20210923_2019-00831 NWP 3 Tearsheet_20210728

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2019-00831 County:Rockingham U.S.G.S. Quad:NC-Reidsville
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: NCDOT Division 7
Attn:Wright Archer III,PE
Address: PO Box 14996
Greensboro,NC 27415-4996
Size(acres) —18 Nearest Town Reidsville
Nearest Waterway Wolf Island Creek River Basin Roanoke
USGS HUC 03010103 Coordinates 36.37237,-79.685748
Location description: The project area is located at Bridge No.239 on SR 1998(Wentworth Street)over Wolf Island Creek in
Reidsville,Rockingham County,North Carolina.
Description of projects area and activity: This verification authorizes the discharge of clean fill material associated with removal
of an existing bridge(Bridge 117 on SR 1780).The project includes permanent impacts to<0.01 acre(54 linear feet)of stream
channel(bank stabilization)and temporary impacts to 0.01 acre(65 linear feet)of stream channel.The project also requires
hand clearing in 0.01 acre of riparian non-riverine wetlands.
Applicable Law(s): N Section 404(Clean Water Act,33 USC 1344)
❑Section 10(Rivers and Harbors Act,33 USC 403)
Authorization: NWP 3.Maintenance
SEE ATTACHED 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,your application signed and dated 6/23/2021,and the enclosed plans"Wetland and Surface Water Impacts Permit",
Permit Drawing Sheets 1 through 5.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.
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 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.
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 David E.Bailey at(919)554-4884 X 30 or David.E.Bailey2 /usace.army.mil.
Corps Regulatory Official: /j' Date:2021.07.28 15:08:29 04'00'
Date: 07/28/2021
Expiration Date of Verification: 03/18/2022

SAW-2019-00831
SPECIAL CONDITIONS
1. Historic Properties (MOA): The Permittee shall fully implement the Memorandum of Agreement
between the Permittee,the North Carolina State Historic Preservation Officer and the U.S. Army
Corps of Engineers,Wilmington District, dated October 2, 2019,which is incorporated herein by
reference.
2. The U.S. Fish and Wildlife Service's (USFWS's) Programmatic Biological Opinion (PBO) titled,
"NCDOT Program Effects on the Northern Long-eared Bat in Divisions 1-8", dated November 6,
2020, contains agreed upon conservation measures for the NLEB. As noted in the PBO,
applicability of these conservation measures varies depending on the location of the project. Your
authorization under this Department of the Army permit is conditional upon your compliance
with all applicable agreed upon conservation measures in the PBO,which are incorporated by
reference in this permit. Failure to comply with the applicable these conservation measures would
constitute non-compliance with your Department of the Army permit. The USFWS is the
appropriate authority to determine compliance with the terms and conditions of its PBO, and with
the ESA.
3. The USFWS's Programmatic Biological/Conference Opinion (PBO/PCO) titled "Bridge and
Culvert Replacements/Repairs/Rehabilitations in Eastern North Carolina,NCDOT Divisions 1-
8)," dated September 11, 2019, contains mandatory terms and conditions to implement the
reasonable and prudent measures that are associated with "incidental take" that are specified in
the PBO/PCO. Your authorization under this Corps permit is conditional upon your compliance
with all the mandatory terms and conditions associated with incidental take of the PBO/PCO,
which terms and conditions are incorporated by reference in this permit. Failure to comply with
the terms and conditions associated with incidental take of the PBO/PCO,where a take of the
listed species occurs,would constitute an unauthorized take, and it would also constitute non-
compliance with your Corps permit. The USFWS is the appropriate authority to determine
compliance with the terms and conditions of its PBO/PCO, and with the ESA.
- Date: 2021 .07.28
15:08:08 -04'00'
Corps Regulatory Official: _ Date: 07/28/2021
Expiration Date of Verification: 03/18/2022
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 the Customer Satisfaction Survey located at https://regulatory.ops.usace.army.mil/customer-service-survey/.
Copy furnished:
Jerry Parker,NCDOT,P.O.Box 14996,Greensboro,NC.27415-4996
Ryan Conchilla,NCDEQ-DWR, 1617 Mail Service Center,Raleigh,NC 27699-1617

