20130968 Ver 1_Application_20130910

Coi•ps Submittal Cover Sheet
Please provide the following info:
1. Project Name: NC 191 Hay�a�ood Road Turii Lanc
2. Name of Properly Owner/Applicaut: NC Deparhneut of Transpoi�tltion
3. Name of Consultant/Aeent: N/A
Aeent authorization needs �o be nitached.
4. Related/Previotis Action ID number(s): N/A
5. Site Address:
6. City:
7. Coiiuty: Heuderson
8. Lat: 35.3806° N Long: -82.5515°W Decim�l Degrees)
9. Quadrangle Name: Hendersonville
10. Waterway: Uunamed Tributary to Mills River (Class WS-TII);
11. Watershed: Freiicll Broad River
12. Requested Action:
X Natiomvide Permit 3
General Permit #
Jurisdictional Determination Request
Pre-Application Request
The Yollowing information will be completecl by Corps offiee:
AID:
Prepare Pile Folder Assign number iu ORM Begin Date
AuUiorization: Sec�ion 10 Section 404
Project Descriptioi�/ Nature of Activity/ Project Purpose:
Site/W�ters Name:
Key�vords:

Pnr McC2oaY
GOVER\OR
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S7�ATE OF NORTH CAROLINA
DEPAR'1 MENT OF "1 IZANSPORTATION
September 9, 2013
Ms. Loretta Beckwitli, NCDOT Regulatoiy Project Manager
U.S. tlrnry Coips of Engineers
I51 Patton Avenue, Rootn 208
Asheville, NC 2 8 80 1-27 1 4
Subject: Nation���ide 3 Permit Application
NC 191 - Ha}nvood Road Turn Lane
Henderson County
Dear Ms. Beck�vith:
ANTHONYJ.TATA
Secarrna��
Tlie Nortli Carolina Departmei�t of Trausportation (NCDOT) is proposing to widen, grade, dl'Hlll fl11C{
pave a section of NC 191, Haywood Road, in Heuderson Couuty iu order to add 125 feet oY turn
lane for the Towu of Mills River Park and new office biiilding. The entire project is approximately
800 feet in length. The project �vill require the replacement vid extension of one cuh�erL The
proposed improvement ofNC l91 has been identified as a necessary maintenance and safety
iuiprovement. Funds have been allocated for tliis project, and NCDOT would like to perform these
activities sometime during the 2013 paving seasou.
I am eiiclosing a PCN application, Rapanos Jurisdictional form, plau sheets sho�ving the proposed
work, a m�rked county map, a USGS quad map and pliotographs.
Tlie North Carolina Natural Heritage Program lists 32 species ���ith federal status for Henderson
County tliat are kno�v�i from cuirent records or �vere kno�vn to occur in the couuty historic�lly. One
species, white fringeless orchid (Pl�dnnt/rern iirtegrilabrn) is a c�udidate species and is known from
histoi•ical records. Tlie bog turtle (Gl��plemys mrJrlerrbergii) is listed as tlneatened due to similarity
of appcarance wilh the no�thern bog turtle. Seven species, Carolina northeru flying squirrel
(Gltntcont��s snbrinus coloraltrs), Appalachian elktoe (Alnsmidonta rove�telimui), swamp pink
(Helortins btd(a/n), small ���horled pogonia (I.soh•in ntedeoloides), bunched arrowhead (Sngrttm•ia
f�scic�dntn), mowitain sweet pitcher plaut (Sm•rnceiria jonesir) and white irisette (Sisyrinchiiun
dicholonunn) are listed as threateued or eudaugered. "I'he small whorl pogouia is known fi�om
liistorical records.
The only records for a tlu•eatened and endaugered species witliin a Y7ve mile radius of the project are
for tlie Appalachian elktoe. Mills River is approximately 0.6 iniles downsh�eam of tlie culvert site.
The known records are found upstream of tlie project; liowever, there are good popt�lations of State

NC 191 Turn Lane 2 Septembcr 9, 2013
listed mussels that are known to occur ���ith tlie AppalTChiau elktoe downsh•eam of the project The
occapied reacl� of the Mills River to which the wmamed tcibiitai}� flows is listed as a Siguiticent
Natural Heritage Area.
Mountain sweet pitcher plant aud swamp pink are associated witli ��vetlands. Bnnched arrowhead is
considered a submerged ac�uatic plaut that is associated with very low flow seepage areas. Wetlands
and seeps are lacking at tlie cuh�ert site and the flow at tliis site �voulcl be too great for tlie bunclied
arro�a�head.
White irisette habitat is found on iuid-elevation slopes witli open diy to mid-moisture oak-hickoiy
forest. The habitat is typic�lly on rocky steep ten•aiu witli sliallo�v soils. Tlie habitat at the bridge
site l�as been highly disturbed by tlie bridge, road and driveways. "I'he dowustream area is withiu tl�e
floodplain of tlie Mills aiid French Broad Iuveis a�id is not characteristic of the white irisette.
Small whorled pogonia habitat is considered variable in Nortl� Caro]ina. 'I'ypically, it occurs in
open, dry, deciduons woods with acid soi1. However, it is also knowu to occur iu a variety of
habitats iit North Carolina, including on slopes along streams. It is also known to occur in rich,
mesic forest in association with white pine and rhododendron. Tlie Trea to be Tffected is highly
disturbed and much of tlie area in vicinity of the project has been disturbed by tlie road and
ag�icultural activities. Habitat at die site is uot characteristic of the small whorled pogonia.
Diie to the limited scope of tliis project and fl�e proposed BMPs, tlie potential for adverse impacts to
downstream aquatic liabitat sliould be miuimal. Terrestrial habitat does not appear to be
characteristic of auy of tl�e listed terrestrial species aud has been highly� dishu�bed in the vicinity of
tlie projecL For these reasons and Uiose discussed above, we reconunend a determination of "no
effecP' for tln•eatened and eudangered species e.ccept for the Appalael�iau elktoe. Due to tlie
protimity of tlie Appalachian elktoe aud its associated species, we reconm�end a determination of
"ui�y affect, not lilcely to ad�-ersely affect" for the Appalacliian elktoe.
This project is in an area that has had a long history of being in agricnitural production. 17ie project
is located within e�isting NCDOT right of �vay Tlong NC 191. For these reasons, we believe the
potential for aicl�aeological resources to be extremely low. The area is primarily a business area
with green houses, tield cro�s and two muuicipal water treatment pl�nts; therefore, tlie potential to
affect historical arcliitectiire is limited. Tliere are no iecords listed in The North Caroliva State
Historic Yreservation GIS Dat�U�se for tlte vicinity of tlie project.
