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Home My WebLink About2019-00840 RGP 50 Tearsheet.pdfU.S. ARMY CORPS OF ENGINEERS WILMINGTON DISTRICT Action Id. SAW-2019-00840 County: Guilford U.S.G.S. Quad: NC -Guilford GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION Permittee: NCDOT Attn: Jerry Parker Address: 1584 Yancevville Street Greensboro, NC 27415-4996 Size (acres) -50.5 Nearest Town Greensboro Nearest Waterway East Fork Deep River River Basin Cape Fear USGS HUC 03030003 Coordinates 36.068865,-79.951941 Location description: The project area for NCDOT TIP U-4015A is located along Gallimore Dairy Road, from NC 68 (Eastchester Drive) to lust south of Airpark Road in Greensboro, Guilford County, North Carolina. Description of projects area and activity: This verification authorizes the discharge of clean fill material associated with NCDOT TIP U-4015A, improvements to Gallimore Dairy Road (SR 1556). from NC Highwav 68 to Airpark Drive, to a rive -lane typical section. Impacts include permanent impacts to 346 linear feet (0.13 acre) of stream channel, 248 linear feet (0.08 acre) of which is considered a permanent loss, and 0.02 acre of riparian non-riverine wetlands, as well as temporary impacts to 37 linear feet (0.04 acre) of stream channel. These impacts are necessary for roadway fill, culvert extensions, and bank stabilization. Note that, of the above impact totals, permanent impacts to 10 linear feet (<0.01 acre) of stream channel and 0.01 acre of riparian non-riverine wetlands. and temporary impacts to 6 linear feet (<0.01 acre) of stream channel. alreadv occurred at Site 2 due to adjacent land development. Applicable Law(s): ® Section 404 (Clean Water Act, 33 USC 1344) ❑ Section 10 (Rivers and Harbors Act, 33 USC 403) Authorization: Regional General Permit 50 - NCDOT - Bridges, Road Widenings, and Interchanges SEE ATTACHED 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, your application signed and dated 11/l/2022, and the enclosed plans "Wetland & Stream Impacts Permit Drawings", Permit Drawing Sheets 1 through 10, dated 10/12/2022. 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. 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 919-807-6300) to determine 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. This Department 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 David E. Bailey at (919) 817-2436 or David.E.Bailey2(&usace.army.mil. Corps Regulatory Official: a Date: 2022.12.02 16:39:54-05'00' Date: 12/02/2022 Expiration Date of Verification: 5/25/2025 SAW-2019-00840 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. The U.S. Fish and Wildlife Service's (USFWS's) Programmatic Biological Opinion (PBO) titled, "NCDOT Program Effects on the Northern Long-eared Bat in Divisions 1-8", dated November 6, 2020, contains agreed upon conservation measures for the NLEB. As noted in the PBO, applicability of these conservation measures varies depending on the location of the project. Your authorization under this Department of the Army permit is conditional upon your compliance with all applicable agreed upon conservation measures in the PBO, which are incorporated by reference in this permit. Failure to comply with the applicable these conservation measures would constitute non-compliance with your Department of the Army permit. The USFWS is the appropriate authority to determine compliance with the terms and conditions of its PBO, and with the ESA. r �®� Date: 2022.12.02 Corps Regulatory Official: _ Date: 12/02/2022 Expiration Date of Verification: 5/25/2025 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 the Customer Satisfaction Survey located at https://re ug latory.ops.usace.g.M.mil/customer-service-survey. Copy furnished electronically: Ryan Conchilla, NCDEQ-DWR, ryan.conchillakncdenr.gov U.S. ARMY CORPS OF ENGINEERS Wilmington District Compensatory Mitigation Responsibility Transfer Form Permittee: NCDOT (Attn: Jerry Parker) Action ID: SAW-2019-00840 Project Name: NCDOT / U-4015A / Gallimore Dairy Road Improvements / Guilford County County: Guilford Instructions to Permittee: The Permittee must provide a copy of this form to the Mitigation Sponsor, either