MEMORANDUM OF AGREEMENT
AMONG THE U.S.ARMY CORPS OF ENGINEERS,
THE NORTH CAROLINA DEPARTMENT OF TRANSPORTATION,
AND
THE NORTH CAROLINA STATE HISTORIC PRESERVATION OFFICER
FOR
REPLACEMENT OF BRIDGE NUMBER 239 ON SR 1998 (WENTWORTH STREET)
OVER WOLF ISLAND CREEK
ROCKINGHAM COUNTY,NORTH CAROLINA
WBS No. 17BP.7.R.140
PA No.19-01-0025
AID#SAW-2019-00831
WHEREAS, the U.S. Army Corps of Engineers (LTSACE) is considering issuance of a permit under
Section 404 of the Clean Water Act to the North Carolina Department of Transportation (NCDOT)
for Replacement of Bridge Number 239 on SR 1998 (Wentworth Street) over Wolf Island Creek,
Rockingham County,North Carolina (the Undertaking);and
WHEREAS, the USACE has determined that the Undertaking will have an adverse effect upon
Rockingham County Bridge Number 239, a property determined eligible for listing in the National
Register of Historic Places (NRHP) (historic property);and
WHEREAS, the USACE has consulted with the North Carolina State Historic Preservation Officer
(SHPO) pursuant to 36 CFR Part 800, regulations implementing Section 106 of the National
Historic Preservation Act(16 U.S.C. 470f);and
WHEREAS, USACE has notified the Advisory Council on Historic Preservation (Council) of the
adverse effects and the Council has declined to comment or participate in the consultation;and
WHEREAS,NCDOT has participated in the consultation and has been invited by the USACE and
SHPO to be a signatory to this Memorandum of Agreement (MOA);and
NOW,THEREFORE, USACE, NCDOT,and the SHPO, agree that any authorization issued for
the Undertaking shall include the following stipulations to take into account the effect of the
Undertaking on the historic property.
7110A for Bridge Number 239
Rockingham County
pg.1

STIPULATIONS
The USACE will require compliance with the following measures by including a special condition in
any authorization that is issued to NCDOT for the Undertaking.
I. Photorecordation
Prior to the initiation of construction, NCDOT will record the existing condition of Bridge No.
239 and its surroundings in accordance with the attached Historic Structures and Landscape
Recordation Plan (Appendix A). Copies of the documentation will be deposited in the files of
the State Historic Preservation Office, and the NCDOT Historic Architecture Section.
II.Unanticipated Discovery
In accordance with 36 CFR 800.11(a),if NCDOT identifies additional cultural resource(s)
during construction, all work will be halted within the limits of the resource(s) and the USACE
will be contacted. The USACE will initiate the appropriate agency and/or Tribal coordination
required for a determination of eligibility or recovery effort. If after consultation between the
Signatories and concurring parties, additional mitigation is determined necessary, the NCDOT,
in consultation with the Signatories and concurring parties,will develop and implement
appropriate protection/mitigation measures for the resource(s). Inadvertent or accidental
discovery of human remains will be handled in accordance with North Carolina General
Statutes 65 and 70.
III.Amendments
Should any of the Signatory Party(ies) to this MOA believe that its terms cannot be carried out
or that an amendment to the terms must be made,that party(ies) shall immediately consult
with the other party(ies) to develop amendments in accordance with 36 CFR 800.6(c)(7). This
MOA may be amended when such an amendment is agreed to in writing by all signatories. The
amendment will be effective on the date a copy,signed by all of the signatories,is filed with
the ACHP. If an amendment cannot be agreed upon, the dispute resolution process set forth
in Stipulation IV will be followed.
IV. Dispute Resolution
Should any of the Parties to this MOA object within (30) days to any plans or documentation
provided for review pursuant to this MOA, the USAGE shall consult with the objecting
party(ies) to resolve the objection. If the USACE or the objecting party(ies) determines that
the objection cannot be resolved, the USACE will forward all documentation relevant to the
dispute to the Council. Within thirty (30) days after receipt of all pertinent documentation, the
Council will either:
1. Provide the USACE with recommendations,which the USACE will take into account in
reaching a final decision regarding the dispute,or
2. Notify the USAGE that it will comment pursuant to 36 CFR Section 800.7(c) and proceed to
comment. Any Council comment provided in response to such a request will be taken into
account by the USAGE in accordance with 36 CFR Section 800.7(c)(4)with reference to the
subject of the dispute.
MOA for Bridge Number 239
Rockingham County
pg.2