Tlie consU•ttction foremau rvill review all erosiou coutrol measures daily to ensm�e erosion and
sedimentation ace being coutrolled effectively. If the devices are not functioning as inte�ided, tliey
`vill be replaced inunediately with better devices.
Impaets to Waters of the United States
The uimamed tributaiy to the Mills River (WS-III) is not shown on die USGS topographic map.
The streaui is approximately rivo feet iu widtli witli a well-defined chamiel composed of silt, saud
aud gravel substrate. Tl�e channel lacks vegetation. The unnamed tributai}� flows approsimately 0.6
miles to Mills River. Mills River then flows appinsim�tely 1.2 miles to die French Broad River.

NC 191 Turn Lane 3 Septeuibei• 9, 2013
Tlie Freucli Broad River meets the definition of a Tiaditional Navigable Water. For these reasoiis,
we believe the unnamed tributary is a Relatively Peruianent Water and is wider tlie jurisdiction of
the U.S. Army Corps of Engineers. lu order to replace this culvert, it will be necessai}� to iuipact
waters of the United States in the Prench Broad River Basin (HUC 06010105). Specifically,
NCDOT is rec�uestiug to extend aue metal culvert in an unnamed tributaiy to tlie Mills River.
Listed below is a summaiy of the proposed impacts.
Site No. �sisting Condition Proposed Cm�dition Net Impacts
Site 1 36" Y 36' CMP 36" s 66' CMP 30'
Site 1 A Free Flo�ving Cha��nel Temporacy Flow Diversion ] 00'
Total Permauent Stream Impact for Culvert 30'
Tempora��� Stream Lupact fm• Lupe�vious Dikes and I'lo«� Diversiou 100'
Permits Requested
NCDOT is hereby requesting autl�oiization under Section 404 of t�e Clean Water Act for the
constraction project outlined above. By copy of this letter, I am asking Ms. Marla Chambers,
Western Region DOT Review Coordivator, of tlie North Carolina Wildlife Resources Connnission
(NCWRC) to commeut directly ro you concerning tlie 404 Nation���ide Permit request. In addition,
am askiug Ms. ChamUers and Mr. Ben DeWit, Ro�dside E��viromnental Field Operations �ngineer
(NCDOT), to comment directly to me concerning this permit request.
If you have any questions or ueed additional information, please contact me at [phone] or
Mr. Steve Ca�inou at [phone]. Your early review aud consideration will be greatly
appreciated.
Sin��� ���
Mark S. Davis
Division 14 Enviroivuental Sttpeivisor
Enclosures
cc: Ms. Amy Chapmau, Division of Water Resources - DENR, Raleigli (Courtesy Copy)
Ms. Marla ChamUers, Western Region NCDOT Review Coordinator, NC\A�RC, Oakboro
Mr. Jason Mays, Biologist, U.S. Fish 1nd Wi1dliYe Service, Asheville
Mr. Ben DeWit, EI, Roadside Environmental Field Operations Engineer, NCDOT
Mr. Steve Cannon, PE, District Engiueer, NCDOT, Mills River
Mr. ,lason Willis, PE, Heiidersou Coimty Maintenance Engineer, Mills River

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OKce Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Consh�uction Notification PCN Form
A. Applic�nt Information
1. Processing
1 a. Type(s) of approval sought from the
Corps: � Seclion 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: NW 3 or General Pennit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ❑ Yes � No
1 d. Type(s) of approval sought from the DWQ (check all ihat apply):
❑ 401 Waler Qualily Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e. Is ihis notification solely for the record For lhe record only for DWQ 401 For the record only for Corps Permit:
because wrilten approval is not required? Certifcation:
� Yes ❑ No ❑ Yes � No
1 f. Is payment into a mitigation bank or in-lieu fee program proposed for miligation � Yes � No
of impacts? If so, altach the acceptance letter from mitigation bank or in-lieu
fee program.
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h ❑ Yes � No
below.
1 h. Is the project located wilhin a NC DCM Area of Environmenlal Concem (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: NC 191 (Haywood Road) Turn Lane at Mills River Town Hall and Park
2b. County: Henderson
2c. Nearest municipality / town: Mills River
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state 14C.045068
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: NC Dept. of Transporlation
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if Mark S. Davis, Environmental Supervisor
applicable):
3d. Street address: 253 Webster Road
3e. City, state, zip: Sylva, NC 28779
3f. Telephone no.: [phone]
3g. Fax no.: [phone]
3h. Email address: [e-mail]
Page 1 of 11
PCN Form — Versian 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent ❑ Olher, specify: N/A
4b. Name: N/A
4c. Business name N/A
(if applicable):
4d. Streetaddress: N/A
4e. City, state, zip: N/A
4f. Telephone no.: N/A
4g. Fax no.: N/A
4h. Email address: N/A
5. Agent/Consultant Information (if applicable)
5a. Name: N/A
5b. Business name N/A
(if applicable):
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
Page 2 of 11
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): N/A
1 b. Site coordinates (in decimal degrees): Latitude: 35.3806° Longitude: - 82.5515°
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: N/A acres
2. Surtace Waters
2a. Name of nearest body of water (stream, river, etc.) to UT to Mills River
proposed project:
2b. Water Quality Classification of nearesl receiving water. WS-III
2c. River basin: French Broad (HUC 06010105)
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of lhe project al the lime of this
application:
Landscape is a mixture of forest with single family residences and commercial and agricullural properties.
3b. List the total eslimated acreage of all existing wetlands on lhe property:
N/A
3c. List the total estimated linear feet of all existing streams (intermiltent and perennial) on the property:
N/A
3d. Explain the purpose of the proposed project:
Replace and add length to an existing culvert to facilitate the insfallation of a lurn lane for the Town of Mills River Park
and ofiice building. All work is on existing NCDOT right of way.
3e. Describe lhe overall project in detail, induding the lype of equipment lo be used:
Water will be diverted. The pipe will be excavated and replaced/extended and concrete headwalls will be inslalled. The
road will be widened by grubbing and grading to provide sufficient width lo constnict lhe turn lane. The area will be
graded and paved. Track hoes, dump trucks, paving equipment, water pumps, diversion pipe, and various hand tools will
be used to accomplish lhe work.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinalions by the
Corps or State been requesled or obtained for this property /
project (including all prior phases) in the past? ❑ Yes � No ❑ Unknown
Comments: N/Fl
4b. If the Corps made the jurisdiclional determinalion, what type
of determination was made? ❑ Preliminary ❑ Final
4c. If yes, who delineated lhe jurisdictional areas? Agency/Consullant Company: N/A
Name (if known): N/A Other: N/A
4d. If yes, list lhe dates of the Corps jurisdictional determinations or State determinalions and attach documentation.
N/A
5. Project Histary
5a. Have permils or certifcations been requested or obtained for � Yes � No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help fle" instnictions.
