20211834 Ver 1_SAW-2021-02686_permitverification1_20220127

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2021-02686 County: Davie County U.S.G.S.Quad: Mocksville
GENERAL PERMIT (REGIONAL AND NATIONWIDE)VERIFICATION
Permittee: Amy Euliss
NCDOT Division 9
Address: 375 Silas Creek Parkway
Winston Salem,North Carolina 27127
Telephone Number: [phone]
Size(acres) 3.3(approximate) Nearest Town Mocksville
Nearest Waterway Nelson Creek River Basin Upper Pee Dee
USGS HUC 03040101 Coordinates Latitude:35.899771
Longitude:-80.547144
Location description: The site is located along Sheek Street over an unnamed tributary to Leonard Creek in Davie County,
North Carolina.The site is approximately 700 feet west of the Sheek Street/Industrial Boulevard intersection.
Description of projects area and activity: This authorization is for the permanent and temporary discharge of clean fill material
associated with an existing culvert replacement/facility upgrade project.Permanent impacts include replacement of a single
36" CMP with a new 66" CAAP(3 linear feet of impact)and the placement of rip rap within 26 linear feet of stream channel.
The rip rap will be placed so that the top of the rip rap is even with the existing stream bed/culvert.bottom Temporary
impacts are within 6 linear feet of jurisdictional stream and are associated with dewatering activities(see attached plans).
Applicable Law: ® Section 404(Clean Water Act,33 USC 1344)
❑ Section 10(Rivers and Harbors Act,33 USC 403)
Authorization: Regional General Permit Number and/or Nationwide Permit Number:NWP 14 Linear Transportation Projects
SEE ATTACHED RGP or NWP GENERAL,REGIONAL AND/OR SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and attached information dated December 21,2021.Any violation of the attached
conditions or deviation from your submitted plans may subject the permittee to a stop work order,a restoration order,a Class
I administrative penalty,and/or appropriate legal action.
Special Conditions:
1. In order to compensate for impacts associated with this permit,mitigation shall be provided in accordance with the
provisions outlined on the most recent version of the attached Compensatory Mitigation Responsibility Transfer
Form.The requirements of this form,including any special conditions listed on this form,are hereby incorporated as
special conditions of this permit authorization.
2. Northern long-eared bat(NLEB)(Myotis septentrionalis).Standard Local Operating Procedures for Endangered
Species(SLOPES)for the NLEB have been approved by the Corps and the U.S.Fish and Wildlife Service.See
http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/ESA/.This SLOPES
details how the Corps will make determinations of effect to the NLEB when the Corps is the lead federal agency for
an NCDOT project that is located in the western 41 counties of North Carolina.This SLOPES does not address
NCDOT projects(either federal or state funded)in the eastern 59 counties in North Carolina.Note that if another
federal agency is the lead federal agency for a project in the western 41 counties,procedures for satisfying the
requirements of Section 7(a)(2)of the ESA will be dictated by that agency and will not be applicable for consideration
under the SLOPES; however,information that demonstrates the lead federal agency's(if other than the Corps)
compliance with Section 7(a)(2)/4(d)Rule for the NLEB,will be required in the PCN.Currently,the federal listing
status of the NLEB as"Threatened"is being litigated at the National level.If,as a result of litigation,the NLEB is
federally listed as"Endangered",this general condition("s")will no longer be applicable because the 4(d)Rule,and
this NLEB SLOPES,will no longer apply/be valid.