Any recommendations or comments provided by the Council will be understood to pertain
only to the subject of the dispute;the signatories' responsibilities that are not the subject of the
dispute will remain unchanged.
V.Termination
Any of the Signatory Party(ies)to this MOA may terminate the agreement by providing notice
to the other parties,provided that the signatories and concurring parties will consult during the
period prior to termination to seek agreement on amendments or other actions that would
avoid termination. Termination of this MOA will require compliance with 36 CFR 800. This
MOA may be terminated by the execution of a subsequent MOA that explicitly terminates or
supersedes its terms.
VI. Duration
Unless terminated pursuant to Stipulation XII above, this MOA will be in effect until the
USACE,in consultation with the other Signatory Parties,determines that all of its terms have
been fulfilled or if NCDOT is unable or decides not to construct the Undertaking.
Execution of this MOA by USACE,NCDOT,and the North Carolina SHPO, its subsequent filing
with the Council, and implementation of its terms evidence that the USACE has afforded the
Council an opportunity to comment on the Undertaking, and that USACE has taken into account
the effect of the Undertaking on the historic property.
MOA for Bridge Number 239
Rockingham County
pg.3

AGREE:
United States Army Corps of Engineers:
FOR THE COMMAN7ER
Scott McLendon Date
Chief, Regulatory Division
Wilmington District
State Historic Preservation Officer:
Date: r7 1 03 /?„Att. l
Kevin henry,Ph.D.
Deputy Secretary North Carolina Department of Natural and Cultural Resources
North Carolina Department of Transportation:
14- OS /1/443
�
�—�.� Date:
Philip S. Har III,P.E., CPM
Environmental Analysis Unit Head
MOA for Bridge Number 239
Rockingham County
pg.4

MEMORANDUM OF AGREEMENT
AMONG THE U.S.ARMY CORPS OF ENGINEERS,
THE NORTH CAROLINA DEPARTMENT OF TRANSPORTATION,
AND
THE NORTH CAROLINA STATE HISTORIC PRESERVATION OFFICER
FOR
REPLACEMENT OF BRIDGE NUMBER 239 ON SR 1998 (WENTWORTH STREET)
OVER WOLF ISLAND CREEK
ROCKINGHAM COUNTY,NORTH CAROLINA
Execution of this MOA by USACE, NCDOT, and the North Carolina SHPO,its subsequent filing
with the Council, and implementation of its terms evidence that the USAGE has afforded the
Council an opportunity to comment on the Undertaking, and that USACE has taken into account
the effect of the Undertaking on the historic property.
FILED:
Date:
Advisory Council on Historic Preservation
11�#DA for Bridge Number 239
Rockingham County
pg.5

APPENDIX A
Historic Structures and Landscape Recordation Plan
For
The Replacement of Bridge Number 239
on SR 1998 (Wentworth Street) over Wolf Island Creek
Rockhingham County,North Carolina
PHOTOGRAPHIC REQUIREMENTS
• Elevations and oblique views of Bridge Number 239 and its setting.
• Representative structural and ornamental details of the bridge.
Photographic Format
■ Color digital images (all views). Images are to be shot on a SLR digital camera with a minimum
resolution of 6 megabyte pixels, at a high quality (preferably RAW) setting, to be saved in TIF
format as the archival masters and labeled according to the State Historic Preservation Office
standards.
• All processing to be done to archival standards.
■ The accompanying printed inventory of the images — including subject, location, date, and
photographer information for each image — is to be completed according to the State Historic
Preservation Office standards.
Copies and Curation
• One (1) set of all above mentioned photographic documentation, including a compact disc of
labeled images,will be deposited with the North Carolina Office ofArchives and History/Historic
Preservation Office to be made a permanent part of the statewide survey and iconographic
collection.
■ One (1) contact sheet shall be deposited in the files of the Historic Architecture Section of
NCDOT.
MOA for Bridge Number 239
Rockingham County
pg.6