N/A
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

6. Future Project Plans
6a. Is lhis a phased project? ❑ Yes � No
6b. If yes, explain.
N/A
Page 4 of 11
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all lhat apply):
❑ Wellands � Streams - iributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacls
If lhere are welland impacts proposed on the site, lhen complete lhis question for each welland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
WeNand impact Type of jurisdiction
number — Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanenl (P) or (if known) DWQ — non-404, other) (acres)
Tem ora T
W1 ❑ P❑ T N/A N/A � Nos ❑ DWQ N/A
W2 � P� T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W3 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W4 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W5 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W6 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
2g. Total wetlnnd impacis N/A
2h. Comments: N/A
3. Stream Impacts
If there are perennial or inlermittent stream impacts (including temporary impacls) proposed on lhe site, then complete this
question for all slream 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, widlh (linear
Temporary (T) (INT)? other) (feet) feet)
S1 � P❑ T Culvert UT to Mills River � PER � Corps Z 3�,
❑ INT ❑ DWQ
S2 ❑ P� T Flow Diversion UT to Mills River � PER � Corps Z 100'
❑ INT ❑ DWQ
S3 ❑ P❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
S4 ❑ P❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
S5 ❑ P❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
S6 ❑ P❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
3h. Tot�l Permanent Stream �nd Tributary Impncts 30'
Tofnl Tempm•�ry Sfream Impncts fm• impervious dike �nd flow diversim� 100'
3i. Comments:.
Page 5 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, lributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. lhen 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
Tem ora T
01 ❑ P❑ T N/A N/A N/A N/A
02 ❑P❑T
03 ❑P❑T
04 ❑P�T
4C Total open �vafer impacls
4g. Comments: N/A
5. Pond or Lake Construction
If ond or lake construction ro osed, lhen com lete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impac[s (acres) Slream Impacts (feet) Upland
Pond ID Proposed use or purpose (acres)
number ofpond
Flooded Filled Excavaled Flooded Filled Excavated Flooded
P1 N/A N/A N/A N/A N/A N/A N/A N/A
P2
SP. Total N/A N/A N/A N/A N/A N/A N/A
5g. Comments: N/A
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permil ID no:
5i. Expected pond surface area (acres): N/A
5j. Size of pond watershed (acres): N/A
5k. Method of canstruclian: N/A
6. Buffer Impacts (for DWQ)
If projecl will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigalion, then you MUST fill out Seclion D of this form.
6a.
❑ Neuse ❑ Tar-Pamlico ❑ Olher:
Project is in which protected basin? ❑ Catawba ❑ Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Bufferimpact
number — Reason Buffer Zone 1 impact Zone 2 impact
Pennanent (P) or for Stream name mifigalion (square feet) (square feet)
Tem ora T im acl re uired?
B1 ❑ P❑ T N/A NIA � Nos N/A N/A
B2 ❑P❑T ❑Yes
❑ No
B3 ❑P❑T ❑Yes
❑ No
6h. Tatal buCPer impacts
6i. Comments: N/A
Page 6 of 11
PCN Fonn — Version 1.3 December 10. 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The culvert is being extended only to the lenglh needed to facilitate the addition of the lurn lane. Headwalls are being used lo
minimize lhe lenglh of extension.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construclion techniques.
An impervious dike will be installed in the channel to minimize the water flowing into lhe work area at culvert installation site.
Water will be diverted around the site during pipe inslallation to limit downstream habilat and water quality degradation.
Appropriate BMPs according to lhe approved erosion and sedimenlation conUol plan will be installed prior to culvert
installation.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for ❑ Yes � No
impacts to Waters of the U.S. or Waters of the State? As er conversation with Cor s Re resentative
26. If yes, mitigation is required by (check all Ihat apply): ❑ DWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation oplion will be used for this
project? ❑ Payment to in-lieu fee program
❑ Permittee Responsible Miligation
3. Complete if Using a Mitigation 8ank
3a. Name of Mitigation Bank: N/A
3b. Credits Purchased (attach receipt and lelter) Type N/A Quantity N/A
3c. Comments: N/A
4. Complete if Making a Payment to In•lieu Fee Program
4a. Approval letter from in-lieu fee program is atlached. ❑ Yes
4b. Stream mitigafion requested: linear feet
4c. If using stream mitigation, slream temperature: ❑ warm � cool ❑cold
4d. Buffer mitigalion requested (DWQ only): N/A square feet
4e. Riparian welland mitigation requested: N/A acres
4f. Non-riparian wetland mitigation requested: N/A acres
4g. Coastal (tidal) wetland mitigation requested: N/A acres
4h. Comrnents: N/A
5. Complete if Usinc� a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed miligation plan.
N/A
Page 7 of 11
PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a prolected riparian buffer that requires ❑ Yes � No
buffer miligation?
6b. If yes, then identify the square feet of impact lo each zone of lhe riparian buffer that requires mitigation. Calculate the
amount of miligation required.
6c. 6d. 6e.
Zoi�e Reason for impact Tolal impact M�dtiplier Required mitigafion
(square feet) (square feet)
Zone 1 N/A N/A 3(2 for Catawba) N/A
Zone 2 1.5
6f. Total buffer mitigation required: N/A
6g. If buffer mitigalion is required, discuss what lype of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment i�ito an approved in-lieu fee fund).
N/A
6h. Comments: N/A
Page 8 of 11
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Mana�ement and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers idenlified � Yes � 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: N/A
2. Stormwater Mana ernent Plan
2a. What is the overall percent imperviousness of lhis project? N/A °/a
2b. Does this project require a Stormwater Management Plan? � Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why
2d. If this projecl DOES require a Stormwater Management Plan, lhen provide a brief, narralive description of the plan:
Project is Covered by Individual NPDES Permit No. NCS000250.
❑ Certi(ied Local Govemment
2e. Who will be responsible for lhe review of the Stormwater Management Plan? ❑ DWQ Stormwater Program
� DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local govemmenPs jurisdiclion is this project? N/A
❑ Phase II
3b. Which of the following locally-implemented stormwater management programs ❑ NSW
apply (check all that apply): ❑ USMP
❑ 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 lhe following state-implemented stormwater management programs apply � ORW
(check all that apply): ❑ Session Law 2006-246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
altached? ❑ Yes ❑ No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwaler Management Plan meet the appropriate requirements? N/A � yes ❑ No
5b. Have all of the 401 Unit submiltal requirements been met? N/A ❑ Yes ❑ No
Page 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does lhe project involve an expendilure 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 o� the National or State ❑ Yes � No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to fhe above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of lhe NEPA or SEPA f nal approval
letter.) ❑ Yes ❑ No
Comments: N/A
2. Violations (DWQ Reyuirement)
2a. Is the site in violalion of DWQ Wetland Rules (15A NCAC 2H .0500), Isolaled
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ❑ Yes � No
or Riparian Buffer Rules (15A NCAC 26 .0200)?
