20201815_SAW-2019-01111permitverification1_20210630

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2019-01111 County: Davidson County U.S.G.S.Quad:Welcome
GENERAL PERMIT (REGIONAL AND NATIONWIDE)VERIFICATION
Permittee: Amy Euliss
NCDOT Division 9
Address: 375 Silas Creek Parkway
Winston Salem,North Carolina 27127
Telephone Number: [phone]
Size(acres) 0.2 Nearest Town Welcome
Nearest Waterway Reedy Creek River Basin Upper Pee Dee
USGS HUC 03040101 Coordinates Latitude:35.920939
Longitude:-80.279997
Location description: The site is located along SR 1472(Welcome-Arcadia Road)over Reedy Creek at NCDOT Bridge#63 in
Davidson County.North Carolina.The site is approximately 1000 feet southeast of the Welcome-Arcadia Road,Pickett Road
intersection. NCDOT has identified the project as State Project Number 17.BP.9.R.57.
Description of projects area and activity: This authorization is for the permanent and temporary discharge of clean fill material
associated with an existing bridge replacement project. Permanent impacts include the placement of rip rap within 89 linear
feet of stream channel for bank stabilization. Permanent impacts also include the placement of fill within 0.020 acre of
wetlands(WA and WB)for a driveway connection.Temporary impacts are within 3 linear feet of jurisdictional stream and
are associated with the installation of a water line(See attached plans).
Applicable Law: ® Section 404(Clean Water Act,33 USC 1344)
❑ Section 10(Rivers and Harbors Act,33 USC 403)
Authorization: Regional General Permit Number and/or Nationwide Permit Number: GP 50-NCDOT-Bridge,Road Widenings
and Interchanges
SEE ATTACHED RGP or NWP GENERAL,REGIONAL AND/OR SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and attached information received May 28,2021,including updated plans and
information provided on June 24,2021. Any violation of the attached conditions or deviation from your submitted plans may
subject the permittee to a stop work order,a restoration order,a Class I administrative penalty,and/or appropriate legal
action.
Special Conditions:
1.Northern long-eared bat(NLEB)(Myotis septentrionalis).Standard Local Operating Procedures for Endangered Species
(SLOPES)for the NLEB have been approved by the Corps and the U.S.Fish and Wildlife Service.See
http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/ESA/.This SLOPES details how
the Corps will make determinations of effect to the NLEB when the Corps is the lead federal agency for an NCDOT project
that is located in the western 41 counties of North Carolina.This SLOPES does not address NCDOT projects(either federal or
state funded)in the eastern 59 counties in North Carolina.Note that if another federal agency is the lead federal agency for a
project in the western 41 counties,procedures for satisfying the requirements of Section 7(a)(2)of the ESA will be dictated by
that agency and will not be applicable for consideration under the SLOPES; however,information that demonstrates the lead
federal agency's(if other than the Corps)compliance with Section 7(a)(2)/4(d)Rule for the NLEB,will be required in the
PCN.Currently,the federal listing status of the NLEB as"Threatened"is being litigated at the National level.If,as a result of
litigation,the NLEB is federally listed as"Endangered",this general condition("s")will no longer be applicable because the
4(d)Rule,and this NLEB SLOPES,will no longer apply/be valid.
This verification will remain valid until the expiration date identified below unless the nationwide and/or regional general permit
authorization is modified, suspended or revoked. If, prior to the expiration date identified below, the nationwide and/or regional
general permit authorization is reissued and/or modified, this verification will remain valid until the expiration date identified below,
provided it complies with all requirements of the modified nationwide permit. If the nationwide and/or regional general permit

SAW-2019-01111
authorization expires or is suspended, revoked, or is modified, such that the activity would no longer comply with the terms and
conditions of the nationwide permit, activities which have commenced (i.e., are under construction) or are under contract to
commence in reliance upon the nationwide and/or regional general permit, will remain authorized provided the activity is completed
within twelve months of the date of the nationwide and/or regional general permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify, suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Resources(telephone [phone])to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you must contact the N.C.Division of Coastal Management in Morehead City,NC,at(252) 808-2808.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program,please contact Andrew Williams at(919)554-4884 or Andrew.E.Williams2(a,usace.armv.mil.
