20130078 Ver 1_Application_20130206

2013
DENR - 411ATER 0U
`. " .d WETLAND *' AL11 Y
JAND CTn.tMA 1ATCn n.,...-..
-aj - oo�-� (J 2
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
1 a. Type(s) of approval sought from the
Corps:
X Section 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps?
X Yes
❑ No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
X 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 X No
For the record only for Corps Permit:
❑ Yes X No
If. 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
X No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
X No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
X No
2. Project Information
2a. Name of project:
SR 1169 Caldwell Road
2b. County:
Madison
2c. Nearest municipality / town:
Spring Creek
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
13C.057020
3. Owner Information
3a. Name(s) on Recorded Deed:
North Carolina Department of Transportation
3b. Deed Book and Page No.
N/A
3c. Responsible Party (for LLC if
applicable):
N/A
3d. Street address:
NIA
3e. City, state, zip:
N/A
3f. Telephone no.:
N/A
3g. Fax no.:,
N/A
_
3h. Email address:
NIA
Page 1 of 10
nnet C....... v 4 e

4. Applicant Information (if different from owner)
4a. Applicant is:
North Carolina Department of Transportation
4b. Name:
J.J. Swain, Jr., P.E., Division Engineer
4c. Business name
(if applicable):
N.C. Department of Transportation
4d. Street address:
55 Orange Street, P.O. Box 3279
4e. City, state, zip:
Asheville, NC 28802
4f. Telephone no.:
828 - 251 -6171
4g. Fax no.:
828- 251 -6394
4h. Email address:
yallpn ncdolapy
5. Agent/Consultant Information (if applicable) _
5a. Name:
N/A
5b. Business name
(if applicable):
N/A
5c. Street address:
N/A
5d. City, state, zip:
N/A
5e. Telephone no.:
N/A
5f. Fax no::
N/A
5g. Email address:
N /A. _ __

B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID):
NIA
1 b. Site coordinates (in decimal degrees):
Latitude: 35.80232° N Longitude: - 82.84889 °W
1 c. Property size:
0.83 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project:
Caldwell Branch
2b. Water Quality Classification of nearest receiving water:
C, Tr, ORW
2c. River basin:
French Broad
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:
Existing gravel secondary road
3b. List the total estimated acreage of all existing wetlands on the property:
0.0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
Caldwell Branch -250'; UT to Caldwell Branch 55'
3d. Explain the purpose of the proposed project:
Increase the typical section and pave the secondary road
3e. Describe the overall project in detail, including the type of equipment to be used:
Grade, drain, base and pave the roadway. Extend one pipe on jurisdictional stream. Equipment used will include
excavators, trucks and graders,
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments: blue line stream; field confirmed by NCDOT &
NC DWQ
❑ Yes X No ❑ Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
E] preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): N/A
Agency /Consultant Company:
Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
6. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
X Yes ❑ No ❑ Unknown
5b. If yes, explain in detail according to "help file" instructions. PCN previously submitted for impacts to Caldwell Branch.
Verification from USACE has not been received by NC DOT
6. Future Project Plans
6a. Is this a phased project?
❑ Yes X No
6b. If yes, explain.
Page 3 of 10
1'1/-61 C..— 11—;— 4 O M---k— 'i n nnn0 i t r. ;—

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands X Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary T
❑ Yes
❑ Corps
W1 P ❑ T
❑
❑ No
❑ DWQ
❑ Yes
❑ Corps
W2 ❑ P ❑ T
❑ No
❑ DWQ
El Yes
El Corps
W3 El ❑ P T
❑ No
❑ DWQ
El Yes
El Corps
W4 P ❑ T
❑
❑ No
❑ DWQ
❑ Yes
❑ Corps
W5 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W6 ❑ P ❑ T
❑ 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 jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404,
width
(linear
feet)
Temporary (T)
(INT)?
other)
(feet)
S1 X P ❑ T
Pipe Culvert
Caldwell Branch
X PER
❑ INT
X Corps
X DWQ
4
10
S1 ❑ P X T
Dewatering
Caldwell Branch
X PER
❑ INT
X Corps
X DWQ
4
15
S2 X P ❑ T
Pipe Culvert
UT to Caldwell
Branch
X PER
❑ INT
X Corps
X DWQ
1
10
S2 ❑ P X T
Dewatering
UT to Caldwell
Branch
X PER
❑ INT
X Corps
X DWQ
1
15
' ❑ PER
❑ Corps
S3 ❑ P El T
❑ INT
❑ DWQ
❑ PER
❑ Corps
S5 ❑ P ❑ T
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
50
3i. Comments: 20 feet of permanent and 50 feet of temporary impacts at same location.
Page 4 of 10
"r-111 c...... 4 O n..........L.... • f% '$nn0 v.....:....