an approved Mitigation Bank or the North Carolina Division of Mitigation Services (NCDMS), who will then sign the form to verify the transfer of the mitigation responsibility. Once the Sponsor has signed this form, it is the Permittee's responsibility to ensure that Wilmington District Project Manager identified on page two is in receipt of a signed copy of this form before conducting authorized impacts, unless otherwise specified below. If more than one Mitigation Sponsor will be used to provide the mitigation associated with the permit, or if the impacts and/or the mitigation will occur in more than one 8-digit Hydrologic Unit Code (HUC), multiple forms will be attached to the permit, and the separate forms for each Sponsor and/or HUC must be provided to the appropriate Mitigation Sponsors. Instructions to Sponsor: The Sponsor verifies that the mitigation requirements (credits) shown below have been released and are available at the identified site. By signing below, the Sponsor is accepting full responsibility for the identified mitigation, regardless of whether they have received payment from the Permittee. Once the form is signed, the Sponsor must update the bank ledger and provide a copy of the signed form and the updated ledger to the Permittee, the Project Manager who issued the permit, the Bank Project Manager, and the District Mitigation Office (see contact information on page 2). The Sponsor must also comply with all reporting requirements established in their authorizing instrument. Permitted Impacts and Compensatory Mitigation Requirements: Permitted Impacts Requiring Mitigation* 8-digit HUC and Basin: 03030003, Cape Fear River Basin Stream Impacts (linear feet) Wetland Impacts (acres) Warm Cool Cold Riparian Riverine Riparian Non-Riverine Non -Riparian Coastal 238 0.01 *If more than one mitigation sponsor will be used for the permit, only include impacts to be mitigated by this sponsor. Compensatory Mitigation Requirements: 8-digit HUC and Basin: 03030003, Cape Fear River Basin Stream Mitigation (credits) Wetland Mitigation (credits) Warm Cool Cold Riparian Riverine Riparian Non-Riverine Non -Riparian Coastal 476 0.02 Mitigation Site Debited: NCDMS (List the name of the bank to be debited. For umbrella banks, also list the specific site. For NCDMS, list NCDMS. If the NCDMS acceptance letter identifies a specific site, also list the specific site to be debited). Section to be completed by the Mitigation Sponsor Statement of Mitigation Liability Acceptance: I, the undersigned, verify that I am authorized to approve mitigation transactions for the Mitigation Sponsor shown below, and I certify that the Sponsor agrees to accept full responsibility for providing the mitigation identified in this document (see the table above), associated with the USACE Permittee and Action ID number shown. I also verify that released credits (and/or advance credits for NCDMS), as approved by the Wilmington District, are currently available at the mitigation site identified above. Further, I understand that if the Sponsor fails to provide the required compensatory mitigation, the USACE Wilmington District Engineer may pursue measures against the Sponsor to ensure compliance associated with the mitigation requirements. Mitigation Sponsor Name: Name of Sponsor's Authorized Representative: Signature of Sponsor's Authorized Representative Date of Signature Page 1 of 2 Form Version 10 June 2020 updated CESAW-RG (File Number, SAW-2019-00840) Conditions for Transfer of Compensatory Mitigation Credit: • Once this document has been signed by the Mitigation Sponsor and the District is in receipt of the signed form, the Permittee is no longer responsible for providing the mitigation identified in this form, though the Permittee remains responsible for any other mitigation requirements stated in the permit conditions. • Construction within jurisdictional areas authorized by the permit identified on page one of this form can begin only after the District is in receipt of a copy of this document signed by the Sponsor, confirming that the Sponsor has accepted responsibility for providing the mitigation requirements listed herein. When