20130948 Ver 1_4 PCN SIGNATURE PAGE 001_20130106

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
6a Will this project occur in or near an area with federally protected species or
El Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act
Yes No
Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d, What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
usfw web site Natural HERITAGE
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area'designated as essential fish habitat? I El Yes No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
SOUTH ATLANTIC HABITAT AND ECOSYSTEM IMS
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
Yes No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
STATE HISTORIC PRESERVATION OFFICE WEB-SITE
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 1 00-year floodplain?
D Yes Z No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? NC FLOODPLAIN MAPPING PROGRAM WEBSITE
ell,
HAYWOOD PITTMAN
ApplicantlAgent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
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PCN Form — Version 1.3 December 10, 2008 Version