20130069 Ver 1_Application_20130124

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STATE OF NORTH CAROLINA
�l441
try��lfjY
DEPARTMENT OF TRANSPORTATION `cy
PATRICK L. MCCRORY ANTHONY J. Txl'A
_ _ ___ - SECRETARY - -
:� —___ 201.3
Ms. Lori Beckwith, NCDOT Regulatory Project Manager
U. S. Army Corps of Engineers
151 Patton Avenue, Room 208 2 0 1 3 0 0 6 9
Asheville, NC 28801 -2714
Subject: Nationwide 14 Permit Application
Replace Bridge No. 141 on SR 1367 over Little Savannah Creek
Jackson County
WBS Element No. 17BP.14.R.16 (DWQ Minor Permit Fee $240.00)
Dear Ms, Beckwith:
The North Carolina Department of Transportation ( NCDOT) is proposing to replace the subject
bridge under the Division Bridge Replacement Program. The existing 18' L x 20' W single -span
timber bridge needs to be replaced due to deterioration and insufficient width. The proposed
replacement structure will be a 2 @ 10' W x 5' H x 46' L reinforced concrete box culvert •
(RCBC) on a 48 degree skew. The culvert will be buried one foot below the existing stream bed
elevation and concrete sills will be installed to help naintain aquatic life passage during periods
of low flow. The slope of the culvert is basically flat at 0.67 %; therefore, aquatic life passage
should not be an issue. A temporary detour will be constructed upstream of the existing bridge
in order to maintain traffic during construction.
I am enclosing a PCN application, Rapanos Jurisdictional form, EEP mitigation acceptance
letter, plan sheets showing the proposed work, a marked county map, a USGS quad map and
photographs.
The North Carolina Natural Heritage Database was checked for records of threatened and
endangered species. The database lists 48 species for Jackson County that have federal status.
The sicklefin redhorse (11oxosionia sp.2) is a candidate species for listing. The bog turtle
(Gljplent);s nruhlenbergii) is listed as threatened due to similarity of appearance to the listed
northern bog turtle and is known only from historical records. Seven species, Carolina northern
flying squirrel (Glauconr))s sabrints colommis), Indiana bat (Alyotis sodcdis), Appalachian elktoe
(Alasnlidarta raveneliana), spruce -fir nnoss spider (Alic)-ohexw -a martivogo), small whorled
pogonia (Isohla medeoloi(les), swamp pink (Helonias bullata) and rock gnome lichen
(G),nnroderina lineare), are listed as either threatened or endangered. The Indiana bat is known
only from historical records and the U.S. Fish and Wildlife Service (USFWS) does not consider
Jackson County to be an Indiana bat county.
Fourteenth. QM§ibn Office
Telephone: (8281,586 - 21'4'1 253 "Webster RoaB; -yiYa, North Carolina 28779, Fax: (828) 586 =4043