/l„ Date:2021.06.30
Corps Regulatory Official: M`' t1"'Z 11:43:00 04'00' Date: June 30.2021
Expiration Date of Verification: May 25,2025
A.Determination of Jurisdiction:
1. ❑ There are waters,including wetlands, on the above described project area that may be subject to Section 404 of the Clean
Water Act(CWA)(33 USC§ 1344)and/or Section 10 of the Rivers and Harbors Act(RHA)(33 USC §403).This preliminary
determination is not an appealable action under the Regulatory Program Administrative Appeal Process(Reference 33 CFR Part
331). However,you may request an approved JD,which is an appealable action,by contacting the Corps district for further
instruction. Please note,if work is authorized by either a general or nationwide permit,and you wish to request an appeal of an
approved JD,the appeal must be received by the Corps and the appeal process concluded prior to the commencement of any
work in waters of the United States and prior to any work that could alter the hydrology of waters of the United States.
2. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements
of Section 10 of the Rivers and Harbors Act(RHA)(33 USC §403)and Section 404 of the Clean Water Act(CWA)(33 USC§
1344). Unless there is a change in the law or our published regulations,this determination may be relied upon for a period not to
exceed five years from the date of this notification.
3. ❑ There are waters,including wetlands, within the above described project area that are subject to the permit requirements of
Section 404 of the Clean Water Act(CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
4. ❑ A jurisdiction determination was not completed with this request. Therefore,this is not an appealable action. However,you
may request an approved JD,which is an appealable action,by contacting the Corps for further instruction.
5. ® The aquatic resources within the above described project area have been identified under a previous action. Please reference
the approved jurisdictional determination issued 8/2/2019. Action ID: SAW-2019-01111.
B.Basis For Jurisdictional Determination: N/A.An Approved JD has not been completed.
C.Remarks: None
D. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants,or anticipate participation in USDA programs,you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service,prior to starting work.
E. Appeals Information for Approved Jurisdiction Determinations (as indicated in A2 and A3 above).

1 ligilw ajill North Carolina Department of Transportation
Sion Highway Stormwater Program
.i. ':-T47-°.
STORMWATER MANAGEMENT PLAN "''
(Version 2.08;Released April 2018) FOR NCDOT PROJECTS
WBS Element: SF-280063 TIP No.: 17.BP.9.R.57 County(ies): Davidson Page 1 of 1
General Project Information
WBS Element: SF-280063 TIP Number: 17.BP.9.R.57 MrProject Type: Bridge Replacement Date: 2/26/2021
NCDOT Contact: Daniel Dagenhart Contractor/Designer: Wood Environment&Infrastructure
Address: NCDOT Highway Division 9 Address:2801 Yorkmont Road
375 Silas Creek Parkway Suite 100
Winston-Salem,NC 27127 Charlotte,NC 28208
Phone: [phone] Phone: [phone]
Email:[e-mail] Email: [e-mail]
City/Town: Lexin, ton County(ies): Davidson
River Basin(s): Yadkin Peedee I� CAMA County? No
Wetlands within Project Limits?
Project Description
Project Length(lin.miles or feet): 350 ft. I Surrounding Land Use: Forest&rural farmland
j 1.1. Proposed Project MI Existing Site
Project Built-Upon Area(ac.) 0.2 ac. ac.
Typical Cross Section Description: (Approach)2-11'lanes with 6'shoulders (Approach)18'paved width(2-9'lanes)with 6'unpaved sloped shoulders
(Bridge)2-12'lanes with 7'11"shoulders (Bridge)2-11'lanes(27.833 Ft curb-to-curb)with 2.9 ft shoulders
Annual Avg Daily Traffic(veh/hr/day): Design/Future: 7480 Year:2041 Existing: 3080 Year: 2021
General Project Narrative: The existing single-span 40'7"bridge is being replaced with a proposed 55'single-span(21"cored-slab)structure. The bridge will be normal crown with 2%cross slopes,with
(Description of Minimization of Water 11'travel lanes and 2'11"shoulders,27'10"clear width and 30'OTO width. Existing drainage patterns are being maintained. Runoff is being discharged as far from the stream
Quality Impacts) as practicable. No deck drains are used and,since the roadway has a vertical curve that peaks in the middle of the bridge,a bridge approach drop inlet is provided at each
corner of the proposed bridge. The two inlets on the west end of the bridge discharge to the north into a proposed v-ditch. The two inlets on the east end of the bridge
discharge onto a riprap pad on the overbank and then into an existing stream. Bank protection is also provided along both sides of the stream.