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

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.
Minimum pipe length used to obtain needed typical section and shoulder width for safety.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
N/A
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 X No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
❑ payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
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:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
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.
Page 6 of 10

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 X 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:
PY--- 7 ..f 4e%

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 X No
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
Comments:
2. Stormwater Mana erxient Plan
2a. What is the overall percent imperviousness of this project?
N/A
2b. Does this project require a Stormwater Management Plan?
X Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: NC DOT Project
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
The project will use BMP's to the Maximum Extent Practicable (MEP) in compliance with NCDOT's NPDES Permit No.
000250 Post Construction Stormwater Program.
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan?
X 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
El
apply (check all that apply):
El ❑ Water Supply Watershed
❑ Other: N/A
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: N/A
4b. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes El No
attached?
S. 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 8 of 10
r9/Ihl C...... /.,...:,... 4 7 n-- k— 4n -fnno \�...,.:...,

F. Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal /state /local) funds or the
® Yes
❑ No
use of public (federal/state) land?
1 b.
If you answered 'yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes
® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered `yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑Yes
El No
letter.)
Comments:
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Weband 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 213 .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
® 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.
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 9 of 10
nr+nt r....... . 4 n n---- Lti 4r% nano .

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
❑ Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
field survey, USFWS county list, habitat requirements
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 ?'
Current Maps /Database
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?
Current Maps /Database
8. Flood Zone Designation (Corps Requirement)
-T
8a. Will this project occur in a FEMA - designated 100 -year fioodplain?
❑ Yes ®.No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? Current FEMA Maps
Roger D.Bryan
6 Feb 13
Applicant/Agent's Printed Name
Date
plicanUAgentj Signature
(Agent's signature P valid only If an authorization letter from the applicant
is Drovided .

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 Fonn Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION:
State NC County /parish/borough: Madison City: Spring Creek
Center coordinates of site (lat/long in degree decimal format)- Lat. 35.80232° N, Long. 82.84889° W.
Universal Transverse Mercator:
Name of nearest waterbody: UT to Caldwell Branch
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: French Broad River
Name of watershed or Hydrologic Unit Code (HUC): 06010105
® Check if niap/diagram of review area and/or potential jurisdictional areas is/are available upon request.
❑ - Check if other sites (e.g., offsite mitigation sites, disposal sites, etc... ) are associated with this action and are recorded on a
different JD forni
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
❑
Office (Desk) Determination. Date:
® Fieldlletermination. Datc(s): 118/2013
SECTION H: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
Thicre Are no "navigable waters of the U.S." within Rivers and IIarbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area [RegrureefJ
❑ Waters subject to die ebb and flow of the tide.
❑ Waters are presently used, or have been used in the past, or inay be susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Are "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [RequirerlJ
Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): '
❑ TNWs, including territorial seas
❑ Wetlands adjacent to TNWs
® Relatively perntanent waters (RPWs) that flow directly or indirectly into TNWs
❑ Non -RPWs that flow directly or indirectly into TNWs
❑ Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs
❑ Impoundments of junsdictional 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: 55 linear feet: I width (fl) and/or acres
Wetlands: acres.
c. Limits (boundaries) of jurisdiction based on Established by OHWM.
Elevation of established OHWM (if known):
Non - regulated waters /wetlands (check if applicable):}
❑ Potentially jurisdictional waters and/or wetlands were assessed within the review area and ddennined to be not junsdictional
Explain:
'Boxes checked below shall he supported by completing the appropriate sections in Section III belo«.
a For numnsec ofthis form_ an RPW is defined as a tributary that is tint a TN W and that tvnicaliv flows vear -round or has continuous 11ow at least "seasonalh"