NCDMS provides mitigation for authorized impacts conducted by the North Carolina Department of Transportation (NCDOT), construction within jurisdictional areas may proceed upon permit issuance; however, a copy of this form signed by NCDMS must be provided to the District within 30 days of permit issuance. NCDOT remains fully responsible for the mitigation until the District has received this form, confirming that the Sponsor has accepted responsibility for providing the mitigation requirements listed herein. • Signed copies of this document must be retained by the Permittee, Mitigation Sponsor, and in the USACE administrative records for both the permit and the Bank/ILF Instrument. It is the Permittee's responsibility to ensure that the District Project Manager (address below) is provided with a signed copy of this form. • If changes are proposed to the type, amount, or location of mitigation after this form has been signed and returned to the District, the Sponsor must obtain case -by -case approval from the District Project Manager and/or North Carolina Interagency Review Team (NCIRT). If approved, higher mitigation ratios may be applied, as per current District guidance and a new version of this form must be completed and included in the District administrative records for both the permit and the Bank/ILF Instrument. Comments/Additional Conditions: A letter from NCDMS, confirming they are willing and able to accept the applicant's compensatory mitigation responsibility, dated 10/21/2022 was included with the preconstruction notification. This form is not valid unless signed below by the District Project Manager and by the Mitigation Sponsor on Page 1. Once signed, the Sponsor should provide copies of this form along with an updated bank ledger to: 1) the Permittee, 2) the District Project Manager at the address below, 3) the Bank Manager listed in RIBITS, and 4) the Wilmington District Mitigation Office, 3331 Heritage Trade Drive, Suite 105, Wake Forest, NC 27587 (or by email to SAWMIT@usace. army. mil). Questions regarding this form or any of the permit conditions may be directed to the District Mitigation Office. USACE Project Manager: David E. Bailey USACE Field Office: Raleigh Regulatory Office US Army Corps of Engineers 3331 Heritage Trade Drive, Suite 105 Wake Forest, North Carolina 27587 Email: David.E.Bailey2@usace.army.mil Date: 2022.12.02 16:39:17-05'00' 12/02/2022 USACE Project Manager Signature Date of Signature Current Wilmington District mitigation guidance, including information on mitigation ratios, functional assessments, and mitigation bank location and availability, and credit classifications (including stream temperature and wetland groupings) is available at http://ribits.usace.army.mil. s , North Carolina Department of Transportation t f li�,ll►�'�l} P P r Slorl ri w„ W Highway Stormwater Program STORMWATER MANAGEMENT PLAN (Version 2.08; Released April 2018) FOR NCDOT PROJECTS WBS Element: 35013.1.1 TIP No.: U-4015A County(ies): Guilford Page 1 of 1 General Project Information WBS Element: 35013.1.1 TIP Number: U-4015A Project Type: Roadwa Widenin Date: 9/27/2022 NCDOT Contact: Erik Seiler, PE Contractor / Desi ner: Trent Cormier, PE Address: 1202 Birch Ridge Drive Raleigh, NC 27610 Address: 8601 Six Forks Road (Forum 1) Suite 700 Raleigh, NC 27615 Phone: 919 707-6757 Phone: 984 238-7226 Email: a seiler ncdot. oy Email: tcormier(@rkk.com City/Town: Greensboro/High Point !County(!es : Guilford River Basin(s): Cape Fear CAMA Coun ? No Wetlands within Project Limits? Yes Project Description Project Length (lin. miles or feet): 1.057 MI Surrounding Land Use: lindustrial, Farmland Proposed Project Eli Existing Site Project Built -Upon Area ac. 9.5 ac. 12.6 ac. Typical Cross Section Description: Typical cross-section consists of five 12' lanes with a center turn lane along the corridor and varing locations of sidewalks and shoulders. Typical cross-section is currently two to three lanes - 12.5'. Concrete median island - 13'+/- towards the end of the project. Annual Avg Daily Traffic (veh/hr/day): Design/Future: 18,800 Year: 2024 Existing: 15,900 Year: 2018 General Project Narrative: (Description of Minimization of Water Quality Impacts) Widen and improve Gallimore Diary Road (SR 1556) from NC 68 to Airpark Drive. This section of road is currently two to three lanes and will be widened to five lanes. The typical section includes five 12' lanes with a center turn lane along the corridor. The shoulders and sidewalks will vary along the corridor. The jurisdictional streams within the study area have biological impairments (benthos) and are listed on the draft 2020 303d list. Design Mitigations for streams include: 1. Steepening of roadway fill slopes within jurisdictional areas. 