2b. Is this an aiter-the-fact permit application? ❑ Yes � No
2c. If you answered "yes" to one or bolh of the above questions, provide an explanation of the violation(s): N/A
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anlicipated future impacts) result in � Yes � No
additional development, which coidd impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance wilh lhe
most recent DWQ policy. If you answered "no," provide a short narrative description.
This project is limited to the addition of a turn lane at lhe entrance to the Town of Mills River Park to improve safety. This
safety improvement should not have signifcant impacts on development patterns in the area.
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 facilily.
N/A
Page l0 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirernent)
5a. Will lhis project occur in or near an area with federally protected species or � Yes ❑ No
habilal?
5b. Have you checked wilh the USFWS concerning Endangered Species Act � yes � No
impacts?
❑ Raleigh
5c. If yes, indicale the USFWS Field Office you have contacted.
� Asheville
5d. What data sources did you use to determine whelher your site would impact Endangered Species or Desig�ated Critical
Habitat?
North Carolina Natural Heritage Database anQ onsite investigalion.
6. Essential Fish Habitat (Corps Requirement)
6a. Will lhis project occur in or near an area designated as essential fish habitat? ❑ Yes � No
6b. What data sources did you use to determine whelher your site would impact Essential Fish Habitat?
N!A—There are no marine or estuarine communilies within the Blue Ridge Province
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area lhat the state, federal or tribal
governments have designated as having historic or cultural preservation � Yes � No
status (e.g., National Historic Trusl designation or properlies significant in
Norlh Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
This project is limited in scope. The lane is being installed along a commercial area that has been significantly disturbed in
the past and is wilhin existing NCDOT ROW. Therefore we believe there is very little potential to impact cultural
resources.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ❑ Yes � No
8b. If yes, explain how project meets FEMA requirements: N/A
8c. What source(s) did you use to make the floodplain determination? NC Floodplain Mapping Program
Mark S. Davis ;��,�// !�- /�
Division Environmental Supervisor r � " °
��'/✓ f ,��,�,y � ' / ' / �
ApplicanUAgenYs Signature Date
AppliCenUAgenYs Printed Name (AgenPs signature is valid oNy if an authorization letter (rom the applicant
is provided.)
Page I 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

191 Haywood Road
iderson County
1
-_ � -
Existing & Prop. Center Line
°___.._..________`_____'4____________________
Inlet Invert Elev. Replace Existing
994.3 40'x36"CMP with 70'x36" RCP
with Concrete Headwalls
gs Approximately 20' from shoulder of existing road
1 995.1
2 993.2
plans for erosion control
Oulet Invert Elev.
993.7
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Turn Lane Project - NC 191 Haywood Road — Henderson County
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APf ROYED JURISDICTIONAL UE'I'ER\IINATION FORAI
U.S. Army Cm�ps of Engineers
This fonn should 6e coinpleted bp follo�cing tha instnictions provided in Section ]V ol the JD Porm Instructionnl Guidebook.
SECTION I: BACKGROUYD IN�ORAL�TION
A. RCPORT CO�IPLETION DATE ROR APPROVCD JURISDICTIO�AL DE"CERDIINATION (JD):
B. UISTRICT O�fICIs, I'ILE NAn1E, AND NUi\iBER:
C. PROJECT LOCATION AND BACI(GROUND INRORi�L�TION: NC 191 Hay�eaod Rond
State:NC Counq�/parislilborough: I lenderson City: b]ills 2iccr
Centar coordinates of site QaVlong in degree decimal 1'ormat): Lat. 35380G° N, I.ong. 82.551>° �V.
Unicersal"fransverse \4crcntor:
Nmne of nenrtsl �vaterbody: Unnamed �fributaq� to Mills 2ivcr (D�VQ Clnss VVS-III)
Name of nenrest "Cradilional Na��ignblc AVnter (TNV1') ]nlo �vhich the nquatic resource Flows: French Broad Rirer
Nanre ot �cntershed or Hydrologic Unit Code (IiUC): OW IOI0�020020
� Check if map/diagram of rerie�v area und/or potentinl jurisdictionnl artas is/are available upon request.
❑ Chzek i[ olhor sites (e.g., offsite mitigation siies, disposal sites, e�c...) are associ�ted �cith this nc�ion and are rzcorded on a
dilSerent ID fonn.
D. REVIE�VPERFOR�IGD�ORSPfEEVALUATIO�(CHECICALLTHATAPPLY):
� O(lice (Desk) Dctcrminntion. Date: Sept 5, 2013
❑ Field De�enninntion. Dnte(s):
SECTION II: SU�IDIARI' O� f INUINGS
A. RHA SCCTION 10 DETERMINATION OR JURISDICTION.
Thzre Are no "nrmi,qoble irnters o% lGe U.S." within Ri��ers and Hnrbors Act (RI IA) I���isdic�ion (as datincd by 33 Cf R pnrt 329) in the
rcvie�v Urea. [RequiredJ
❑ Wnters sulilect to ihe ebb and Ilow of �he tide.
❑�Vaters are presently used, or hnve bzen used in the pas[, or mny be susceptible for use to transpon inte�s[nte or foreigii commeree.
Esplain:
B. CR'A SCCTION 40a DCTGRi�11NATI0Y O� JURISDICTION.
'I here Are "irn�ers o% die US." �vitliin Clean AVnter Ac� (CIVA)jurisdiction (as de'ined b}� 33 CPIi purt 328) in the ravie�c nren. [ReguiredJ
1. �\'ntcrs oPthe U.S.
n. Indicnte presence of waters o( U.S. in revicw m�en (check all thnt npply): �
❑ "I'NVVs, including tcrritorit+l seas
❑ \Vctlands ndl�cent lo TNIVs
� Relntively pennanent �vnters' (RP\Vs) that �lo��° directly or indirectly inro "IN Ws
❑ Non-RP\\'s thn� Flon� dircctly or indircctly into'IN\Vs
❑ AVetlands directly �bulting RPR's thnt flo�v directly or indirectly into TNNs
❑ AVetlnnds adln�en� to but not directly abutting RP\Vs ihat tlow direetly or indirectly into TNNs
❑ AVetlands adacoul �o non-RP11's that Ilo�v dircctly or indirectly into TNNs
❑ ImpoundincNS ofjurisdictional ���n�crs
❑ Isolaled (intcrstnte or inuastate) wa�crs, including is-olated e�e�lands
b. Identify (estimntc) sizc of waters of the U.S. in tl�e review area:
Non-���etland «�n�crs: 170 linear feee 2���id[h (R) nnd/or acres.