SECTION Ill: 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 HLA.1 and 2
and Section IILD.1.; otherwise, see Section IU.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
Wetland adjacent to TNW
Sununarize 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 now 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 IILDA.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetiand 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 HLB.1 for
the tributary, Section IILB.2 for any onsite wetlands, and Section I1LB.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section Hf.0 below.
1. Characteristics of non -TNWs that flow directly or indirectly into TNW
(f) General Area Conditions:
Watershed size. Pick List
Drainage area: Pick List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with'fNW.
[:]Tributary flows directly into TNW.
❑ Tributary flows through Pick List tributaries before entering TNW.
Project waters are Pick List river miles from TNW.
Project waters are Pick List river rules from RPW
Project waters are Pick List aerial (straight) miles from TNW.
Project waters are Pick List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explaim
Identify flow route to TNW5:
Tributary stream order, if known:
a Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the avid
r
West.
S Plow 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 apply):
Tributary is: ❑ Natural
❑ Artificial (man -made) Explain:
❑ Manipulated (man - altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick List.
Primary tributary substrate composition (check all that apply):
❑ Silts ❑ Sands ❑ Concrete
❑ Cobbles ❑ Gravel ❑ Muck
❑ Bedrock ❑ Vegetation. Type/% cover:
❑ Other. Explain.
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry: Pick List
Tributary gradient (approximate average slope): %
(c) Elow:
Tributary provides for: Pick List
Estimate average number of flow events in review area/ycar: Pick List
Describe flow regime:
Other information on duration and volume:
Surface flow is: Pick List. Characteristics:
Subsurface flow. Pick List. Explain findings.
❑ Dye (or other) test performed:
'tributary has (check all that apply).
❑ Bed and banks
❑ OHWlvib (check all indicators that apply):
❑ clear, natural ]file 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):
El Discontinuous OHWM.' Explain:
the presence of litter and debris
destruction of tenestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant cotmmmity
If factors other than the OHWM were used to detenniue lateral extLttt of CWA jurisdiction (check all that apply)-
❑ High Tide Line indicated by: ❑ Mean High Water Mark indicated by.
❑ oil or scum line along shore objects ❑ survey to available datum;
❑ fine shell or debris deposits (foreshore) ❑ physical markings;
❑ physical markings/characteristies ❑ vegetation lincs/changes in vegetation types.
❑ tidal gauges
❑ other (list):
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
F,xplain:
Identify specific pollutants, if known:
'A natural or man -made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OIiWM has been removed by development or agricultural practices). Where there is a break in the OIIWM that is unrelated to the waterbody's flow
regime (e g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the bread.
'Ibid.

(iv) Biological Characteristics. Channel supports (check all that apply):
❑ Riparian corridor. Characteristics (type, average width):
❑ Wetland fringe. Characteristics-
Habitat for:
❑ Federally Listed species. Fxplain findings:
❑ Fisln/spawn areas. Explain findings:
❑ Other enviromnentally- sensitive blveres, Fxplain findings•
❑ Aquatic/wildlife diversity. Explain findbigs:
2. Characteristics of wetlands adjacent to non -TNW that stow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as slate boundaries. Fxplain:
(b) General Flow Relationship with Non =1NW.
Flow is: Pick List. Explain:
Surface flow is: Pick List
Characteristics:
Subsurface flow: Pick List. Explain findings:
❑ Dye (or other) test perfonued:
(c) Wetland Adjacency Determination with Non -TNW:
❑ Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection Explain:
❑ Ecological connection. Explain:
❑ Separated by berm/barrier. Fxplain:
(d) Proximity (Relationship) to "INW
Project wetlands are Pick List river miles from TNW.
Project waters are Pick List aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List 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:
(ill) Biological Characteristics. Wetland supports (check all that apply):
❑ Riparian buffer. Characteristics (type, average widdi):
❑ Vegetation type/percent cover. Explain:
❑ Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fislr/spawrn areas. Explain findings:
❑ Other environmentally - sensitive species. Explain findings.
❑ Aquatic /wildlife diversity. Explain fundings.
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pick List
Approximately ( ) acres in total are being considered in the ctuuulative analysts.

l,or each ►vedand, specify the following.
Directly abuts? ()/N) Size {in aches) Directl y abuts? (Y/N) Size (in acres)
Surmnurrize overall biological, chemical and physical functions being pertornied:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists 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 floodplain is not solely determinative of significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support fractions for fisli and
other species, such as feeding, nesting, spmvning, 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 iII D:
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.
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 WATERS/WETLANDS ARE (CHECK ALL
THAT APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
❑ TNWs- linear feet xmdth (11), Or, acres
❑ Wetlands adjacent to "INWs: acres.
RrWs that flow directly or indirectly into TNW9.
® Tributaries of'INWs where tributaries typically flow year -round are jurisdictional Provide data and rationale indicating that
tributary is perennial: Stream has prominent bed/batik features and OHWM
❑ Tributaries of TNW where tributaries have continuous flow "seasonally" (e g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally:

