20120785 Ver 1_Application_20120821

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North Carolina Department of Environment and Natural Reso'�{y� �,,Cc aF 20
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Division of Water Quality 3 Ai
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Beverly Eaves Perdue Coleen N Sullins 9Srg4 `�Al7ry Dee Freeman
Governor Director q Rg� Secretary
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Attachment L Low Impact Bridge Replacement Process
Low Impact Bridge Project No B -5106 County Nash
Bridge No 26 over Sapony Creek WBS Element Number 42245 3 1
This project is subject to the Low Impact Bridge Process as agreed to on October 6
2009 This project meets the documentation requirements and approval procedures
under NEPA as defined by FHWA for Low Impact Bridge Replacements This project
meets the standards of NCDOT s Minimum Criteria Rules
Date 8/20/2012
Applicant Name Chad Coggins DEO
Applicant Address PO Box 3165
Wilson NC 27895
Primary Contact for Project Chad Coggins DEO
Phone No 252 -296- *3,�`32-
Is this an after- the -fact application Yes X No
River Basin Tar-Pam-
Stream Classification C. NSW
Regulatory Authorization Options for this Activity
Federal USACE Nationwide General Permit 3 — Maintenance
State General Water Quality Certification #3886 and /or Buffer Authorization
Local None
Project Description — NCDOT proposes to replace Bridge # 26 which is currently a 5 span
25 X91 bridge with a 2 span 30 X 122 bridge over Sapony Creek All stormwater is directed
to Dls and dissipater pad located outside Buffer Zone 2 on one side and a grass swale through
the buffer other side of bridge Buffer Zone impacts are listed as allowable for bridge projects
The proposed impacts are 3001 sq ft for BZ1 and 2402 sgft for BZ2
Signature
Print Name ,
Title �� Q
Transportation Perrnbng Unit
1650 Mail Service Center Raleigh North Carolina 276991650
Location 2321 Crabtree Blvd Raleigh North Carolina 276(4
Phone [phone] l FAX [phone]
Internet: http Yh2o enr state nc us /nmetlands/
An Equal Opportunity \ Pffinnahve Acton Employe
NorthCarohna
,.Natural4y

Attachment
G Low /Minimal Impact Brld a Project Data Sheet
1
TIP NO
B 5108
2
WBS Element No
4224531
3
County
Nash
4
Bridge Number
26
5
Description
Bridge over Sapony Creek
6
Basin
Classification
Stream SIN
Type
Size
Tar Pam
7
C NSW
8
2855-(55)
9
Inland
10
35
11
Type
Existing Structure Size (W x L)
Suff Rating
5 span
12
25x91
13
249
14
Proposed Structure Type
Size
2 spans
15
30X122
16
Stream USACE (LF)
NCDWQ Impacts (LIF)
40 1166 ft temp causeway
17
0
18
USACE Impacts (AC)
Wetlands Non 404 Impacts (AC)
CAMA Impacts SF
02 AC 903 sq ft
19
0
20
0
21
NC DWQ Buffers Impacts (SF)
BZ1 3001 BZ2 2402
22
Buffer Application Required (YIN)
yes
23
State Stormwater Permit Required /N
no
T&E Species Present
Bio Conclusion
no
H
no
—nVa—ffeevsurvey
26Habitat
done June 16 2012
27
Moratorium Type
Dates
no avis confirmed
28
none
29
Native /Hatchery
Trout Species Present
Trout Waters Trout Conditions (YIN)
WRC Reviewer
no IS confirmed
30
no IS confirmed
31
no IS confirmed
32
no/GIS confirmed
33
CAMA AECs
no /GIS confirmed
34
Essential Fish Habitat
n GIS confirmed
35
Nav Opening
n IS confirmed
36
USCG Permit
no IS confirmed
37
Historic Properties
no/HEU confirmed
38
Archaeological Resources
n EU confirmed
391
Tribal Lands
n IS confirmed
40
Resources
no IS confirmed
41
6 LWC F] Resources
ndfGIS confirmed
421
Wild and Scenic River
no IS confirmed
431
Federal Lands
no IS confirmed
441
TVA Area
no jGiS confirmed
45
FEMA Bu out
-
n survey
461
FEMA Flood Study
Normulkey,
471
USTs Haz Mats
no survey
48
Relocatees
no survey
49
Location LAT
LONG
359246
50
78 048
51
Project Comments
Completed by by,
Lead Engineer
Di vision Envlronme icer
L
"I
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ATTACHMENT
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL DETERMINATION
(JD)
B NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD
Chad Cogg►ns
NCDOT Div 4
PO Box 3165
Wilson NC 27895
C DISTRICT OFFICE FILE NAME AND NUMBER
D PROJECT LOCATION(S) AND BACKGROUND INFORMATION
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT
SITES)
• State NC County /parish /borough Nash City Spring Hope
• Center coordinates of site (lat/long in degree decimal format)
Lat 35 9246 N Long 78 0480 W
Universal Transverse Mercator
• Name of nearest waterbody Sapony Creek
® Identify (estimate) amount of waters in the review area
Non wetland waters 60 linear feet 35 width (ft) and /or 1 acres
Cowardm Class Rivenne
Stream Flow Perennial
Wetlands 1 acres
Cowardm Class Forested
® Name of any water bodies on the site that have been identified as Section 10 waters
Tidal
Non Tidal
1

E REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY)
❑ Office (Desk) Determination Date
❑ Field Determination Date(s)
1 The Corps of Engineers believes that there may be jurisdictional waters of the United States
on the subject site and the permit applicant or other affected party who requested this preliminary
JD is hereby advised of his or her option to request and obtain an approved jurisdictional
determination (JD) for that site Nevertheless the permit applicant or other person who
requested this preliminary JD has declined to exercise the option to obtain an approved JD in this
instance and at this time
2 In any circumstance where a permit applicant obtains an individual permit or a Nationwide
General Permit (NWP) or other general permit verification requiring pre - construction notification
(PCN) or requests venfication for a non reporting NWP or other general permit and the permit
applicant has not requested an approved JD for the activity the permit applicant is hereby made
aware of the following (1) the permit applicant has elected to seek a permit authorization based
on a preliminary JD which does not make an official determination of jurisdictional waters (2)
that the applicant has the option to request an approved JD before accepting the terms and
conditions of the permit authorization and that basing a permit authorization on an approved JD
could possibly result in less compensatory mitigation being required or different special
conditions (3) that the applicant has the right to request an individual permit rather than
accepting the terms and conditions of the NWP or other general permit authorization (4) that the
applicant can accept a permit authorization and thereby agree to comply with all the terms and
conditions of that permit including whatever mitigation requirements the Corps has determined to
be necessary (5) that undertaking any activity in reliance upon the subject permit authorization
without requesting an approved JD constitutes the applicants acceptance of the use of the
preliminary JD but that either form of JD will be processed as soon as is practicable (6)
accepting a permit authorization (e g signing a proffered individual permit) or undertaking any
activity in reliance on any form of Corps permit authorization based on a preliminary JD
constitutes agreement that all wetlands and other water bodies on the site affected in any way by
that activity are jurisdictional waters of the United States and precludes any challenge to such
jurisdiction in any administrative or judicial compliance or enforcement action or in any
administrative appeal or in any Federal court and (7) whether the applicant elects to use either
an approved JD or a preliminary JD that JD will be processed as soon as is practicable
Further an approved JD a proffered individual permit (and all terms and conditions contained
therein) or individual permit denial can be administratively appealed pursuant to 33 C F R Part
331 and that in any administrative appeal jurisdictional issues can be raised (see 33 C F R
331 5(a)(2)) If during that administrative appeal it becomes necessary to make an official
determination whether CWA jurisdiction exists over a site or to provide an official delineation of
jurisdictional waters on the site the Corps will provide an approved JD to accomplish that result
as soon as is practicable
This preliminary JD finds that there may be waters of the United States on the subject project
site and identifies all aquatic features on the site that could be affected by the proposed activity
based on the following information
2

SUPPORTING DATA Data reviewed for preliminary JD (check all that apply checked items
should 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 /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
❑ 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 Spring Hope Quad included
in pennit drawing package 1 = 2000 scale
® USDA Natural Resources Conservation Service Soil Survey Citation USDA Sod Survey
of Nash County NC 1989
❑ National wetlands inventory map(s) Cite name
❑ State /Local wetland inventory map(s)
❑ FEMA/FIRM maps
❑ 100 -year Floodplain Elevation is (National Geodectic Vertical Datum of 1929)
❑ Photographs ❑ Aerial (Name & Date)
or ❑ Other (Name & Date)
❑ Previous determination(s) File no and date of response letter
❑ Other information (please specify)
IMPORTANT NOTE The information recorded on this form has not necessaniv been
venfied by the Corps and should not be relied upon for later iunsdictional determinations
Signature and date of Signature 01 cfte of
Regulatory Project Manager person reqqostft preliminary JD
(REQUIRED) (REQUIRED unless obtaining the
signature is impracticable)
Note — NCDOT Division 4 is requesting that all nationwide permit requests be processed under a
blanket agreement allowing the use of a Preliminary Jurisdictional Determination unless
otherwise specified by NCDOT in writing or by email
3

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NC DOT
DIVISION OF HIGHWAYS
VICINITY
NASH COUNTY
PROJECT B -5108
MAPSREPLACE
BRIDGE 426
ON SR 1145 OVER
(NOT TO SCALE)
SAPONY CREEK
SHEET OF 7/24/2012

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IDIVISION OF HIGHWAYS
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T ®P ® MAP PROJECT B 5108
REPLACE BRI ®GE U26
SCALE 1 = 2000 ON SR 1145 OVER
SAPONY CREEK
SHEET OF 7/24/2012

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