This verification will remain valid until the expiration date identified below unless the nationwide and/or regional general permit
authorization is modified, suspended or revoked. If, prior to the expiration date identified below, the nationwide and/or regional
general permit authorization is reissued and/or modified, this verification will remain valid until the expiration date identified below,
provided it complies with all requirements of the modified nationwide permit. If the nationwide and/or regional general permit
authorization expires or is suspended, revoked, or is modified, such that the activity would no longer comply with the terms and
conditions of the nationwide permit, activities which have commenced (i.e., are under construction) or are under contract to
commence in reliance upon the nationwide and/or regional general permit, will remain authorized provided the activity is completed
within twelve months of the date of the nationwide and/or regional general permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify,suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Resources(telephone [phone])to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you must contact the N.C.Division of Coastal Management in Morehead City,NC,at(252)808-2808.
This Depai tinent of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program,please contact Andrew Williams at(919)554-4884 or [e-mail].
Date:2022.01.25
/4/ii`.62`„' 12:42:13 05'00'
Corps Regulatory Official: Date: January 25,2022
Expiration Date of Verification: March 18,2022
A.Determination of Jurisdiction:
1. ❑ There are waters,including wetlands, on the above described project area that may be subject to Section 404 of the Clean
Water Act(CWA)(33 USC§ 1344)and/or Section 10 of the Rivers and Harbors Act(RHA)(33 USC §403).This preliminary
determination is not an appealable action under the Regulatory Program Administrative Appeal Process(Reference 33 CFR Part
331). However,you may request an approved JD,which is an appealable action,by contacting the Corps district for further
instruction. Please note,if work is authorized by either a general or nationwide permit,and you wish to request an appeal of an
approved JD,the appeal must be received by the Corps and the appeal process concluded prior to the commencement of any
work in waters of the United States and prior to any work that could alter the hydrology of waters of the United States.
2. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements
of Section 10 of the Rivers and Harbors Act(RHA)(33 USC §403)and Section 404 of the Clean Water Act(CWA)(33 USC§
1344). Unless there is a change in the law or our published regulations,this determination may be relied upon for a period not to
exceed five years from the date of this notification.
3. ❑ There are waters,including wetlands, within the above described project area that are subject to the permit requirements of
Section 404 of the Clean Water Act(CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
4. ® A jurisdiction determination was not completed with this request. Therefore,this is not an appealable action. However,you
may request an approved JD,which is an appealable action,by contacting the Corps for further instruction.
5. ❑ The aquatic resources within the above described project area have been identified under a previous action. Please reference
the approved jurisdictional determination issued . Action ID: SAW-
B.Basis For Jurisdictional Determination: N/A.An Approved JD has not been completed.
C.Remarks: USACE has verified the delineation associated with this project,based on a desktop review of information
submitted with the application and contained in the administrative record for this project.
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,FLOOR M9
Atlanta,Georgia 30303-8803
Phone: [phone]
EMAIL: [e-mail]
In order for an RFA to be accepted by the Corps,the Corps must determine that it is complete,that it meets the criteria for appeal
under 33 CFR part 331.5,and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form,it must be received at the above address by:Not Applicable.
It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this
correspondence. Date: 2022.01 .25
,4M w� <7 12:42:45 -05'00'
Corps Regulatory Official:
Andrew Williams
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so,please complete our Customer Satisfaction Survey,located online at
http://corpsmapu.usace.army.mil/cm_apex/f?p=136:4:0.
Copy furnished(via email):
Todd Tugwell
Regulatory Project Manager
U.S.Army Corps of Engineers
3331 Heritage Trade Drive, Suite 106
Wake Forest,North Carolina 27587
[e-mail]
Kim Browning
Regulatory Project Manager
U.S.Army Corps of Engineers
3331 Heritage Trade Drive,Suite 106
Wake Forest,North Carolina 27587
[e-mail]
Beth Harmon
DOT Coordinator
North Carolina Ecosystem Enhancement Program
1652 Mail Service Center
Raleigh,NC 27699-1652
[e-mail]

�1
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A 1'.O L I N SHEET
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PROJECT REFERENCE NO. SHEET NO.
49748
PERMIT DRAWING R'W SHEET NO.
ROADWAY DESIGN HYDRAULICS
SHEET 4 OF 5 ENGINEER ENGINEER
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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)
1A 11+80/11+87-L-RT RIPRAP IN CHANNEL <0.01 12
1A 11+80/11+87-L-RT DEWATERING <0.01 6
1 B 11+82/11+88-L-LT 66"CAAP <0.01 3
1B 11+71/11+87-L-LT RIPRAP IN CHANNEL <0.01 14
1 B 11+71/11+98-L-LT BANK STABILIZATION <0.01 6
TOTALS*: 0.01 <0.01 35 6 0
*Rounded totals are sum of actual impacts
Perm SW Temp SW
NOTES: Impacts Impacts
(sq.ft.) (sq.ft.)
Site 1A 496 148 NC DEPARTMENT OF TRANSPORTATION
Site 1 B 397 96 DIVISION OF HIGHWAYS
TOTAL 893 243 12/9/2021
DAVIE COUNTY
49748
Revised 2018 Feb SHEET 5 OF 5

Highway North Carolina Department of Transportation
4pi:
gstormwater
u- Highway Stormwater Program
STORMWATER MANAGEMENT PLAN w'
(Version 3.00;Released August 2021) FOR NCDOT PROJECTS
WBS Element: 49748 TIP/Proj No: NA County(ies): Davie Page 1 of 2
General Project Information
WBS Element: 49748 ITIP Number: NA I Project Type: 'Other IDate: I11.16.2021
NCDOT Contact: Amy Euliss Contractor/Designer: Jeremy Keaton
Address: 375 Silas Creek Parkway Address: 375 Silas Creek Parkway
Winston Salem,NC 27127 Winston Salem,NC 27127
_ Phone: [phone] Phone: [phone]
Email: aeulissncdot.gov Email:jlkeaton ncdot.gov
City/Town: Mocksville County(ies): Davie
River Basin(s): Yadkin-Pee Dee I CAMA County? No
Wetlands within Project Limits? No I
Project Description
Project Length(lin.miles or feet): 0.193 miles I Surrounding Land Use: 'rural and industrial
Proposed Project Existing Site
Project Built-Upon Area(ac.) 0.5 lac. 0.2 lac. I
Typical Cross Section Description: The existing road cross section is a 10'wide gravel road with 10'shoulders and variable
side slopes. The proposed road cross section will be 2,11'paved lanes with 4'shoulders
and 8'side slopes.
Annual Avg Daily Traffic(veh/hr/day): Design/Future:I I Year:I Existing:I I Year:I
General Project Narrative: Ditches will be grassed lined when possible.Rip rap will be used to control velocities at the following locations: -L-Left Sta 12+30 to 19+00 and-L-Right Sta 16+50 to 19+00.
(Description of Minimization of Water
Quality Impacts)