Waterbody Information
Surface Water Body(1): Reedy Creek NCDWR Stream Index No.: 11-32-4
NCDWR Surface Water Classification for Water Body Primary Classification: Class C None
Supplemental Classification: None
Other Stream Classification: None
Impairments: None
Aquatic T&E Species? Comments:
NRTR Stream ID: Buffer Rules in Effect:
Project Includes Bridge Spanning Water Body? Yes Deck Drains Discharge Over Buffer? No Dissipator Pads Provided in Buffer? N/A
Deck Drains Discharge Over Water Body? No (If yes,provide justification in the General Project Narrative) (If yes,describe in the General Project Narrative;if no,justify in the
(If yes,provide justification in the General Project Narrative) General Project Narrative)

F
See Sheet A.A For Index of Sheets F (OF
STATE STATE PROJECT REFERENCE NO. NO. SHEETS
/ 1ST SHEET TOTOTALd • 1111-1� A_ ii•� ill A
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II I L -L- POT Sta./3+52.88
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cc END BRIDGE
- L - POT Sta . 13+00 . 13
/1 -DRl_A-
DOCUMENT NOT CONSIDERED FINAL
UNLESS ALL SIGNATURES COMPLETED
PLANS PREPARED BY: PLANS PREPARED FOR: HYDRAULICS ENGINEER
c.,) GRAPHIC SCALES DESIGN DATA PROJECT LENGTH DIVISION OF HIGHWAYS
WOOv. DIVISION 9
ADT 2021 = 3,080 4021 STIRRUP CREEK DRIVE
50 25 0 50 100 - DURHAM, NC 27703 375 SILAS CREEK PARKWAY NO(n3?%
ADT 2041 = 7,480 LENGTH ROADWAY PROJECT 17BP . 9 . R . 57 = 0 . 055 mi NC ENG F-1253 WINSTON SALEM, NC 27127 �� C�
itilliplib\- 1111 _ ' ° 2018 STANDARD SPECIFICATIONS �Q� ��°
PLANS K o° LENGTH STRUCTURE PROJECT 17BP . 9 . R . 57 = 0 . 011 mi P.E. % Q�
} Eitel D = �0 SIGNATURE:
50 25 0 50 100 = * ;
� {�} T % TOTAL LENGTH OF PROJECT 17BP . 9 . R . 57 = 0 . 066 mi RIGHT OF WAY DATE: CHRISTOPHER H. LEE, PE �A
PROJECT ENGINEER ROADWAY DESIGN
V -- 50 MPH NOVEMBER 26, 2019 ENGINEER ..e. • ' ''' ''©
iiQ PROFILE (HORIZONTAL) o0
z * TTST = DUAL �� o p��Q
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5 2.5 0 5 10 FUNC CLASS = LETTING DATE: DANIEL R. DAGENHART
-64-69Z cm) T
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11111
LOCAL APRIL 20, 2021 DIV 9 BRIDGEOPROGRAMTMANAGER
PROFILE (VERTICAL) SUB-REGIONAL TIER
- -64-(A �� J SIGNATURE: J� J

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0- PROJECT REFERENCE NO. SHEET NO.
0-
Lc
RAW SHEET NO.
ROADWAY DESIGN HYDRAULICS
ENGINEER ENGINEER
WETLAND AND SURFACE WATER PERMIT IMPACTS
F F PER W L IN
TLANDS
* * MECHANIZED CLEARING
\N * * * *
* * * * IN WETLANDS
// PERMANENT
DOCUMENT NOT CONSIDERED FINAL
IMPACTSEAM UNLESS ALL SIGNATURES COMPLETED
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wood.