\Vetlands: ncres.
c. Limits (boundaries) ofjw�isdiction based on: Established by OI1�1'i�l.
Elevation of established OI INNI (if kno�vn): .
2. Non-regulntecl �vaters/�veHnnds (cliecl<if npplicnble):;
❑ Potenliallyjurisdic�ionnl ���aters and/or ���etlands were assessed �vithin the rarie�c area and detonnined to be not juris�iciional.
E�plain:
� Boses chceked belo�r shall be supported by completing the app�opriate szc�ions in Section III belo�r.
' Por purposes of lhis tumi. an RP�V is Aef ned as a lributary Ihnt is not n TN\V and �hal �ypically Oo��s yaarvrounA or hns conlinuous Flow at Ie.tsl `sevonallp•.
(e.e., typically 3 monlhs).
' Suppor[ine documen�a�iun is presented in Section III.F.

SECTIONIIL• CAVAANALYSIS
A. '1i\\Vs AND �VETLANDS AUJACENT TO TN\Vs
The ngencies will nsscrt jw'isdiction orer TN�Vs nnd wetlnnds adjacent to TNR's. If thc aquntic resow'ce is a TY\V, completc
Section III.A.I and Section III.D.I. anly; if the nquatic resow�ce is n wetlnnd ndjncent fo n TN�V, compiete Sections III.AJ nnd 2
;�nd Section III.DJ.; otherwise, see Section II1.13 belou�.
1. TN1\'
Identifp'I1i'VV:
Summarize rationnlc supporting determinntion:
2. �Yctlnndadjacent to TN�V
Sununarize rationale supporting condusion that ���etland is "adjacen[":
f3. CHARACTERISTICS OR TRIBUTARY (THAT IS NOT A TN��') AND ITS ADJACENT \1'E'I'LANDS (IF AYl'):
Tliis section summarizes infm�mntion regm�ding charneteristics o(the tributm�y nnd its adjacent �vetlands, if nip•, nnd it helps
determine whefher or nof the stnndnrds for jurisdicfion estnblished under Rnpmias hnve been met.
The ngencies will asser[jurisdiction over non-navig:ible iributnries oPTN\Ys where tl�e trib�rtaries nre "relntively permnnent
wntcrs" (RP\Vs), i.e. tribidnrics tliat h�picall�� Oow yenr-romid or have continuous Oo�v at lenst sensonnlly (c.g., typically 3
months). A�vetlnnd thnt directly abuts nn RP�V is nlso jurisdictionnL If the nquntic resource is not �"1'N�V, but h�is yenr-round
(perenninl) ilo���, skip to Section III.D1. If the nquntic resource is n�retlnnd directly nbufting a tributary with perenninl Ilow,
skip to Secfion III.U.4.
A�reHnnd ihnt is ndjacent to bul tlint docs not directly nbut nn RP�9 requires n significnnt ne�us evaluntion. Corps dish�icts nnd
CPA regions �eill include in the record any nvailnble informntion tlmt documents tl�e e�istence of n significnnt iresus betn�een n
rclntively permnnent iributnry thnt is not perenninl (nnd its ndjncent wetlands if nny) nnd n irnditionnl nnvignble �rster, even
tliough n significnnt necus finding is not required ns n matter of I�nv.
If the waterbody' is not nn RPAV, or n wetland directly nbutting an RP�V, n JD will requirc ndditional data to determine if thc
�raterbody hns n significnnf nezus ���ith n TN�V. If the tributary hns ndjncenl wetlnnds, thc significnnt nesus evaluntion nmst
consider the h'ibutarl' in combinntion witl� all of its adjncent wetlnnds. This significant nevis e�•nhintion ihnt combines, fm•
nnalytienl purposes, ihe tributnry nnd nll of its ndjncent wetiands is usecl whether the review nren identified in the JD request is
tlie h�ibutm�y, or its adjacent wetlmids, or both. 1(the JD corers n tribufary with ndjacent �retlands, complete Secfion III.B.1 (or
the tributary, Sectimi III.B.2 for nny onsite wetinnds, nnd Section 111.B.3 fm� nll wetlnnds nAjncent to thnt tributary, both onsite
and oCPsite Thr determination �vl�ether n significnnt ne�us esists is determined in Section IILC belo�v.
l. Chnracferistics of non-TN\\'s thnt Oow directly or iudirectly info'1 i�\1'
(i) Gencrnl Area Cm�ditions:
\Va�ershed size: Pick List
Draina�e area: Pick List
Avernec annunl rninfell: inches
Avzrage nnnual sno�vlall: inches
(ii) Physicnl Chnrncteristics:
(a) Rcln�ionship with T1�lV:
❑'fribulary Llo���s dircc�ly into'IN\V.
❑ Tribulary Flo���s ihrough Pick Lisf tributnries before enlering TN1V.
Prolcct �vnters nro Pick List �ivcr milzs trom "I�N�V.
Prolect o�aters ara Pick List river miles Gom RPIV.
Project �caters nre Picl< List aerial (straight) miles from'f�1V.
Pmject �vators nm Pick List trerial (straieht) miles from RPAV.
Project �vn[ers cross or sen�e as stnte boundaries. Esplain:
Identity Ilow routc to 1NVV':
Tributaq� stnam order, if known:
' Note lhat the Instructional GuiAebook contains' addilional infommiion rega�Jing s�cales, ditches, �cashes, mid erosional features generally nnd in tliz aeid
Nes'l.
' Plo�c rou�e can be desaibzd by identiCying, e.g., lri6utaq� u, �chich Flo�cs Ihrouoh lhe mvizw ama, lo flo�e into �eibinap� b. �chich Ihen Oo�cs into TNR'.

(b) Geneml Tributnrv Chnracteristics (check ull that auph�):
Tributnry is: ❑ Naturnl
❑ Artificinl (mnn-nmde). Explain:
❑ binnipulated (man-allcccd). Expinin:
Tributary properties �vilh respect to [op of bank (estimafe):
A��erage �vidth: Ceet
Aacrage depth: tee[
Arernge sidz slopes: Pick Lisf.
Priinnq� tributaq� substratc composilion (check nll that apply):
❑ Sil�s ❑ Sands ❑ Concrctc
❑ Cobblcs ❑ Gcavcl ❑ Mimk
❑ Bedrock ❑ Vegetation. Type/%core%
❑ Othcc Gsplain: .
Tributnq• condition/stability [e.g., highly eroding, sloughing bnnks�. F,splain:
Presence oCrm�/riRle/pool compleses. 8spinin: .