2
There are records for the Appalachian elktoe and the sicklefin redhorse within a five mile radius
of the project. The Tuckasegee River is considered critical habitat for the Appalachian elktoe.
Both species occur within the Tuckasegee River approximately 2.3 miles downstream of the
project area. Little Savaiuiah Creek is approximately seven feet in width and is not characteristic
of habitat for the Appalachian elktoe or sicklefin redhorse.
lichen-are-
The-Carolina northern-squirrel, the_sp%uce -fir moss spider and the rock gnome lichen-are -
!= -- - - - - -= species -that are- typically - associated with high elevation sites.- The rock gnome_lichen,may_oceur___ —___
at lower elevations within deep gorges where there is high humidity. The bridge site is
approximately 2160 feet elevation and lacks the habitat characteristics for these species. r
Swamp pink and the bog turtle are associated with wetland habitat. Wetlands are lacking at the
bridge site.
The small whorled pogonia, according to the USFWS, generally occurs in open, dry, deciduous
woods with acid soil. However, it is also known to occur in a variety of habitats in North
Carolina, including along streams. The habitat at the project is primarily open grassed areas with
a few trees along the riparian area. Habitat along the stream is characterized by dense vegetation
primarily of vines and shrubby vegetation that is not typical of the small whorled pogonia.
The culvert project is limited in scope and should have minimal effect on downstream aquatic
habitat. BMPs will finilier limit the effects to downstream aquatic resources. No threatened or
endangered species were observed during the field scoping process or are known to occur within
the Little Savannah Creek watershed. For these reasons and those discussed above, we
recommend a "no effect" determination for threatened and endangered species.
This project was reviewed by the State Historic Preservation Office in 2012. Surveys
determined that no historic structures or archaeological resources would be affected by this
project.
NCDOT best management practices will be used to minimize and control sedimentation and
erosion on this project. The construction foreman will review all erosion control measures daily
to ensure sedimentation and erosion controls are being controlled effectively. If the devices are
not functioning as intended, they will be replaced immediately with better devices.
Impacts to Waters of the United States
Little Savannah Creek (DWQ Class: C) is shown on the USGS topographic map as a perennial
stream. The channel is well defined and approximately seven feet in width with a substrate of
cobble, gravel, sand and silt. The stream has sufficient flow to support fish, including rainbow
trout, and other aquatic life. Little Savannah Creek flows approximately 1.4 miles to Savannah
Creek. Savannah Creek then flows for approximately 0.8 miles to the Tuckasegee River. The
Tuckasegee River meets the definition of a Traditional Navigable Water (TNW). For these
reasons, we believe Little Savannah Creek is a Relatively Permanent Water (RPW) and is under
the jurisdiction of the U.S. Army Corps of Engineers. In order to construct the project, it will be
necessary to impact waters of the United States in the Little Temmessee River Basin (HUC

06010203). Specifically, NCDOT is requesting to replace Bridge No. 141 with a RCBC. The
proposed impacts are listed in the table below.
Site No.
Existing Condition
Proposed Condition
Net
Station
Impacts
-_ —
Free_Flowing.Streani
10',W a 5'H x _46' L_ Double Celled
46,
Site I-
with Sparining Structure
RCBC —
Build Floodplain Bench iii EXisthig
Chamiel at High Flow Cell hilet
Site IA
Natural Ground at Inlet
With Stream Substrate Material or
55'
of High Flow Culvert
Soil and Large Quarry Rock as
Needed; Ri ra ) Adjacent Banks
Excavate and Build Floodplain
Bench at High Flow Cell Outlet with
Site 113
Natural .Ground at Outlet
Stream Substrate Material or Soil
461
of High Flow Culvert
and Large Quarry Rock as Needed;
Ri ra Adjacent Batiks
Flow Diversion for Installation of
80,
Site 1 C
Free Flowing Stream
Box Culvert
Install a 60" x 80' CMP for
80'
Site 2
Free Flowing Stream
Temporary Detour and 105' Flow
105'
Diversion
Total Permanent Stream Impact 46
Total Permanent Impact for Floodplain Benches and Riprap Banks 101'
Total Temporary stream Impact for Flow Diversion Box Culvert 80'
Total Temporary Impact for Detour Culvert & Flow Diversion 105'
Permits Requested
NCDOT is hereby requesting authorization under Section 404 of the Clean Water Act to proceed
with the construction project outlined above. By copy of this letter, I am asking Ms. Marla
Chambers, Western DOT Review 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 Ms. Chambers and Mr. Ben DeWit, Roadside
Environmental Field Operations Engineer ( NCDOT), to continent directly to me concerning this
permit request.
If you have any questions or need additional information, please contact me at (828) 586 -2141 or
Mr. Josh Deyton, PE, at (828) 488 -2131. Your early review and consideration will be greatly
appreciated.

4
Sincerely,
Mar S. Davis
Division 14 Environmental Program Supervisor
-Enclosures
cc: Ms. Amy Chapman, DWQ-DENR, Raleigh
Mr. Mike Parker, DWQ-DENR, Asheville Regional Office
Mr. Jason Mays, Biologist, USFWS, Asheville
Ms. Marla Chambers, Western NCDOT Review Coordinator, NCWRC
Mr. Josh Deyton, PE, Division 14 Bridge Program Engineer, NCDOT, Bryson City
Mr. Ben DeWit, EI, Roadside Environmental Field Operations Engineer, NCDOT
1L.