Provide estimates for jurisdictional waters in the review area (check all that apply):
® Tributary waters: 55 linear feet I width (fl).
❑ Other non - wetland waters- acres.
Identify type(s) of waters:
3. Non -RPWss that flow directly or indirectly into TNWs.
❑ Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
❑ Tributary waters: linear feet width (fl)
❑ Other non - wetland waters: acres.
identify type(s) of waters:
Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
❑ Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
❑ Wetlands directly abutting an RPW where tributaries typically flow year - round. Provide data and rationale
indicating that tributary is perennial in Section III.D 2, above. Provide rationale indicating that wetland is
directly abutting an RPW:
❑ Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section II1.B 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.
5. 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 welhunds, have a significant nexus with a TNW are jinisidictional Data supportnng this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non -RPWs that flow directly or indirectly into TNWs.
❑ Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres
7. Impoundments of jurisdictional waters.9
Asa general rule, the inpoundnnent of a jurisdictional tributary rennains jurisdictional.
❑ Demonstrate that impoundment was created from "waters, of the i].5.," or
❑ Demonstrate that water meets the criteria for one of the categories presented above (1 -6), or
❑ Denonstrate that water is isolated with a nexus to conunerce (see E below).
E. ISOLATED (INTERSTATE OR INTRA -STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY): r0
❑ which are or could be used by interstate or foreign travelers for recreational or other purposes.
❑ from which fish or shellfish are or could be taken and sold in interstate or foreign conunerce.
❑ which are or could be used for industrial purposes by industries in interstate commerce.
❑ Interstate isolated waters. Explain:
❑ Other factors. Explain:
Identify water body and summarize rationale supporting determination:
"See Footnote g 3
To complete the analysis refer to the key in Section 111.13.6 of the Insinicrional Guidebook
r" Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and i?PA HQ for
review consistent with the process described in the Corps/EPA .Memorandum Regarding CIVA Act Jurisdiction Following Rapanoy.

Provide estimates for jurisdictional waters in the review area (check all that apply)
❑ Tributary waters' linear feet width (11).
❑ Other non - wetland waters: acres.
Identify type(s) of waters:
❑ Wetlands: acres.
NON - JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
❑ If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
❑ Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
❑ Prior to the Jan 2001 Supreme Court decision in "SIVANCC," the review area would have been regulated based s olel on the
"Migratory Bird Ride" (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 j urisdiction 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):
❑ Non - wetland waters (i.e., rivers, streams): linear feet width (ft).
❑ Lakes /ponds: acres.
❑ Other non- wetland waters- acres. List type of aquatic resource:
❑ Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jru-isdiction (check all that apply)-
❑ Non - wetland waters (i.e., rivers, streams): linear feet, width (fl).
❑ 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/stibnutted by or on behalf of the applicant/consultant.
❑ Office concurs with data slieets/delineation report
❑ Office does not concur with data sheeWdelineation 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 niap(s) Cite scale & quad name: 1:24000, Sprung Creek Quadrangle.
❑ USDA Natural Resources Conservation Service Soil Survey. Citation:
❑ National wetlands inventory map(s). Cite name:
❑ State/l.ocal wetland inventory niap(s):
❑ FEMA/FIRM maps-NC Floodplain Mapping Program.
❑ 100 -year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
® Photographs: ❑ Aerial (Name & Date)
or ® Other (Name & Date):Stream photos in NWP Application, 1 /8/13.
❑ Previous detennination(s). File no. and date of response letter:
❑ Applicable/supporting case law:
❑ Applicable/supporting scientific literature:
❑ Other inforination (please specify):
R ADDITIONAL COMMENTS TO SUPPORT JD:

Figure 1 Site 2 Inlet
Figure 2 Site 2 Outlet

N.0 'DEPARTMENT OV TRANSPORTATION
DIVISION OF HIGHWAYS
SECONDARY ROAD SURVEY
SUBJECT: SR 1169 Caldwell Rd.
LOCATION: From 1168 to EOM
WORK TYPE: Grade, Drain, Base, and Pave
WORK ORDER: 13C.057020 PRIORITY: Rural #13
COUNTY: Madison TOWNSHIP: Spring Creek
DATE 12 -07 -11 SCALE: 113=50'
NOTES: R/W 45'
Length : 800 ft or. 15 mi
PREPARED BY: JSA/JMD
qs