04- 4021 STIRRUP CREEK DRIVE
2 DURHAM, NC 27703
NC ENG F-1253
DETAIL 1 DETAIL 2
SPECIAL LATERAL 'V' DITCH SPECIAL LATERAL BASE DITCH o DETAIL 3 DETAIL 4
(Not to Scale) (Not to Scale)
o o o / TOE PROTECTION
toScale BANK STABILIZATION
(Inn. i'' e
in ''Front oo
(Not ) (Not to Scale) Natural Bed
*`A o< Ditch N MARLIN & M W < Elevation
Natural 3'1 g< Natural o< Fill LARRY & KATHLEEN MICHAEL ale Natural Natural
Ground ?•/ D F\a'� Slope Ground •./ D F\a'e< Slope wv� C JUDY PARKER DB 2065 PG 1812 N 0, ove Ground Ground
946 PG 606 Natural
,-� s�
p Min. D= 1 Ft. ti�
Min. D= 1 Ft. Geotextile 6= 2 Ft. I
` b 'i d 2' Flatter
or
Flatter(TYP)
'� d= 1 Ft. Geotextile
b= 3.5 Ft. Geotextile Channel Bed
-L- STA. 12+90 LT TO STA. 13+00 LT Length= 30 Ft.
-L- STA. 11+25 LT TO STA. 12+40.52 LT (variable)
CL I RIP RAP = 8 TONS / Type of Liner= Class "I" Rip-Rap Type of Liner= CL"II" Rip Rap - Keyed-In
*-DRl_A- STA. 10+35 LT TO STA. 11+87.00 RT GEO = 15 SY (4)11
SITE 2 SPECIAL LATERIAL V DITCH-L- STA. 13+73 LT TO STA. 14+25 LT 2' LAT. BASE-DITCH / SEE DETAIL 1 / FROM STA. 11+25 RtTO STA. 11+45 Rt STA. 12+44 TO 12+55, STA. 12+84 TO 12+99
CL I RIP RAP = 42 TONS CL I RIP RAP = 13 TONS CL II RIP RAP = 26 TONS
GEO = 80 SY (SEE DETAIL 2) GEO = 26 SY GEO = 54 SY
I 8 TN CL "I" RR
8 SY GEOel") SITE
SITE 4
"'(0 PIPE OUTLET DITCH
0o DISTURB TREES ONLY AS NEEDEDJAMES E CRAVER JR. STABILIZATION (DETAIL 5) \,RENAL & ARRY " N DB 2250 PG 2418 6 TN CL "I" RR f)ii,:a
OUTSIDE OF SLOPE STAKES DANIEL G & JULIA R SWAIN LARRY MICHAEL FAMILY TRUST
//V DITCH 1' MINIMUM 6 SY GEO o DB 1004 PG 593/ F A E if / / o .
p `' ' / DB 2065 PG 1807
50 P 24 ., 4 0. '�� U —
iEP H SE D A�1) ���
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)7 � i• g p � t I `/� 111,2 (SEE DETAIL 3) ��/� Tir:lirrDr0111
�11litI `i �_� ��� I f V /
/ .,/� WOODS /
e/ /.: '/v . BK WI L r _ / \ WOO S ,bL •
/ / NMARK CRAVER / / �^ L� / i I bLEDB 1020 PG 172i /' - - ,_,- `1 / /I—�' ^ (0` i i' _ 0 ' AS NEEDEC SbL- HN BOND
�°' CLASS "II" RIPRAP AND 1OUTSIDE OF SLOPE STAKES DB 2052 PG 1127
GEOTEXTILE FABRIC ���o. �/1, FILL IN EXISTING
0) ti( STEVEN HUNT i�;,k OUTLET DITCH /
orv�P M DB 1167 PG 130 Rit 6 TN CLASS "I" RR
SITE 3 6 SY GEO
\Ai
/ JAMES E CRAVER JR. SL--OULDER BERM STA 12+2 01 TO
STA 12+32.01 LT & RT
DB 2256 PG 1426 / ww" -L- STA 13+11.01 TO -L- STA 13+16.01 LT & RT
);'
BANK STABILIZATIONDETAIL 5 DETAIL 6 (DETAIL 4)
PIPE OUTLET DITCH STABILIZATION RIP RAP AT EMBANKMENT(Not to Scale) (Not to Scale)Natural Bed Elevation 10'min.-> \ -DR/_Aatural Natural aHGround Ground Ditch ��l.o'min 2' N 792506M E 1621031 THOMAS & AUDRA SOUTHER P/ Sto /0+47.49
Grade BL STA 10+73 58RT1' . ELEV.=730.06' DB 1736 PG 396 = 43` 3/� 14.3" (LT)
RR SPIKE IN 24" MAPLE 1 D = /68` 3/' 0/.2"
Geotextile GEOTEXTILEdio 0 L = 25.83/
Channel Bed
(Variable) =
Length= 2 Ft. a M co T /3.57'
Type of Liner= 380 TONS,CL II Rip-Rap v J
Type of Liner= CL I Rip-Rap - Keyed-In Geotextile= 284 sy M co M co
STA. 12+29 CL I RIP RAP = 2 TONS STA. 12+44 TO 12+55, STA. 12+84 TO 12+99 z ° ^n R = 34.00
GEO = 3 SY
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0- PROJECT REFERENCE NO. SHEET NO.