11 0� AT F9�G
7
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form
A. Al)plicailt Information
1. Processing
-1 a_-Type(s) of approval sought from t-he---_
- -- =Corps: _—C
Section 404 Permit _E1 Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 14 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):
N 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 [D No
For the record only for Corps Permit:
❑ Yes [D 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.
Z Yes
❑ No
Ig. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below.
❑ Yes
N No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
No
,2. Project Information
2a. Name of project:
Replace Bridge No. 141 on SIR 1367 over Little Savannah Creek
2b. County:
Jackson
2c. Nearest municipality I town:
Sylva
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
14.R.16
3. Owner Information
3a. Name(s) on Recorded Deed:
North Carolina Department of Transportation
3b. Dead 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: Division 14 Environmental Supervisor
4b. Name:
Mark S. Davis
4c. Business name
(if applicable):
North Carolina Department of Transportation
4d. Street address:
253 Webster Road
4e. _City, state, zip:
Sylva, NC 28779 -
4f: -Telephone no.:-
828- 586 -2141 - - - - -
4g. Fax no.:
4h. Email address:
markdavis @ncdot.gov
5. Agent/Consultant Information (if applicable)
5a. Name:
N/A
5b. Business name
(if applicable):
NIA
5c. Street address:
N/A
5d. City, state, zip:
N/A
5e. Telephone no.:
NIA
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
1a. Property identification no. (tax PIN or parcel ID):
N/A
Latitude: 35.325135 Longitude: - 83.22366
1b. Site coordinates ) decimal degrees):
(MMMOD) (•DD.DDDDDD)
"1c Property size:
acres ----- - - -------
4--Surface-Waters—_
2a. Name of nearest body of water (stream, river, etc.) to
Little Savannah Creek
proposed project:
,2b. Water Quality Classification of nearest receiving water:
C
2c. River basin:
Little Tennessee (HUC 06010203)
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:
Rural residential with a forested landscape.
3b. List the total estimated acreage of all existing wetlands on the property:
None
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
NIA
3d. Explain the purpose of the proposed project:
The purpose of this project is to replace a structurally deficient and functionally obsolete bridge with a 2 @ 10'W x 5'H x
46'L reinforced concrete box culvert (RCBC).
3e. Describe the overall project in detail, including the type of equipment to be used:
Erosion and sedimentation BMPs will be installed. Flow diversion will be installed to facilitate construction in the dry. A
temporary culvert will be placed in the creek and a temporary detour constructed. The old bridge will be removed. A
double celled RCBC will be constructed on the old bridge location. The road will be regraded and resurfaced. The
temporary pipe will be removed and the temporary detour fill material removed. Track hoes, dump trucks, bulldozers,
water pumps, sandbags, diversion pipe and 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 Z No ❑ Unknown
project (including all prior phases) in the past?
Comments: N/A
Ab. 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: NIA
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.
NIA
6. Project History
5a. Have permits or certifications been requested or obtained for
�E] Y e �s �NN o El Unknown
o�
t?
this project (including all prior phases) in the past?
5b. 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