Z
PIPE DATA
SR 1169, Caldwell Rd.
County:
WORK ORDER:
Madison
STATION
PRESENT
PROPOSED
NOTES
SIZE
SIZE
10 +47
30'x36 "CMP
40'x36 "CMP
Cross pipe/Ext. 10'
YE 11 +79
40'X24 "CMP
Cross Pipe (t� ►rC cs a;
11+97
30' x24 "CMP
i
Cross pipe/ Remove! t t i t i
6r A ( iA- q ?)

jk 11Vf Ufdwtlf Md
1 S MQdlsorr C.owvly
RGMDe�b .,�
Rona loll Grp
i 3y�fr2 TYPE
WA.,tk rN pars
"PC A gpc K
L
V,4 I 4 �. L��a Aotnfr 3
V / r1 Iryp 63dllcilli
— C"'t Ff96R
T4 #-E A QocK CN[Ck
i N+,Lk Gf R,f� �= D
--',0() /7F7
4 ^t _ I00 `FSaa�FFE2
S
i
VOeI��iNN4 �Ifm�ysuf Exf:IQ,
10 �-33L 469
.V......���I1..SR IIGS WEST AA......�........._..
CO
fo' GR. DR.
34,11 -VVPE
ens„
7yAE Alo6 ft
t f.-^...
. ,�xbKL i" ✓P6d BASFN
1J(Coir Ftier � «tS
iyP6A Roc kcI+KCK
/00' P5A duFiER
LI' L 6 K , ,
I
* install low & or endpoint measures in TSF.
*
I
Construct using the 30 day option.
All wattles require PAM.
* All basins located at a 5% or greater grade
must be tiered.
c q l/
I 1�
lI
D a � r; s P
i3 �
3�cRaZ+� a6
F�SECL gRC -FEES
d
w(cb�Y. .
h
h
�g
l
re
RGMDe�b .,�
Rona loll Grp
i 3y�fr2 TYPE
WA.,tk rN pars
"PC A gpc K
L
V,4 I 4 �. L��a Aotnfr 3
V / r1 Iryp 63dllcilli
— C"'t Ff96R
T4 #-E A QocK CN[Ck
i N+,Lk Gf R,f� �= D
--',0() /7F7
4 ^t _ I00 `FSaa�FFE2
S
i
VOeI��iNN4 �Ifm�ysuf Exf:IQ,
10 �-33L 469
.V......���I1..SR IIGS WEST AA......�........._..
CO
fo' GR. DR.
34,11 -VVPE
ens„
7yAE Alo6 ft
t f.-^...
. ,�xbKL i" ✓P6d BASFN
1J(Coir Ftier � «tS
iyP6A Roc kcI+KCK
/00' P5A duFiER
LI' L 6 K , ,

ri b 1 L-a td we, l t -rd
Woo Soj
* Install low & or endpoint measures in TSF.
* Construct using the 30 day option.
I
* All wattles require PAM.
* All basins located at a 5% or greater grade
must be tiered.
`o
V!
I
� czz
f �I
Cc,'j- clt
/a- 0. 4• � I
V
1 6,XTY GAFT1s-t<-- C �(Ukc �-
Q9
V
!o `A
'99(6%Z TIFE %
L'1
al Coto- Fuca. %*Wts
7yPC- A 12WIL CttGctc-
N
N
�
`�`�
Plem o s
�,,
`--- -- ---- --
Yj
Ills!

1' t .•S G' A, 11
S T ;
rI Balm Gra ?asa
DIM F
l 1 N
y 1 1
.; \.. Wap Mtn.
Site 1
' End SR 1169
f � 1
7 .�• Troublesome
Gap f
Uhrr(W CI►
1 • Y QHQ
Begin SR 1169
? Site 2 0/
o U n
taro
13 1
j a r
lt.r cam'
d .' 0100 �• /�wr� ! • %% _ \
41% '
! T \ 1 V
ap of the Mountain y�tsr �r� � • f j i,
v.
.0 f"'INthei fit
Copyright C zoos To
- SCALE 1:24000 SR 1169 Site 2
0 1000 2000 3000 4000 5000 bppp Caldwell Road
- - - - -- Madison County, NC
NFEET Spring Creek quad topo