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DATE OF SURVEY _ 06/21/2019
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-CI a D E: 06 21 2019 ` AT DATE OF SURVEY
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/ PROJECT REFERENCE SHEET NO.
DENOTES IMPACTS IN 17BP.7.R.140 — ROCKINGHAM 239 4
O SURFACE WATER ROADWAY DESIGN ENGINEER HYDRAULICS
ENGINEER
' COD
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DENOTES TEMPORARY
<< IMPACTS IN SURFACE WATER
/
O / / DENOTES HAND MOTT MACDONALD. VHB ENGINEERING
I& E,LLC
LICENSE NO.F-0669 LICENSE NO.C-3705 1
CLEARING DOCUMENT NOT CONSIDERED FINAL
TEMPORARY UNLESS ALL SIGNATURES COMPLETED
Prepared in theM PO Box�/�
SVI lisA PAC T Office of: M
MOTT Fuquay-Varina,O NC 27526
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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 13+53 to 13+86-L- Bank Stabilization <0.01 0.01 54 65
2 12+27 to 13+19-L- 1 @70'24"CORED SLAB W/4'-0"CAPS 0.01
TOTALS*: 0.01 <0.01 0.01 54 65 0
*Rounded totals are sum of actual impacts
NOTES: -Existing Channel Impacts Permanent and Existing Channel Impacts Temp.are coincident
NC DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
04/30/2021
ROCKINGHAM
17BP.7.R.140
Revised 2018 Feb SHEET 5 OF 5

Action ID Number: SAW-2019-00831 County: Rockingham
Permittee: NCDOT Division 7 (Attn: Wright Archer III, PE)
Project Name: NCDOT/Bridge 239/SR 1998/Wolf Island Creek/Rockingham County
Date Verification Issued: 07/28/2021
Project Manager: David E. Bailey
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: David E. Bailey
Raleigh Regulatory Office
U.S Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest,North Carolina 27587
or
[e-mail]
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

SAW-2019-00831
A. Determination of Jurisdiction:
1. I1 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). This determination may be relied upon for a period not to exceed five years from the date of this notification,provided
there is no change in law or our published regulations or new information that warrants revision of this determination.
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). This determination may be relied upon for a period not to exceed
five years from the date of this notification,provided there is no change in law or our published regulations or new information
that warrants revision of this determination.
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 jurisdictional areas within the above described project area have been identified under a previous action.Please reference
jurisdictional determination issued_. Action ID:_.
B. Basis For Determination: See the Preliminary Jurisdictional Determination form dated 07/28/2021.
C. Remarks:
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).
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,Room 10M15
Atlanta,Georgia 30303-8801
Phone: [phone]
AND
[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.

SAW-2019-00831
It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this
correspondence.
��� Date: 2021.07.28
Corps Regulatory Official: 14:56:21 -04'00'
David E.Bailey
Date of JD:07/28/2021 Expiration Date of JD:Not applicable

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL`1 .
Applicant:NCDOT Division 7(Attn: Wright Archer III,PE) File Number: SAW-2019-00831 Date: 07/28/2021
Attached is: See Section below
❑ INITIAL PROFFERED PERMIT(Standard Permit or Letter of permission) A
❑ PROFFERED PERMIT(Standard Permit or Letter of permission) B
❑ PERMIT DENIAL C
❑ APPROVED JURISDICTIONAL DETERMINATION D
Z 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 or http://www.usace.army.mil/Missions/CivilWorks/RegulatoryProgramandPermits.aspx
or the 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 district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish,you may request an approved JD(which may be appealed),
by contacting the Corps 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 MR.PHILIP A. SHANNIN
Attn:David E.Bailey ADMINISTRATIVE APPEAL REVIEW OFFICER
Raleigh Regulatory Office CESAD-PDS-O
U.S Army Corps of Engineers 60 FORSYTH STREET SOUTHWEST,FLOOR M9
3331 Heritage Trade Drive,Suite 105 ATLANTA,GEORGIA 30303-8803
Wake Forest,North Carolina 27587
PHONE: [phone];FAX[phone]
EMAIL:PHILIP.A.SHANNIN@,USACE.ARMY.MIL
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 investigations.
Date: Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer,Wilmington Regulatory Division,Attn:David E.Bailey,69 Darlington Avenue,Wilmington,North Carolina
28403
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,Room 10M15,Atlanta,Georgia 30303-8801
Phone: [phone]