7
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

Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. 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.- �— -
-
Wetlandimpact -
- -- - - - -
- -� --
-
-- TYPeofjurisdiction - - --
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
El Yes
❑ No
El Corps
[:1 DWQ
N/A
❑ Yes
❑ Corps
W2 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W3 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W4 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W5 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
El Corps
W6 ❑ T
❑ P
❑ 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
length
number -
(PER) or
(Corps - 404, 10
stream
Permanent (P) or
intermittent
DWQ - non -404,
width
(linear
feet)
Temporary (T)
(INT)?
other)
(feet)
S1 ®P ❑ T
Double Celled
Little Savannah
® PER
® Corps
46
RCBC
Creek
El INT
® DWQ
S1A ®P ❑ T
Floodplain Bench
& Riprap Banks at
Little Savannah
Creek
® PER
❑ INT
® Corps
® DWQ
7
55
High Flow Inlet
Floodplain Bench
Little Savannah
® PER
® Corps
7
46
SIB ®P ❑ T
& Riprap Banks at
Creek
❑ INT
® DWQ
High Flow Outlet
SIC ❑ P ®T
Flow Diversion for
RCBC
Little Savannah
Creek
® PER
❑ INT
®Corps
® DWQ
7
80
S2 ❑ P ®T
Corrugated Metal
Pipe & Flow
Little Savannah
Creek
® PER
❑ INT
® Corps
® DWQ
7
105
Diversion Detour
❑ PER
❑ Corps
S6 ❑ P ❑ T
❑ INT
❑ DWQ
3h. Total Permanent Stream and Tributary Impacts for RCBC
46'
3i. Comments: Permanent impacts for floodplain benches and riprap of adjacent streambanks 101'
Temporary stream impact for temporary detour and flow diversion 80'
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version

Temporary Impact for sandbag dikes and flow diversion 105,
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.
Open water
impact number -
Permanent (P) or
Tem orar
4b.
Name of waterbody
(if applicable)
- - - - -
4c.
Type of impact
-
4d.
Waterbody type
4e.
Area of impact (acres)
01 ❑-P ❑_T -.. _
_ .. N/A
N/A
N/A
NIA-
02 ❑PELT
03 ❑P ❑T
04 ❑POT
4f. Total open water impacts
N/A
4g. Comments: N/A
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID
number
5b.
Proposed use or purpose
of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
N/A
N/A
N/A
NIA
N/A
N/A
N/A
N/A
P2
5f Total
N/A
N/A
N/A
N/A
N/A
NIA
N/A
5g. Comments: N/A
5h. Is a dam high hazard permit required?
❑ Yes No If yes, permit ID no: NIA
5i. Expected pond surface area (acres):
N/A
5j. Size of pond watershed (acres):
N/A
5k. Method of construction:
N/A
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version

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
number-__
Reason_
Buffer
- _Zone- 1_impact—
- - - -Zone 2-impact - -
_P_ermanent_(P) or_
-_ -_ -for
.__ _
_ Stream name
mitigation.
-_ (square feet)
,____(square feet)
Temporary
impact
required?
131 ❑ P ❑ T
N/A
NIA
El Yes
N/A
N/A
El Yes
B2 ❑P ❑T
❑ No
El Yes
B3 []PEI T
'❑ No
6h. Total buffer impacts
NIA
N/A
6i. Comments: N/A
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 minimum length culvert will be constructed to provide the necessary road width. Floodplain benches will be installed at
inlet and outlet of the high flow barrel to help maintain channel stability.. Sills will also be placed in the barrels to maintain
aquatic life passage during periods of low flow.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Erosion and sedimentation BMP's will be installed prior to construction. The water will be diverted around the work areas-to
minimize sedimentation from the work area and to minimize the potential for uncured concrete to contact 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
® Yes ❑ No
impacts to Waters of the U.S. or Waters of the State?
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: N/A
3b. Credits Purchased (attach receipt and letter)
Type N/A
Quantity N/A
Page 7 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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:
N/A linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ®cold
=4d. -Buffer mitigation-requested (DWQ only): - - -
NIA-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
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
N/A
N/A
3 (2 for Catawba)
N/A
Zone 2
1.5
6f. Total buffer mitigation required:
NIA
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).
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
1 a.
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, thenAs a diffuse flow plan included? 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 No. 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
❑ 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
❑ HQW
4a.
Which of the following state - implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006 -246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes El No
attached?
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)
la. 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 = --- - -- -
. -E]-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
❑Yes ❑ No
letter.)
Comments: NIA
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
1 Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
El 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 is limited to the replacement of an existing bridge with a RCBC. The road is not being widened. Therefore,
secondary and cumulative impacts would not be anticipated from this maintenance activity.
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.
NIA
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
I
5a. Will this project occur in or near an area with federally protected species or
0 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
El Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
The North Carolina Natural Heritage Database and onsite investigation.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑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 environments within 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 was submitted to the NCDOT Human Environment for Review. Surveys were performed for archaeological
and architectural resources. It was determined that there would be "no effect" on these respective resources.
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: NCDOT Hydraulics Unit coordination with FEMA and NC
Floodplain Mapping Program
8c. What source(s) did you use to make the floodplain determination? NC Floodplain Mapping Program
Mark S. Davis
Applicant/Agent's Printed Name
Applicant/Agent's Signature
Date
(Agent's 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