1 li;hway North Carolina Department of Transportation
Stomlwate r
Highway Stormwater Program
STORMWATER MANAGEMENT PLAN
(Version 3.00;Released August 2021) FOR NCDOT PROJECTS
WBS Element: 49748 TIP/Proj No.: NA County(ies): Davie Page 2 of 2
General Project Information
Waterbody Information
Surface Water Body(1): _ UT to Leonard Creek NCDWR Stream Index No.: 12-102-16
NCDWR Surface Water Classification for Water Body Primary Classification: Class C
Supplemental Classification:
Other Stream Classification:
Impairments: none
Aquatic T&E Species? none I Comments:
NRTR Stream ID: not applicable Buffer Rules in Effect: N/A
Project Includes Bridge Spanning Water Body? not applicable Deck Drains Discharge Over Buffer? N/A Dissipator Pads Provided in Buffer? N/A
Deck Drains Discharge Over Water Body? not applicable (If yes,provide justification in the General Project Narrative) (If yes,describe in the General Project Narrative;if no,justify in the
(If yes,provide justification in the General Project Narrative) General Project Narrative)
Surface Water Body(2): NCDWR Stream Index No.:
NCDWR Surface Water Classification for Water Body Primary Classification:
Supplemental Classification:
Other Stream Classification:
Impairments:
Aquatic T&E Species? Comments:
NRTR Stream ID: Buffer Rules in Effect:
Project Includes Bridge Spanning Water Body? Deck Drains Discharge Over Buffer? Dissipator Pads Provided in Buffer?
Deck Drains Discharge Over Water Body? (If yes,provide justification in the General Project Narrative) (If yes,describe in the General Project Narrative;if no,justify in the
(If yes,provide justification in the General Project Narrative) General Project Narrative)
Surface Water Body(3): NCDWR Stream Index No.:
NCDWR Surface Water Classification for Water Body Primary Classification:
Supplemental Classification:
Other Stream Classification:
Impairments:
Aquatic T&E Species? I Comments:
NRTR Stream ID: Buffer Rules in Effect:
Project Includes Bridge Spanning Water Body? Deck Drains Discharge Over Buffer? I Dissipator Pads Provided in Buffer?
Deck Drains Discharge Over Water Body? (If yes,provide justification in the General Project Narrative) (If yes,describe in the General Project Narrative;if no,justify in the
(If yes,provide justification in the General Project Narrative) General Project Narrative)

Action ID Number: SAW-2021-02686 County: Davie County
Permittee: Amy Euliss
NCDOT Division 9
Project Name: NCDOT/Sheek Street/Div 9
Date Verification Issued: January 25, 2022
Project Manager: Andrew Williams
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn: Andrew Williams
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee Date

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: Amy Euliss NCDOT Division 9 File Number: SAW-2021-02686 Date: January 25,2022
Attached is: See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter of permission) A
[ PROFFERED PERMIT (Standard Permit or Letter of permission) B
L PERMIT DENIAL C
[ APPROVED JURISDICTIONAL DETERMINATION D
PRELIMINARY JURISDICTIONAL DETERMINATION E
SECTION I-The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at http://www.usace.army.mil/Missions/CivilWorks/RegulatoryProgramandPermits.aspx or
Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit,you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission(LOP),you may accept the LOP and your work is authorized. Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety,and waive all rights to appeal the
permit,including its terms and conditions,and approved jurisdictional determinations associated with the permit.
• OBJECT: If you object to the permit(Standard or LOP)because of certain terms and conditions therein,you may request that the
permit be modified accordingly.You must complete Section II of this form and return the form to the district engineer. Your
objections must be received by the district engineer within 60 days of the date of this notice,or you will forfeit your right to appeal
the permit in the future. Upon receipt of your letter,the district engineer will evaluate your objections and may: (a)modify the
permit to address all of your concerns,(b)modify the permit to address some of your objections,or(c)not modify the permit
having determined that the permit should be issued as previously written. After evaluating your objections,the district engineer
will send you a proffered permit for your reconsideration,as indicated in Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit,you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission(LOP),you may accept the LOP and your work is authorized. Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety,and waive all rights to appeal the
permit,including its terms and conditions,and approved jurisdictional determinations associated with the permit.
• APPEAL: If you choose to decline the proffered permit(Standard or LOP)because of certain terms and conditions therein,you
may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of this form
and sending the form to the division engineer. This form must be received by the division engineer within 60 days of the date of
this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative
Appeal Process by completing Section II of this form and sending the form to the division engineer. This form
must be received by the division engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or
provide new information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the date of
this notice means that you accept the approved JD in its entirety,and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD,you may appeal the approved JD under the Corps of Engineers Administrative
Appeal Process by completing Section II of this form and sending the form to the division engineer. This form must be received by
the division engineer within 60 days of the date of this notice.

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