0-
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ROW SHEET NO.
ROADWAY DESIGN HYDRAULICS
ENGINEER ENGINEER
WETLAND AND SURFACE WATER PERMIT IMPACTS
/y// PERit)I ANDS L IN
\li'\ r . . .
MECHANIZED CLEARING
IN WETLANDS
DOCUMENT NOT CONSIDERED FINAL
WU PERMANENT STR
IMPACTSEAM UNLESS ALL SIGNATURES COMPLETED
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wood.
0is 4021 STIRRUP CREEK DRIVE
1- DURHAM, NC 27703
NC ENG F-1253
DETAIL 1 DETAIL 2
SPECIAL LATERAL 'V' DITCH SPECIAL LATERAL BASE DITCHo /
o DETAIL 3 DETAIL 4
(Not to Scale) (Not to Scale)
o o TOE PROTECTION BANK STABILIZATION
V) N. N Not to Scale)( (Not to Scale) Natural Bed
Front*`.1 of Ditch N MARLIN & M W t Elevation
Natural 3'1 e< Natural of Fill LARRY & KATHLEEN MICHAEL ode Natural Natural
Ground '''../ � Slope Ground ?•� D �` ,�e< Slope z JUDY PARKER DB 2065 PG 1$12 N N t�\ a iitIil
k Natural o �oQN Ground �.. F`�\SmD= 1Ft. Geotextile B= 2 Ft• M ` 'i d Ln
d= 1 Ft. e
�- b= 3.5 Ft. Geotextile Channel Bed
-L- STA. 12+90 LT TO STA. 13+00 LT Length= 30 Ft.
-L- STA. 11+25 LT TO STA. 12+40.52 LT CL I RIP RAP = 8 TONS N Type of Liner= Class "I" Rip-Rap Type of Liner= CL"II" Rip-Rap�aKeyed-In
*-DR1_A- STA. 10+35 LT TO STA. 11+87.00 RT GEO = 15 SY SITE 2 SPECIAL LATERIAL V DITCH
-L- STA. 13+73 LT TO STA. 14+25 LT 2' LAT. BASE-DITCH SEE DETAIL 1 FROM STA. 11+25 Rt TO STA. 11+45 Rt STA. 12+44 TO 12+55, STA. 12+84 TO 12+99
/
CL I RIP RAP = 42 TONS CL I RIP RAP = 13 TONS CL II RIP RAP = 26 TONS
GEO = 80 SY (SEE DETAIL 2) GEO = 26 SY GEO = 54 SY
8 TN CL "I" RR
8 SY GEO
/
el") SITE 4 �s SITE 1
"' PIPE OUTLET DITCH ` ) 1'
00DISTURB TREES ONLY AS NEEDED
JAMES E CRAVER JR. STABILIZATION (DETAIL 5) .