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Site Location Map
Bridge # 141
TIP 17BP.14.R.16
Jackson County, North Carolina
North Garoll Department
Date tabon
na
D te OfTranspor Figure
D.Y;sion of Highways 1
06/2012 14�
Project Development And �\' /'
EnvicrimentalAnatysis Branchl ".ieY

Bridge No 141 on SR 1357 (Little Savannah Road) over Little Savannah Creek
Jackson County, North Carolina
Bridge 141 --s Looking North from South of Bridge
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Bridge 141— Looking South from North of Bridge
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"ECEIVLZ®
In
JAN 16 2012
rS eo s tem : ®I VI
PROGRAM
- - - - - - -- -- - - - — - - -- - - January 15, 2013 - - — -- - - — - - -- - -- --
Mr. Mark S. Davis
NCDOT Division 14 Environmental Supervisor
North Carolina Department of Transportation
253 Webster Road
Sylva, North Carolina 28779
Dear Mr. Davis:
Subject: EEP Mitigation Acceptance Letter:
Division 14 Project, Replace Bridge 141 over Little Savannah Creek on SR 1367,
Jackson County; WBS Element 17BP.14.R.16
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 received on January 11, 2013, (lie
impacts are located in CU 06010203 of the Little Tennessee River basin in the Southern Mountains (SM) Eco-
Region, and are as follows:
Little Tennessee
Stream
Wetlands
Buffer (Sq. Ft.)
06010203
SM
Cold
Cool
Warnn
Riparian
Non-
Coastal
Zone 1
Zone 2
Riparian
Marsh
Impacts
feettacres)
46
0
0
0
0
0
0
0
This impact and associated mitigation need were under projected by tine 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 deter nined by tine regulatory agencies using the delivery timeline listed in Section F.3.c.iii of tine
N.C. Department of Enviromnent 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.
8420.
If you have any questions or need additional information, please contact Ms. Beth Harmon at 919 -707-
Sincerely,
6-t-
SUZIL)Klinick
EEP Acting Director
cc; Ms. Lori Beckwith, USACE - Asheville Regulatory Field Office
Ms. Amy Chapman, Division of Water Quality, Wetlands/401 Unit
Mr. Josh Deyton, P.E., NCDOT - Division 14 Bridge Program Engineer
Ms. Linda Fitzpatrick, NCDOT - PDEA
File: SR 1367 - Bridge 141 - Division 14
RestOr�... ... Z�{'OtP.Gtl.K� OGL{� Stag ®�
NCDENR
North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699 -1652 1919-707-8976 / 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 1: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
_—B.—DISTRICT-OFFICE, _ FILE, NAME, AND NUMBER:
—___C. = PROJECT- - LOCATION AND BACKGROUND INFORMATION Bridge-141 on SR-1367-(Little Savannah Road)
State: NC County /parish/borough: Jackson City: Webster
Center coordinates of site (lat/long in degree decimal format): Lat. 35.325135° N, Long. 83.22366° W.
Universal Transverse Mercator:
Name of nearest waterbody: Little Savannah Creek (Class C)
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Tuckasegee River
Name of watershed or Hydrologic Unit Code (HUC): 06010203020030
® Check if map /diagram of review area and /or potential jurisdictional areas is/are available upon request.
El Check if other sites (e.g., oflsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORATED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
® Office (Desk) Determination. Date: January 7, 2013
Field Determination. Date(s): May 24, 2011
SECTION 11: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There re no "i migable craters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required)
Q Waters subject to the ebb and flow of the tide.
Q Waters arc 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 re "waters ojthe U.S." 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):
Q TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waterS2 (RPWs) that flow directly or indirectly into TNWs
Q Non -RPWs that flow directly or indirectly into TNWs
El 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
0 Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional 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: 225 linear feet: width (fl) 7 and/or acres.
Wetlands: acres.
c. Limits (boundaries) of jurisdiction based on: stalilished by OfIWAt:
Elevation of established OI•IWM (if known): .
2. Non - regulated waters /wetlands (check if applicable):''
(] Potentially jurisdictional waters and /or wetlands werc assessed within the review area and determined to be not jurisdictional.
Explain:
Boxes checked below shall be supported by completing the appropriate sections in Section III below.
' For purposes of this form, an RPW is defined as a tributary that is not a TNW and That typically floes year -round of 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.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.I and 2
and Section III.D.I.; otherwise, see Section III.B below.
1. TNW
Identify TNW: .
Summarize 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 under Rapanos 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 (lint 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'i is not an RPW, or n 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.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.0 below.
1. Characteristics of non -TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: Pitk,List
Drainage area: Pick Lis
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
❑ Tributary flows directly into TNW.
❑ Tributary flows through Pick List tributaries before entering TNW.
Project waters are Pick L'iR river miles from TNW.
Project waters are Pick,Lisj river miles from RPW.
Project waters are ick,Lisi aerial (straight) miles from'INW.
Project waters are ick�List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain: .
Identify flow route to TNW': ,
Tributary stream order, if known:
' Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the arid
West.
5 Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.

