20140140 Ver 1_20140140 Ver 1 _signature pg _20140326_20140326

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
Yes M No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes FX1 No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Site visit and NHP database
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
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 21 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?
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100 -year floodplain?
Yes F-I No
8b. If yes, explain how project meets FEMA requirements:
Project is a linear at grade trait. There will be no above grade structures located within the floodplain.
8e. What source(s) did you use to make the floodplain determination?
FEMA flood map
:Pau I 4�''cd
ApplicarittAgents, Printed Name
Applic6k*Agenrs Signature
Date
(Agenrs signature is valid only if an authorization
letter from the applicant is provided.)
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