"fributary geomc[ry: Pick List
Tcibutary @raAiznt (npprosima�c nverage slope): %
(c) Flo�v:
'fributary providcs for: Pick List
Estinmte m�crngz number ol �lo��� cven(s in reviz�r are.�/year: Piek List
Describz Ilo�v regime: .
Other informa�ion on dur�tion anA rolumc: .
Surtacc flo�v is: Pick List Chnracteristics:
Subsudacc Flo�v: Pick List. Gsplain tindings:
❑ Dyc (or other) test perfonned: .
Tributaq� has (check �II that apply):
❑ 13ed and banks
❑ OHWA�1° (check all indicators �h�t npplp):
❑ cicnr, n�tural line impressed on the bank
❑ changes in �he ehnrncter of soil
❑ shelving
❑ cegetelion matted do«-n, benl, or absent
❑ lenC liuer dislurbed or �cached a���ay
❑ sedimcn[ dcposition
❑ ��'nter st�ining
❑ other(list):
❑ Discontinuous OH\VM.' Explain:
■
■
■
■
■
■
■
(he presenec of litter nnd debris
destruc�ion of terrestrial vegetation
Ihe presence of wrnck line
scdinrent sohing
scour
multiple obsen�ed or prcdictzd Flow events
abrupt changc in plant community
Iffaelors ulher than the OI IAl'\1 �vere used to determine Interal estent o(CAYeAjurisdietion (cheek all thnt apply):
❑ High Tide Linc inAica�ed by: ❑ blenn I ligh Nater Mack indicn�cd by:
❑ oil or scum liire along shore oliiects ❑ sun�ey to availnble dntum;
❑ fine shell or debris deposi�s (foreshore) ❑ physical mnrkings;
❑ physical mnrkings/characteris�ics ❑ vegetation lines/changcs in vcge[ntion types.
❑ tidal gnugcs
❑ othcrQist):
(iii) Chemical Clinracteristics:
Ghnrne[erize lribumq� (e.g., wnter color is clear, diseolorzd, oily film; �cater qualily; eeneral �vatershed chnracteristics, ete.).
Ezplain:
Identih� spccific polluUmis, il kno�vn: .
`A nn[ural or man-made discoNinuit}� in the OHWM does noi necess,uilp seeerju�isdicfion (e.g� �chere Ihe stremn temporaeily �lows undzreround, or �chere
the OHNM hus 6zen re�norrd by devalop�ucnl or nericuliural pracliczs). \Vhere there is a brenk in Ihe OH\1'M Ihnt is unrelnied ro �he �ca�erbody's Ilo�e
regime (e.e., llo�e over a�ock outemp or IheouJi a culrert), tliz agencirs �cill look (ur in�icamr of ilo�c nbovz anA belo�c tlie break.
'Ibid.

(iv) Biologicnl Charnrteristics. Chnnncl suppm�ts (chccl<nll tl�at opply):
❑ 2iparinn corridoc Chnr�icterislics (lype, avzragc «•idth): .
❑ AVetlend Iringe. Cheracteristics: .
❑ Habita! for:
❑ Fedecally Listed species. Eaplain findings: .
❑ Fisli/spnu�n areas. Gxpinin findines: .
❑ Othcr environmentnlly-sensi�iec species. Explain findings:
❑ Aquatic/�vildlife dircrsi�y. Esplain tindings: .
2. Chnrncteristics oC wetlnnds adjacent to non-TNVV thnt ilo�r directip or indireetly into TN�V
(i) Physical Chnrnctcristies:
(�) General AVetlnnd Cha�acteristics:
Propchics:
\Yetland size: acres
\1'c[land type. Gxplain: .
WeUand qualiq�. F.xplain: .
Prolz�� «'z�lnnds cross or scrve ns state boundnries. Esplain:
(b) Geneml Plo��� Relaiionshio �vi�h Non-TN1V:
Plo«� is: Pick Lisf. 8xplain' .
Surface tlo�v is: Pick Lisl
Charncteristics:
Subsurface Flo�c: Picic LisL 6xpinin findin�s:
❑ Dye (or otlie�) �cst perfonued: .
(c) AVetlund Adiaccncv Detennination �rith Non-"I'NVV:
❑ Directly nbutting
❑ Not direc�ly abutting
❑ Discrete �retlnnd hydrologie connection. G�pinin:
❑ 8wlogicnl connec�ion. Explain: .
❑ Separated by bermlbarriec 6xplzin: .
(d) Proeimih�(Rela�ionshiplto'PNIV
Prolec� �cetlnnds arz Picl< List river miles from T`N\V.
Project �vaters are Cicle List acrinl (s�inight) iniles from TN\V.
Flo�v is Irom: Picic Lisf.
�stimnte approsimnte Iceation of���eUand as a�ithin the Pick List IlooApinin.
(ii) Cheroicnl Chnrncteristics:
Charactcrize �retland systcm (e.e., wntcr color is clear, bro�vn, oil film on surfnce: water qualily; general �va�ershcd
characteristics: cta). Explain: .
Idcntifi� speci�ic pollu�nnls, ifkno�vn: .
(iii) Biologicnl Charncferistics. �Vetlnnd supports (check all thnt npply):
❑ Riparian buflcc Charameristics (type, aaernge width): .
❑ Vegetation type/percent co��cc E;splain: .
❑ Habitnt for:
❑ Federally Listed species. C�pinin findings: .
❑ Fish/spmen nreas. 8spinin findines: .
❑ Other cnvironmentalip-sensitive specics. F,�plain findings:
❑ Aquntid�rildlife diversih�. Esplain tmdings: .
3. C�mrncteristics of nll wetinnds ndjncent to the h�ibutary (if any)
All �cetlund(s) being considered in the cumulatire nnelysis: Piek List
Approsimntcly ( ) ncres in total are beine considered in Ihe cumulmiro nnnlqsis.

Por cach weUand, specit}� �he follo�ving:
Directly nbuts? (1'N) Sizc (in acres) Directh� nbuls? (Y/N) Sizc (in ncresl
Summarize orerall biologicul, chemical nnd physicnl funetions bzing performed: .
C. SIGNIPICANT NEXUS DETER�IINATIOY
A significnnt ne�us annlysis will nssess the ilow chnracteristics and fwictions o(the tributnry i1selPnnd the funetions perfm�med
bv nny wetlands ndjncent to the tribidn�}• to determine if H�ey significnntiy affect the chemicnl, physicnl, nnd biologicnl integrity
oPn TN\V. �m� encl� of Ihe follo�ring sit�mtions, n significnnt nezus esists if the fribotary, iu combiimtion with nll of its ndjncent
wetlands, hns more Ihnn n specidative or insubstonfi�il efPect on thc chemical, physicnl nnd/or biological inlegrity oPn TNN.