RENAE C & LARRY N DB 2250 PG 2418 6 TN CL "I" RR OUTSIDE OF SLOPE STAKES DANIEL G & JULIA R SWAIN LARRY MICHAEL FAMILY TRUST
F BAILEY 6 SY GEO •, f /.- / DB 1004 PG 593 0 DB 2065 PG 1807
V-DITCH 1' MINIMUM `X ,�� , j— — o
DB 2250 PG 2415 N
DEPTH (SEE DETAIL 1) t / ; o
RIPRAP Iiik
`
I I r
\ o (SEE DETAIL 6) ABr:V 'OU D DI . '� F\� ��� \g2�'� �1 WOODS
N E AS T T ' \ C4 1� " / I I I I
Nc 8\ EIR _ ' �R�CM P �r 040► 0
I • I
_w EXISTING R/W -• .N A
�,- _ _ —�� 2' BASE DITCH (SEE DETAIL 2) 16,1
� ..�� C GRE . �o�a��f r.,F %''-� '� �_ .�� vw�rt W 1 y 15" RCf�
— w— w - 0' � ,� — — — 1 8"PVC _I 12"1RCP —
����1Gi'fe! a �� . _ �. ._ ff� EXIST. PIP �— — _/ V���-
i= . ._wawa' ,. MIA M_ =I (� �� BOLLARD I
\ 11 yID■ r r —TV
—
P \ 23.6'BST o �// 2B 2G1<0404> I �lyl f" i I =�—
�� \� .. MOM OLD US 52
�� WELCOME ARCADIA ROAD (SR 1472) N ��Ij11 ^� ��� I N
'� 2" RCP A__ 0 2B 2GI<040'' lilt 'rAfia— r'�� ; 2: iy
i _ RIPRAP . — 81 _� �Si?x t � �f1 S 4 i � ' 1 _ — _ / _ — —c- - - - — — — —
j��- _ 4 PL GREU TL-3 1�,i As�./ tar • 8 — —c / I —
G may a�.. t r it L� :_ \ 24" CM
WOODS ./ i LLgkst _ G �!,!r - — —
urr
8" BK WALL / ��// � W EXISTING R/W y���' iiU���/in i '44♦�0 �� •.- ��� 1 I (=Pr
/ "� //j UY N �S°I5'22' TOE PROTECTION ��� 4 4
(SEE DETAIL 3) R PAW ,�Q40� 1 1 /
w �`�., 111,29,
/� Am MIT
e� ,+ 8" BK WALL ��j ---- WOODS I f i /
/ / \./ ai / `\ WOODS / I
MARK GRAVER Q/PP / o
DB 1020 PG 1721 / 6)' �� _, i JOHN BOND
°• /\ �� CLASS "II" RIPRAP AND 7 �" DIST i' : TREES ONLY AS NEEDEC '.�` DB 2052 PG 1127
OUTSI D E OF SLOPE STAKES
1
GEOTEXTILE FABRIC +
�°� �°j STEVEN HUNT �' FILL IN EXISTING
OUTLET DITCH
P^-) DB 1167 PG 130 2 b TN CLASS I RR
SITE 3 /// / 6 SY GEO
JAMES E CRAVER JR. Wl \ SHOULDER
E2 B2 Ol TOERM
STA 12+32.01 LT & RT
/ DB 2256 PG 1426 ti -L- STA 13+11.01 TO -L- STA 13+16.01 LT & RT
BANK STABILIZATION
DETAIL 5 DETAIL 6 (DETAIL 4)
PIPE OUTLET DITCH STABILIZATION RIP RAP AT EMBANKMENT
(Not to Scale) (Not to Scale)
Natural Bed
Elevation 10'min.-i-
-DR/-A
atural Natural B M
Ground Ground Ditch ��l.o'min. 2' N 792506 E 1621031 THOMAS & AUDRA SOUTHER P/ Sto 10+47.49
Grade BL STA 10+73 58RT p6 1736 PG 396 A = 43` 3/' 14.3" (LT)
1, GI ELEV.=736e06'
�, RR SPIKE IN 24" MAPLE D = 168` 3/' 0/.2"
Geotextile < GEOTEXTILE 0 L = 25.83'
Channel Bed
(Variable) CD =
Length= 2 Ft. p M co T /7.57
Type of Liner= 380 TONS,CL II Rip-Rap v J
Type of Liner= CL I Rip-Rap - Keyed-In Geotextile= 284 sy M co M co
STA. 12+29 CL I RIP RAP = 2 TONS STA. 12+44 TO 12+55, STA. 12+84 TO 12+99 z ° ^n R = 34.00
GEO = 3 SY
/
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�-(79

r
o- PROJECT REFERENCE NO. SHEET NO.
L j R'W SHEET NO.
ROADWAY DESIGN HYDRAULICS
ENGINEER ENGINEER
WETLAND AD SURFA RFAZ WAT ' ERMIT IMPACTS
i \ / / •
, .
/F PER WETLANDS L IN
I , / r33
• : :. * MECHANIZEDDLANDSRING
\\?, ,
PERMANENT STREAM DOCUMENT NOT CONSIDERED FINAL
SI T E 2 \\\� IMPACTS UNLESS ALL SIGNATURES COMPLETED
, ',j3
/ V . WO 0
d.