(b) General Tributary Characteristics (check all that app! J
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 Lis .
- — - -v -- Primary fributary 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/riffle/pool complexes. Explain: .
Tributary geometry: KckList
Tributary gradient (approximate average slope): %
(c) Elo�v:
Tributary provides for: Pick'L`is
Estimate average number of flow events in review area/year: P1ck,,LW
Describe flow regime: .
Other information on duration and volume:
Surface (low is: ick,Lis.. Characteristics:
Subsurface flow: . Explain findings:
❑ Dye (or other) test performed: .
Tributary has (check all that apply):
❑ Bed and banks
❑ OI I1VM6 (check all indicators that apply):
❑ clear, natural line impressed on the bank
❑
❑ changes in the character of soil
❑
❑ shelving
❑
❑ vegetation matted down, bent, or absent
❑
❑ leaf litter disturbed or washed away
❑
❑ sediment deposition
❑
❑ water staining
❑
❑ other (list):
❑ Discontinuous OHWIVf.7 Explain:
f 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 /characteristics
❑ tidal gauges
❑ other (list):
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
ine lateral extent of CWA jurisdiction (check all that apply):
Mean High Water Mark indicated by:
❑ survey to available datum;
❑ physical markings;
❑ vegetation lincs/changes in vegetation types.
(iii) 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 Of l%%FM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been renroved'by development or agricultural practices). Where there is a break in the Ol IWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), file 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:
❑ Fislt/spawn areas. Explain findings: .
❑ Other environmentally - sensitive species. Explain findings:
❑ Aquatic /wildlife diversity. Explain findings: .
2; Characteristics of wetlands adjacent to non -TNW that (low directly or indirectly into TNW
— - - —(i) Physical Characteristics: - -
- ---- ._-- � - - - - --
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Prdject wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Nat -TNW:
Flow is: icy "k Gisf. Explain: .
Surface flow is: P,ickiList
Characteristics: .
Subsurface flow: PiekuLisi. Explain findings:
❑ Dye (or other) test perforated: .
(c) Wetland Adiaceinc Determination with Non -TNW:
❑ Directly abutting
❑ Not directly abutting
❑ Discrete Nvetland hydrologic connection. Explain:
❑ Ecological connection. Explain:
❑ 'Separated by bernt/barrier. F,xplain:
(d) Proximity (Relationship) to TNW
Project wetlands arePickLlisi river miles from TNNV.
Project waters are�Picklisi aerial (straight) miles from 7NW.
Flow is from: Pick L' isf
Estimate approximate location of wetland as within the P,iek,LW floodplain.
(ii) 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:
(iii) Biological Characteristics. Wetland supports (check all that apply):
❑ Riparian buffer. Characteristics (type, average tvidth):
❑ 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: 1�ick•Lisf
Approximately ( ) acres in total are being considered in the cumulative analysis.