Considerntions when evalunting significant nenis include, but are not limited to the vohune, duration, nnd frequency of the ilo��•
of �rnter in the tributnry nnd its pro�imitp to n TN�\', nnd the functions perfm�ined by the tribidnry m�d nll its �djacent
wetlnnds. It is not approprinfe to de[ermine significnnt ne�us bnseA solely on niq� specific threshold of disfnnce (e.g. behreen n
h�ibutary and its ndjncent �re�land m-behrecn n tributnry nnd tl�r TN�V). Similarly, ihe fnct mi ndj�cent wetl�nd lies wifhin or
oufside of n Iloodpinin is not solely determinntive oPsignificnnt nexus.
Draw connections bet�reen fhe fentw'es docwnented nnd tlie effects on the TN\V, as identified in ihe Rnpmm.c Guidnnce and
discussed in ihe Insh�uctionnl Guideboolc. �nctors to consider inciude, (or ezample:
• Does the tribulfiq�, in combinntion �cilh iis aAjacent ���etlnnds (if any), have [he enpacity to carry pollutanls or flood warters io
TNVVs, or to reduce the nmoimt of pollwan�s or Flood �i�alen reaching a TN1V'?
• Does �he tribut�p�, in cumbi�mtion «-ith its adjacen[ �vetlnn<Is (ifeny), pro��ide habita� nnd lifecycle suppod lunetions for fish and
olher species, such �s Ceeding. nes�ing. spa�vnine, or renring young Cor species �hnt nre przsenl in theTNlV?
• Does the tribWnry. in combinaiion �cith its ndl�cent �retlands (it any). have �he capacity to trnnsfer nutrients and orgm�ic earbon Ihat
support don�nstream food�rcb.s'?
• Does llie tributaq�, in combination �ri�h its ndjncent ���etlands (it nny). have other relationships to the physicnl, chemical, or
biologicnl integrity of the TN\V?
Note: the nbore list of cousideratim�s is not inclusive nnd other functions observed or kno�rn to occw� should be documented
below:
I. Significant nezus fiudings for non-RP�Y that has no ndjncent �retlands snd Oo�rs direc�ly m� indirectly into TNVVs. Explt�in
findings ot presence or absenee of significant nesus bdo�v, bnsed on the tributaq• itsclt. then go to Section III.D: .
2. Significnnt nexus findings fa' non-RP�V and its ndjncent wetl�nds, where the non-RP\V ilows direcfll' or indirectly into
TNR's. 8spinin findings o[ presence ar absence ot significant ne.cus belo�v, based on the tributaq� in combinntion with nll of its
adjncent �vetlands, then go �o Section III.D: .
3. Signifcnnt nesus findings fm� wetlnnds ndjaeent to nn RP�A' but that do nol directly nbut the RPAA'. E�plaiu lindings of
presence or sbsence ol significnnt ne�us belo�v, bnsed an the vibumq� in combinntion �rith all of its adjacent �cetlnnds, then eo to
Scction III.D: .
D. DCTCR\11YATIONS O� JURISDICTIONAL �INUINGS. THG SU6JEC7' R'ATERS/NGTLA\DS ARE (CHECI{ ALL
THAT A PPLY):
I. TN�Vs nnd Adjncent �Vetlands. Check all tha� apply and provide size estimates in revie�r area:
❑'I'vVVs: linear lect �sidtli (�9), Or, ncres.
❑ VVctinnds ndlacent to TN\Vs: acres.
2. RPVA's thnt Oow directly ar indirectl,y into TMV's.
� Tribut�ries of TNVl's �vhere Iributaries typically flo�c yearround are jurisdietionnl. Proride dam and ra�ionnle indicating that
�ribut�ry is perennial: The s�ream is not shown on the USGS roap. The strenm hns a well-defined chnnncl nnd lacks aegetation
nnd lias had tlow on seceral dillemnt site visits.
❑ Tribmarics of'fN\1' �ehere tributnries have contimious flo�v "senson�ll}�' (e.g., q�picnliv Ihree monlhs each penr) arz
jurisdictional. Daln supporling this conclusion is provided at Section III.6. Provide nllionale indica�ing thn� tributaq� flo���s
seasonally: .

Provide estimntes for jurisdictional �cnters in lhe revie��� area (check all �hnt apply):
� "I'ributnry �caters: 170 lincar feet 2 ���idlh (tt).
❑ O�her non-�relland �raters: �cres.
Identif}' type(s) of �ratcrs: .
3. Non-RP1Vse th:il ilow dirccfly or indirectly iuto TN\1's.
❑\Vaterbodp thm is no[ n'IN\1' or an RPN, but flo�cs directly or indirectly inm a TNR', end i� has a significnnt nesus �citli a
'I��'1V isjurisdic�ional. Dnta supporling this conclusion is provided nt Secliun IILC.
Proride estima�es forjurisJic�ional �vaters «�i�hin the rzvie��� area (check all tha� npply):
❑ "I'ributaq• �vuters: lincnr feet ���idth (tt).
❑ O�her non-�cetland �vntzrs: acres.
IdentiCy iype(s) of wnters: .
4. AA'etlmids directly abutting nn RP�V tliat ilo�r directly m� inAirectly into TNNs.
❑ Ne�lnnds directly t�but RPN and �hus �re jurisdictional as adacent �vetl�nds.
❑ R�ellands directly abutting nn RPAV where tribulnrics typicnlly Flo�v yeao-round. Provide dam and cationalc
indicuting thnt tributnq� is perennial in Scction III.D2, nbove. Provide rationale indicating thnt ���ctlnnd is
dircctly nbutting �m RP\V: .
❑�Vetlnnds directly abut�ine nn RPIV �chere �ributaries typieally flo�v "sensonnlly °� Provide dnta indicating thnt Iribu�ary is
seaconal in Sec�ion III.I3 end rationale in Seeiion III.D2, nbore. Provide rationale indicatine thnt �cetlnnd is directly
nbWtingnn RPN�: .
Provide acreage estimates for jurisdie�ionnl �cetlands in the revic�r nren: ncres.
5. �Vetlnnds ndjacent to but �wt directl}� nbutting an RP�V tlint Ilow directly or indirectly into TNVVs.
❑ 11'etlands �hat do nol direelly nbut an RPAV, 6ut «�hen considered in combination �ciih Ihe uibu�nq� to �chich they nre adjacent
and �cith similnrly situated adjacent ���etlnnds, hare a significant ne�us with a"CNN arejurisidiclionel. Dnta supponing this
conclusion is providad at Scction III.C.
Pro��ide acmnec cstimntes for jurisdictional ���cdlands in the review area: acras.
