20131201 Ver 1_USACE Permit_20131202

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW- 2013 -01518 County: Guilford U.S.G.S. Quad: NC- PLEASANT GARDEN
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Pennittee: NCDOT
J Mills
Address: P.O. Box 14996
Greensboro, NC 27415
Telephone Number: 336 - 334 -3297
Size (acres) <1 Nearest Town Greensboro
Nearest Waterway Hickory Creek River Basin Deep. North Carolina.
USGS HUC 3030003 Coordinates Latitude: 35.9636
Longitude: - 79.8650
Location description: The project site is located on Burnetts Chapel Road (SR 1131) over Hickory Creek, in Guilford County,
North Carolina.
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 discharge of rip rap within 52 linear
feet of jurisdictional stream for bank stabilization. Temporary impacts are authorized within 10 linear feet of jurisdictional
stream for construction activities.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Pen-nit Number or Nationwide Pennit Number: NWP 14 Linear Transportation
Projects.
SEE ATTACHED R 6 or NWP GENERAL, REGIONAL AND 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 on 11/14/2013. Any violation of the attached
conditions or deviation from your submitted plans may subject the permittee to a stop work order, a restoration order and /or
appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide pennit 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 pen-nit. If the nationwide 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 pennit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide pen-nit'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 Quality (telephone [phone]) to detennine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (LAMA),
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 Anny verification does not relieve the pennittee 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 Pennit, or the Corps of Engineers regulatory
program, please contact Andrew Williams at 919- 554 -4884 x26 or Andrew.E.Williams2(i usace.armv.mil.
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Corps Regulatory Official: �d`R"' E -- 132124 1r111'ss1'2'��' Date: 12/02/2013
Expiration Date of Verification: 03/18/2017

Determination of Jurisdiction:
A. ❑ Based on preliminary information, there appear to be waters of the US including wetlands within the above described project
area. This preliminary detennination is not an appealable action under the Regulatory Program Administrative Appeal Process
( Reference 33 CFR Part 331).
B. ❑ 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 and Section 404 of the Clean Water Act. 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.
C. ® There are waters of the US and /or wetlands within the above described project area subject to the pen-nit 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.
D. ❑ The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued . Action ID: SAW -
Basis For Determination: The stream (Hickory Creek) is a relatively permanent water (RPW) and a tributary to
the Randleman Lake, an impoundment of the Deep River, a traditionally navigable water (TNW). The Deep River below
Randleman Lake flows to the Cape Fear River, a navigable water of the United States. The Ordinary High Water Mark
(OHWM) of Hickory Creek was indicated by the following physical characteristics: clear natural line impressed on the bank,
shelving, scour and the destruction of terrestrial vegetation.
This jurisdictional determination is only for the stream proposed for impacts associated with this Nationwide Permit
verification and does not include any other waters /wetlands that may be located on the project site.
Remarks: None
E. Attention USDA Program Participants
This de line ation/detennination 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 detennination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B
and C above).
This correspondence constitutes an approved jurisdictional detennination for the above described site. If you object to this
detennination, 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 detennination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room 10M15
Atlanta, Georgia 30303 -8801
Phone: [phone]
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 January 31, 2014.
* *It is not necessary to submit an RFA form to the Division Office if you do not object to the detennination in this correspondence. **
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Corps Regulatory Official: Eb613,2423 „32124,691 16�1 1(
Andrew Williams

Date of JD: 12/02/2013
Expiration Date of JD: December 2, 2018
The Wilmington District is connmitted 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 online at hqp:/ /per2.nwp.usace.arM.mil /surve.y.1-itml .
Copy furnished (via e-mail):
Sue Homewood
North Carolina Department of Natural Resources
Division of Water Resources
585 Waughtown Street
Winston-Salem, NC 27107
Jerry Parker
Division Environmental Supervisor
NCDOT- Division 7
P.O. Box 14996
Greensboro, NC 27415
Nicole Thomson
SEPI Engineering
1025 Wade Avenue
Raleigh, NC 27605

Action ID Number: SAW- 2013 -01518 County: Guilford
Permittee: NCDOT
J Mills
Project Name: NCDOT / SR 1131 Burnetts Chapel Road / BR 400027 / DIV 7
Date Verification Issued: 12/02/2013
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
3331 Heritiage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. If you fail to comply with this permit you are subject to permit suspension,
modification, or revocation.
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

Applicant: NCDOT File Number: SAW -2013 -01518 Date: 12/02/2013
J Mills
Attached is: See Section below
"I
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
F-1
PRELIMINARY JURISDICTIONAL DETERMINATION
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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.
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.
If you have questions regarding this decision and /or the
appeal process you may contact:
District Engineer, Wilmington Regulatory Division, Attn:
Andrew Williams
3331 Heritiage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
If you only have questions regarding the appeal process you may
also contact:
Mr. Jason Steele, Administrative Appeal Review Officer
CESAD -PDO
U.S. Army Corps of Engineers, South Atlantic Division
60 Forsyth Street, Room 1OM15
Atlanta, Georgia 30303 -8801
Phone: [phone]
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: I Telephone number:
of appellant or
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. Jason Steele, Administrative Appeal
Officer, CESAD -PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303 -8801
Phone: [phone]