\, 4021 STIRRUP CREEK DRIVE
D URHAM, NC 27703
,_)3
NC ENG F-1�� \\ 253
3 SITE 1
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S I T E 4 \C \ c
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4:11\
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E:i ,
-'''
,__\
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- \ CASV \ T 0 A I .-� .. L—CP \ \ s. — \
I141
.• /kIPRAP V.
\040J MIL 41.11181 PVC ,_,,,,,„.____PR, - !,J .- 7 -
, _,..,_....... w . . . . .
-NENN ---- 1 otolopircol r=.4 tri wilt*..,____4.;,i ivilii
1\
-Ilackt."\ Aw*. - ww.) \\ C_________M?__-___ irt
Il ale
1 0,1100.00,...,
1 'T FP.Ilr% ritillirr - W
c\._ <0404 . 4110 - ir,- - A r // , ,
�r 1 z1� � UILIMM IVATEfIllPI �
. ...40,
...„.„,,„,,, C,0407> 4m1 o
triliNil rellireTk 1
ir
0 04 0 �� !�►�►1 � �� of
►-�-���,_ _G RE U T L-3 �141111►�-.� r �/-.�� :::::::::,,,kli:' Iv gi 03 *Ng 1 pp 4 A A : -GREU - _ _ _ - -
Ar'' 7 C\..
Im
I,� i�� ��-rtitti�t � -- r - r ,90 tr G ifirtirAkierfiftt ._- , _ _ _ — 2
afe
F6-1
S I T E 3 /--40
,, i 1,L, '4.i grarittiOilli
111,111
/ AS itiki -, *4 4f' K04o6 , ,
M MIT il
WOODS I
j3 '
//(81 ---,,
-
-
- -
-
H.
, , - ',i --3
JAIVES E CAVER JRo / \Oil
D3 2256 PG I 4 2 6 y \
/ \/
CO
/
4-
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Laeo_i 4-4
*44 -

WETLAND AND SURACE WATER IMPACTS SUMMARY
WETLAND IMPACTS SURFACE WATER IMPACTS
Hand Existing Existing
Permanent Temp. Excavation Mechanized Clearing Permanent Temp. Channel Channel Natural
Site Station Structure Fill In Fill In in Clearing in SW SW Impacts Impacts Stream
No. (From/To) Size/Type Wetlands Wetlands Wetlands in Wetlands Wetlands impacts impacts Permanent Temp. Design
(ac) (ac) (ac) (ac) (ac) (ac) (ac) (ft) (ft) (ft)
1 LT. 13+47-14+06 Driveway,30"Pipe,&Waterline <0.01 <0.01
2 LT. 13+20-13+40 Driveway,30"Pipe,&Waterline <0.01 <0.01
3 12+56-12+83 Bridge/Bank Stabilization <0.02 _ 89.00
4 12+54-12+89 Waterline Installation <0.01 3.00
(Temporary Impacts associated with Site 4 fall entirely within the footprint of Site 3)
TOTALS*: <0.01 0.00 0.00 <0.01 0.00 1 <0.02 <0.01 89 3.00 0.00
*Rounded totals are sum of actual impacts
NOTES:
NC DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
02/26/2021
DAVIDSON
17BP.9.R.57
Revised 2018 Feb SHEET 1 OF 1

SAW-2019-01111
If you object to this determination,you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed
you will find a Notification of Appeal Process(NAP)fact sheet and Request for Appeal(RFA)form. If you request to appeal this
determination you must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Philip Shannin,Appeal Review Officer
60 Forsyth Street SW,FLOOR M9
Atlanta,Georgia 30303-8803
Phone: [phone]
EMAIL:[e-mail]
In order for an RFA to be accepted by the Corps,the Corps must determine that it is complete,that it meets the criteria for appeal
under 33 CFR part 331.5,and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form,it must be received at the above address by:Not Applicable.
It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this
correspondence.
rl,4 Date: 2021 .06.30 11 .4332
At -04'00'
Corps Regulatory Official:
Andrew Williams
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so,please complete our Customer Satisfaction Survey,located online at
http://corpsmapu.usace.army.mil/cm_apex/f?p=136:4:0.