6. R'etlnndsndjncent to non-RPR's lhnt (tow directly or indirectly into TN�Vs.
❑\Vetlnnds acl,l��ent to such �ea[cn, nnd hnve when wnsidomd in combina[ion �cith the �ributary to �vhich they na nAjaccnt and
�cith similarly si�unted adjacent wetlands, harc n significnnt nezus �vitli a'I'uR' arejurisdictionnl. Dnln supporting tliis
conclusion is provided at Section I[I.C.
Provide estima�es locjurisdictionnl �vetlxnds in Ihe re�•ic��� nren: ncres.
7. Impoundments ofjw�isdictionnl �vnters.'
As a general mle, Ihc impoundment of ajurisdic�ionnl tribulary remains jurisdictional.
❑ Demonstrnle Ihnt impoundmenl �ras created tYnm "water, of the U.S.," or
❑ Demonstr�le �h�t �veter meets �he criterin for one of tlie cnteeories presentcd nbove (I-6). or
❑ Demonstra�e ihat �cater is isolnted �cith n nesus to commcrcc (see F' belo�r).
E. ISOLATCD �I\'"PERSTATE OR INTRA-STA"PE� \VAT�RS, INCLUDING ISOLATED 1\'ETLANDS, THE USE,
DEGRAUATION OR DESTRUCTION O� R'HICH COULD AP F�C'I' INTERSTATE CODID�ICRCE, 1\CLUDING ANS'
SUCH \VATERS (CHECI<.\LL THAT APPLI'):10
❑ which are or could 6c used by interstate or 1'oceign trnvelers for recrealional or other purposes.
❑ trom �vhich fish or shellfish are or could be tnken and sold in interstate or Foreign eommerce.
❑ which nrz or could 6e used for industrinl purpuses by indus�rics in interstatz eommerce.
❑ Interstate isolated �vatcrs. Espinin: .
❑ Other fac�on. Eapinin: .
"Sez Pwinote N ?.
"To complete Ihe anal}'sis' reti� to Ihc kcy in Section IILD.6 of �he Inslmctional Guide6aak.
�0 Prior lo asserting m� Jeclining C\\':\ jurisdicfion bnscJ solcly nn Ihis cntegm�r, Cm�ps Uistricls e�ill cleva�c fhe action lo Corps and GYA IIQ for
rerie�c consislcnt �si�h the p�rocess Jescribcd in thc Cnips/EPA b/rnmrnnAmu RegnrdingCll:1 AclJarisdirliou Fofloiriu� Rnp�mos.

IdentiP}' �rater body and summm�i�e rntionnle supporting determination:
Provide estima[cs torjurisdictional �caters in �he revie�v area (chcck nll that apply):
❑ Tributnq� �vnters: linear feet �eidth (ft).
❑ O�her non-�+�eUancl �caters: acrcs.
Identify q�pe(s) of �caters: .
❑ 1YeUunds: acres.
IP. NON-JURISDICTIONAL\1'ATERS,INCLUDING\VGTLANDS(CHECI<ALLTHATAPPLI'):
❑ I[ potcn�inl «�etlnnds �vere nssessed �vithin �he reric��� nrca, thcse nrzns did not meet the cri[crin in tlic 1987 Corps of F,ngineers
\Vetland Dalineution Nlanual and/or approprinte Rcgionnl Supplemen�s.
❑ Kevie�c area included isolnted ���nters �vi�h no substaniial nexus to inierstate (or forzign) convuerce.
❑ Prior to the lan 2001 Supreme Court decision in':SD'A�A'('C'," �he ravie�r nrea �could have been rzgulated based so� on the
"T4igcatoq� Bird Rulc" (b1E3R).
❑ R'alers do not meet Ihe'Significunt Vesus" standard, �vhcre such a finding is rcquircd forjurisdiction. Expl�in: .
❑ Other. (esplain. if not co��ered above): .
Provide ecreuge es�imates (or non-jurisdietionnl ���a�ers in ihe revie�c area, �vhere tl�e sole potential basis uf jurisdiction is the bBR
facmrs (i.e., presencc of miere�toq� birds, pres-ence of endangered species, use of water for irrigmcd agricul�ara), usine bcst professionnl
judgmcnt (check all Ihnt npply):
❑ A'on-�cetlnnd �caters (i.e., rivers. streams): linenr feet �cidth (ft).
❑ Lnkes/ponds: acres.
❑ Otlier non-wetlnnd �vnters: ncres. List �ype ol aquntic resouree: .
❑ AVctlnnds: acres.
Proride acreage estimates for non-jurisdictionnl �caters in the revie�v area that do not meet the "Signiticant Nesus" standard, ���here such
a LinAin@ is required for I��risdiclion (check all that apply):
❑ Non-�vetland �caters (i.e., rivers. strenins): linear feet. �vidtli (Il).
❑ Lnkes/ponds: acres.
❑ Other non-�cetllnd «�alers: txres. List type o} aqunlic resouree: .
❑ \Vetlands: acres.
SGCTION R': DATA SOURC�S.
A. SUPPORTI�G DATA. Dnta rerie�ved for JD (check nll thnt npply - checked iteins shnll be included in cnse tile and, �rhere checked
and requested, appropriately referenee sources belo�v):
�\4aps. plaus. plo�s or pla( si�bmittcd by or on behalf of the applican�/considtani: .
❑ Da�a shects prepnred/submitted by or on behalf of Ihc applicnnt/consultnnt.
❑ OFtice concurs �vith datn sheets/delinca�ion repor�.
❑ Ottice docs not concur «°ith dntn sheels/delinemion report.
❑ Data shcets prcparzd by the Corps: .
❑ Corps navigable �ca�ers' s�udy: .
❑ U.S. Geological Suracy Hydrologic Atlns: .
❑ USGS NI-ID Anln.
❑ USGS 8 anA 12 digit I IUC maps.
❑ U.S. Geologiral Sun�ey map(s). Cile scalc fi qund naine: .
❑ USDA Nalurnl Resourecs Conscrvntion Service Soil Sun�ey. Ci�a�ion: .
❑ Nn�ional wctlnnds inventory map(s). Cite name: .
❑ State/Loeal �veUnnd inven�ory mnp(s): .
❑ PI:MA/FIR\-0 maps: .
❑ 100-pear Floodpinin Blevntion is: (Na�ional Geodectic Veriical Datwn of 1929)
� Photogr�phs: � Aerinl (Nnme R Date): .
or � Other (Name & Da�e):Culrert Site, April 20U.
❑ Previous determination(s). File no. and dntc of rzsponse Iztter: .
❑ Applicable/supporting casc In���: .
❑ Applieable/supportingscien�ificlitemture: .
❑ Other intormntion (plense specify): .
13. AUDITIONAL CODI\II:NTS TO SUPPOIi'1' JD:

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