland delineation in a timely m..nner For a more timely
delineation you may wish to obtain a consultant To be considered final any delineation must be verified by the Corps
X The waters of the U S including wetland on your project area have been delineated and the delineation has been
verified by the Corps We strongly suggest you have this delineation surveyed Upon completion, this survey should be
reviewed and verified by the Corps Once verified this survey will provide an accurate depiction of all areas subject to
CWA jurisdiction on your property which, provided there is no change in the law or our published regulations may be
relied upon for a period not to exceed five years
_ The wetlands have been delineated and surveyed and are accurately depicted on the plat signed by the Corps
Regulatory Official identified below on Unless there is a change in the law or our published regulations this
determination may be relied upon for a period not to exceed five years from the date of this notification
There are no waters of the U S to include wetlands present on the above described property which are subject to the
permit requirements of Section 404 of the Clean Water Act (33 USC 1344) Unless there is a change in the law or our
published regulations this determination may be relied upon for a period not to exceed five years from the date of this
notification
_ The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act
(CAMA) You should contact the Division of Coastal Management in Washington NC at [phone] to determine
their requirements
Page 1 of 2

Action -
Placement of dredged or fill material within waters of the US and/or wetlands without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311) If you have any questions regarding this
determination and/or the Corps regulatory program, please contact John Thomas at 919 5544884 ext 25
C Basis For Determination
Stream channels within your project site which are tributaries of Little Yadkin River which flows into the Yadlan
River and the Atlantic Ocean
D Remarks
E Appeals Information (This information applies only to approved ,jurisdictional determinations as indicated in
B above)
This correspondence constitutes an approved jurisdictional determination for the above described site If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR part 331 Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form If you request to appeal this
determination you must submit a completed RFA form to the following address
District Engineer Wilmington Regulatory Division
Attu Jean Grabby Project Manager
Raleigh Regulatory Field Office
3331 Heritage Trade Drive Suite 105
Wake Forest North Carolina 27587
In order for an RFA to be accepted by the Corps the Corps must determine that it is complete that it meets the criteria for
appeal under 33 CFR part 3315 and that it has been received by the District Office within 60 days of the date of the NAP
Should you decide to submit an RFA form, it must be received at the above address by November 14, 2011
* *It is not necessary to submit an RFA f to the District Office if you do not object to the determination in this
correspondence **
Corps Regulatory Official
Date 09/14/2011
Expiration Date 09/14/2016
The Wilmington District is committed to providing the highest level of support to the public To help us ensure we continue to
do so please complete she Customer Satisfaction Survey located at our website at http //regulatory usacesurvev com/ to
complete the survey online
Copy furnished
Page 2 of 2

Applicant NC DOT / Greg Price/ B -4744 101703
File Number SAW 2011
Date September 14 2011
Attached is I See Section below
I F1 INITIAL PROFFERED PERMIT (Standard Permit or Letter of I A
PROFFERED PERMIT Standard Permit or Letter of permission) B
PERMIT DENIAL C
APPROVED JURISDICTIONAL DETERMINATION D
PRELIMINARY JURISDICTIONAL DETERMINATION E
A IMTML PROFFERED PERMIT You may accept or object to the permit
• ACCEPT If you received a Standard Permit you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP) you may accept the LOP and your work is authorized Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety and waive all rights to appeal the
permit, including its terms and conditions and approved jurisdictional determinations associated with the permit
• OBJECT If you object to the permit (Standard or LOP) because of certain terms and conditions therem, you may request that the
permit be modified accordingly You must complete Section II of this form and return the form to the district engineer Your
objections must be received by the district engineer within 60 days of the date of this notice or you will forfeit your right to appeal
the pernut in the future Upon receipt of your letter the district engineer will evaluate your objections and may (a) modify the
permit to address all of your concerns (b) modify the permit to address some of your objections or (c) not modify the permit
having determined that the permit should be issued as previously written. After evaluating your objections the district engineer
will send you a proffered permit for your reconsideration, as indicated in Section B below
B PROFFERED PERMIT You may accept or appeal the permit
• ACCEPT If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization If you received a Letter of Permission (LOP) you may accept the LOP and your work is authorized Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety and waive all rights to appeal the
permit, including its terms and conditions and approved jurisdictional determinations associated with the permit
• APPEAL If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein, you
may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of this form
and sending the form to the division engineer This form must be received by the division engineer within 60 days of the date of
thins notice
C PERMIT DENIAL You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section Hof this form and sending the form to the division engineer This form must be received by the division engineer
within 60 days of the date of this notice
D APPROVED JURISDICTIONAL DETERMINATION You may accept or appeal the approved JD or
provide new information
• ACCEPT You do not need to notify the Corps to accept an approved JD Failure to notify the Corps within 60 days of the date of
this notice means that you accept the approved JD in its entirety and waive all rights to appeal the approved JD
• APPEAL If you disagree with the approved JD you may appeal the approved JD under the Corps of Engineers Administrative
Appeal Process by completing Section Hof this form and sending the form to the district engineer This form must be received by
the division engineer within 60 days of the date of this notice