For cacti 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 NE\US- 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 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 lies within or
outside of a flood plain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapauos 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'rNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle 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 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 111.13: .
2. 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 with all of its adjacent wetlands, then go to
Section III.D: .
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERSAVETLANDS ARE (CHECK ALL
THAT APPLY):
I. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
Q "IN Ws: linear feet width (ft), Or, acres.
Wetlands adjacent to TNWs: acres.
2. 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: Little Savannah Creek is shown as a perennial stream on the USGS map and has sufficient flow to
support fish..
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 111.13. Provide rationale indicating that tributary flows
seasonally: .

Provide estimates for jurisdictional waters in the revic%v area (check all that apply):
Tributary waters: 225 linear feet width (ft). 7
Other non - wetland waters: acres.
Identify type(s) of waters: .
3. Non -RPWs8 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): --- - - - - - - - -- - -- - - --
- `-- ❑-Tiibutauy'waters: - -- linear feet - width (ft). - - - - - -- -- — - - - -- -�. -- - - -� —
-- - �Q- Otlici non- wetIand-waters: -- acres.!
Identify type(s) of waters:
Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
E j Wetlands directly abut RPW and thus arc 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 111.13.2, 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
seasonal in Section 111.13 and rationale in Section 111.13.2, 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 TN W are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
Wetlandsadjacent 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 far jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.'
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
❑ Demonstrate that impoundment was created from "waters of (tie 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).
E. ISOLATED ]INTERSTATE OR INTRA- STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE CODIDIERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY): 10
which are or could be used by interstate or foreign travelers for recreational or other purposes.
❑ from which fish or shellfish arc or could be taken and sold in interstate or foreign commerce.
El which are or could be used for industrial purposes by industries in interstate commerce.
❑ Interstate isolated waters. F,xplain:
❑ Other factors. Explain: .
'Sce Footnote N 3.
' To complete the analysis refer to the key in Section 111.13.6 of the Instructional Guidebook.
10 Prior to asserting or declining OVA 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 CorpsTTA Alemorandnul Regarding Cli'A Ac! Jurisdiction Follon,ing Rapanos.

Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
1'ribtitary waters: linear feet width (ft).
Other non - wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
— — — F:- -NON= JURISDICTIONAL WATERS; INCLUDING IVETLANDS (CHECK ALL THAT APPLY):" -
- - - -- - - - - - -- -If potential wetlands-were assessed within the review area; these areas did -not meet (lie-criteria in th'e -1987 Corps - --
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 "Sif'ANCC," the review area would have been regulated based solely 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 jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
judgment (check all that apply):
0 Non - wetland waters (i.e., rivers, streams): linear feet width (ft).
El Lakes/ponds: acres.
❑ Other non - wetland waters: acres. List type of aquatic resource:
El 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 forjurisdietion (check all that apply):
El Non - wetland waters (i.e., rivers, streams): linear feet, width (ft).
El 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):
® 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:
El 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:
E] USDA Natural Resources Conservation Service Soil Survey. Citation:
El National wetlands inventory map(s). Cite name:
State /Local wetland inventory map(s):
El FEMA/HRM maps: .
❑ 100 -year Floodplain Elevation is: (National Gcodcctic Vertical Datum of 1929)
Photographs: ❑ Aerial (Name R Date): .
or ® Other (Name R Date): Project Site 11/16/2011.
❑ Previous detennination(s). File no. and date of response letter:
Applicable /supporting case law:
Applicable /supporting scientific literature:
U Other information (please specify): .
B. ADDITIONAL COMMENTS TO SUPPORT JD:

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