Copy furnished(via email):
Dave Wanucha
North Carolina Department of Natural Resources
Division of Water Resources
585 Waughtown Street
Winston-Salem,NC 27107
dave.wanucha(a�ncdenr.gov

Action ID Number: SAW-2019-01111 County: Davidson County
Permittee: Amy Euliss
North Carolina Department of Transportation-Division 9
Project Name: NCDOT/SR 1472/BR 63/Division 9/17BP.9.R.57
Date Verification Issued: June 30, 2021
Project Manager: Andrew Williams
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn: Andrew Williams
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee Date

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
.1411 REQUEST FOR APPEAL AIL
Applicant: Amy Euliss North Carolina Department of File Number: SAW-2019-01111 Date: June 30,2021
Transportation-Division 9
Attached is: See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter of permission) A
L PROFFERED PERMIT (Standard Permit or Letter of permission) B
PERMIT DENIAL C
P APPROVED JURISDICTIONAL DETERMINATION D
PRELIMINARY JURISDICTIONAL DETERMINATION E
SECTION I-The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at http://www.usace.army.mil/Missions/CivilWorks/RegulatoryProgramandPermits.aspx or
Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit,you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission(LOP),you may accept the LOP and your work is authorized. Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety,and waive all rights to appeal the
permit,including its terms and conditions,and approved jurisdictional determinations associated with the permit.
• OBJECT: If you object to the permit(Standard or LOP)because of certain terms and conditions therein,you may request that the
permit be modified accordingly.You must complete Section II of this form and return the form to the district engineer. Your
objections must be received by the district engineer within 60 days of the date of this notice,or you will forfeit your right to appeal
the permit in the future. Upon receipt of your letter,the district engineer will evaluate your objections and may: (a)modify the
permit to address all of your concerns,(b)modify the permit to address some of your objections,or(c)not modify the permit
having determined that the permit should be issued as previously written. After evaluating your objections,the district engineer
will send you a proffered permit for your reconsideration,as indicated in Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit,you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission(LOP),you may accept the LOP and your work is authorized. Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety,and waive all rights to appeal the
permit,including its terms and conditions,and approved jurisdictional determinations associated with the permit.
• APPEAL: If you choose to decline the proffered permit(Standard or LOP)because of certain terms and conditions therein,you
may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of this form
and sending the form to the division engineer. This form must be received by the division engineer within 60 days of the date of
this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative
Appeal Process by completing Section II of this form and sending the form to the division engineer. This form
must be received by the division engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or
provide new information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the date of
this notice means that you accept the approved JD in its entirety,and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD,you may appeal the approved JD under the Corps of Engineers Administrative
Appeal Process by completing Section II of this form and sending the form to the division engineer. This form must be received by
the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps
regarding the preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved
JD (which may be appealed),by contacting the Corps district for further instruction. Also you may provide new
information for further consideration by the Corps to reevaluate the JD.
SECTION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your
objections to an initial proffered permit in clear concise statements. You may attach additional information to
this form to clarify where your reasons or objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record,the Corps
memorandum for the record of the appeal conference or meeting, and any supplemental information that the
review officer has determined is needed to clarify the administrative record. Neither the appellant nor the Corps
may add new information or analyses to the record. However, you may provide additional information to clarify
the location of information that is already in the administrative record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the If you only have questions regarding the appeal process you may
appeal process you may contact: also contact:
District Engineer,Wilmington Regulatory Division, CESAD-PDO
Attn:Andrew Williams U.S.Army Corps of Engineers, South Atlantic Division
3331 Heritage Trade Drive,Suite 105 60 Forsyth Street,FLOOR M9
Wake Forest,North Carolina 27587 Atlanta,Georgia 30303-8803
[e-mail] Phone: [phone]
EMAIL: [e-mail]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel,and any government
consultants,to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investigation,and will have the opportunity to participate in all site investi ations.
Date: Telephone number:
Signature of appellant or agent.
For Permit denials,Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer,Commander,U.S.Army Engineer Division,South Atlantic,Attn: Mr.Philip Shannin,Administrative
Appeal Officer,CESAD-PDO,60 Forsyth Street,FLOOR M9,Atlanta,Georgia 30303-8803
Phone: [phone]
EMAIL: [e-mail]