E PRELIMINARY JURISDICTIONAL DETERMINATION You do not need to respond to the Corps
regarding the preliminary JD The Preliminary JD is not appealable If you wish, you may request an approved
JD (which may be appealed), by contacting the Corps distract for further instruction Also you may provide new
information for further consideration by the Corps to reevaluate the JD
REASONS FOR APPEAL OR OBJECTIONS (Describe your reasons for appealing the decision or your
objections to an initial proffered permit in clear concise statements You may attach additional information to
this form to clarify where your reasons or objections are addressed in the administrative record )
ADDITIONAL INFORMATION The appeal is limited to a review of the administrative record, the Corps
memorandum for the record of the appeal conference or meeting, and any supplemental information that the
review officer has determined is needed to clarify the administrative record Neither the appellant nor the Corps
may add new information or analyses to the record However, you may provide additional information to clarify
the location of information that is already in the administrative record
If you have questions regarding this decision If you only have questions regarding the appeal process you
and/or the appeal process you may contact may also contact
John Thomas @ 919 554 -4884 ext 25 Mr Mike Bell Admimsh-ative Appeal Review Officer
CESAD- ET -CO -R
U S Army Corps of Engineers, South Atlantic Division
60 Forsyth Street, Room 9M15
Atlanta, Georgia 30303 -8801
RIGHT OF ENTRY Your signature below grants the right of entry to Corps of Engineers personnel, and any
government consultants, to conduct investigations of the project site during the course of the appeal process You
will be provided a 15 day notice of any site investigation, and will have the opportunity to participate in all site
Date
of appellant or
Telephone number
For appeals on Initial Proffered Permits and approved Jurisdictional Determinations send this
form to
District Engineer, Wilmington Regulatory Division, Attu Jean Gibby, Protect Manager, Raleigh
Regulatory Field Office, 3331 Heritage Trade Drive, Suite 105, Raleigh, North Carolina 27587
For Permit denials and Proffered Permits send this form to
Division Engineer, Commander, U S Army Engineer Division, South Atlantic, Attn Mr Mike Bell,
Administrative Appeal Officer, CESAD-ET-CO-R, 60 Forsyth Street, Room 9M15, Atlanta,
Georgia 30303 -8801

W
001111M.—
PROGRAM
June 7 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 4744, Replace Bridge Number IS on SR 1604 over the Little Yadkin River Forsyth
County
The purpose of this letter is to notify you that the Ecosystem Enhancement Program (EEP) will provide the
compensatory stream mitigation for the subject project Based on the information supplied by you on June 5 2012
the impacts are located in CU 03040101 of the Yadkin River basin in the Central Piedmont (CP) Eco Region and
are as follows
Yadkin
Stream
Wetlands
Buffer (Sq Ft )
03CP101
Non
Coastal
Cold
Cool
Warm
Riparian
Ri avian
Marsh
Zone 1
Zone 2
Impacts
0
0
402
0
0
0
0
0
feettacres)
This impact and associated mitigation need were under projected by the NCDOT in the 2012 impact data
EEP will commit to implement sufficient compensatory stream mitigation credits to offset the impacts associated
with this project as determined by the regulatory agencies using the delivery timeline listed in Section F 3 c in of 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
Micha Ilison
EEP Deputy Director
r i
cc Mr John Thomas USACE — Raleigh Regulatory Field Office
Mr David Wainwright Division of Water Quality Wetlands/401 Unit
File B 4744
N Rmbr' Pro Our _Mz&
North Carolina Ecosystem Enhancement Program 1652 Mail Service Center Raleigh NC 27699 1652 / 919 715 0476 / www nceep net

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WETLAND PERMIT IMPACT SUMMARY
WETLAND IMPACTS I SURFACE WATER IMPACTS
Site
No
Station
(From/To)
Structure
Size / Type
CAMA
Permanent
Fill In
Wetlands
ac
404
Permanent
Fill In
Wetlands
ac
Temp
Fill In
Wetlands
ac
Excavation
in
Wetlands
ac
Mechanized
Clearing
in Wetlands
ac
Hand
Clearing
in
Wetlands
(ac)
Permanent
SW
impacts
ac
Temp
SW
impacts
ac
Existing
Channel
Impacts
Permanent
ft
Existing
Channel
Impacts
Temp
(ft)
Natural
Stream
Design
(ft)
1
I 17 +50 Lt
Bank Stabdzation
<0 01
7
III
2
II 18 +25 Lt
Bank Stabilization
<0 01
7
II �
3
II 18 +20 Rt
Bank Stabilization
<0 01
7
IINI
4
I) 20 +45 22 +53 Lt
Roadway Fill
001
215
I
5
I 18 +24 20 +00 Rt
Roadway Fill
001
187
I
I
II
II
I
I�
I'
I
I
li
II
I
it I
it
TOTALS
1
0
0
0
0
0
0
003
0
423
0
0
NOTE
1 Temporary Impact for on site detour bridge substructure 20 sq ft

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