2. Stormwater was designed to avoid direct discharge into jurisdictional features to maximum extent practicable. 3. Stormwater design velocities entering jurisdictional features have beem mitigated to be non -erosive (less than 2 fps). 4. Open shoulder sections were maximized to promote sheet flow from the roadway. 5. Diffuse flow provided at outlets that do not have a well defined outfall. 6. Dissipator pads are provided in buffers at pipe outlets where channel change occurs. Waterbody Information Surface Water Body 1 : East Fork Deep River NCDWR Stream Index No.: 17-2-(0.3) NCDWR Surface Water Classification for Water Body Primary Classification: Water Supply IV (WS-IV) Supplemental Classification: None Other Stream Classification: None Impairments: biological impairment Aquatic T&E Species? No Comments: NRTR Stream ID: East Fork Deep River Buffer Rules in Effect: Randleman Lake Project Includes Bridge Spanning Water Body? INo I Deck Drains Discharge Over Buffer? INo Dissipator Pads Provided in Buffer? IYes Deck Drains Discharge Over Water Body? N/A (If yes, provide justification in the General Project Narrative) (If yes, describe in the General Project Narrative; if no, justify in the General Project Narrative) (If yes, provide justification in the General Project Narrative) I 0 M- V nbols STATE OF NORTfi CAROLINA I DIVISION OF HIGIiWAYS Ao GREENSBORO.� ,�40 �z GUILFORD COUNTY END PROJECT HIGH POINT BEGIN PROJECT I � 11 I 73 o 68 ' I VICINITY MAP (NTS) I LOCATION: SR 1556 (GALLIMORE DAIRY RD.) FROM NC 68 (LYNWOOD SMITH EXPY.) TO AIRPARK RD.IN GREENSBORO TYPE OF WORK: GRADING, PAVING, WIDENING, DRAINAGE, CULVERT, SIGNING, RETAINING WALLS, AND SIGNALS WETLAND & STREAM IMPACTS PERMIT DRAWINGS SITE 2 (DISTURBED NOTES: i 'V27 1. A PORTION OF THIS PROJECT IS WITHIN THE MUNICIPAL BOUNDARIES OF THE CITY OF GREENSBORO & THE CITY OF HIGH POINT. 2. CLEARING ON THIS PROJECT SHALL BE PERFORMED TO THE LIMITS ESTABLISHED BY METHOD II. GRAPHIC SCALES 50 25 0 50 100 PLANS 50 25 0 50 100 PROFILE (HORIZONTAL) 10 5 0 10 20 PROFILE (VERTICAL) DESIGN DATA ADT 2018=15,900 ADT 2040=18,800 V = 50 MPH DHV =10% D = 65% T=6% * TTST=2% DUAL=4% FUNC CLASS = URBAN MINOR ARTERIAL STATEWIDE TIER PROJECT LENGTH LENGTH ROADWAY TIP PROJECT U-4015A ............ 1.045 miles LENGTH STRUCTURE TIP PROJECT U-4015A ........... 0.011 miles TOTAL LENGTH OF PROJECT U-4015A................... 1.056 miles BTATB STATB PROIHCI' RRFRRRNCR Na N.C. U-4015A 1 RTAn MM.NO F. IMM.N0. —RIPPION 35013.1.1 WA PE 35013.2.4 WA ROW 35013.2.5 WA UTL ADJACENT DEVELOPMENT) DOCUMENT NOT CONSIDERED FINAL UNLESS ALL SIGNATURES COMPLETED PLANS PREPARED BY: RALEIGH, NORTH CAROLINA 27615-3960 jq#C fC 8601 Sm Forks Road, Forum 1 Suite 100 NC LICENSE NO. F-0112 1-888-521-4455 OR 919-878-9560 FOR NORTH CAROLINA DEPARTMENT OF TRANSPORTATION 2018 STANDARD SPECIFICATIONS SCOTT D. BLEVINS, PE PROJECT ENGINEER RIGHT OF WAY DATE: 05-21-2021 ZAC WILSON, EIT PROJECT DESIGN ENGINEER LETTING DATE: 05-16-2023 BRIAN KETNER, PE DIVISION PROJECT ENGINEER HYDRAULICS ENGINEER ROADWAY DESIGN ENGINEER P.E. 0 O 0 0 N� NW r J vi Lu LLILLJ ZN J DETAIL A CHANNEL CHANGE (Not( Not to Sc le) b NoNrol Proposed Ground �^ b _ _Fir^Slope r d p 1�`• ill/Ft. � J GeoteMile g Place GeoteMile Under Riprap Exist. Chonnel 'n L—i— Directed by Engineer Min. D=2.5 Ft. Tuck GeehxRle = d=2.5 Ft. IMinimem dIB(TYP) B=8 Ff. Type of Liner= CL I Rip -Rap, Keyed -In b=2 Ft. O' JNS PROPERTIES LLC 1 1 PDE -L- STA. 24+25 TO STA. 25+50 LT 0✓� O \ TUTS PROPERTIES LLC 'BZ-1rCRVARIES RaVo O CITY OF HIGH POINT PERMANENT CHANNEL EXCAVATION TOTAL CHANNEL EXCAVATION = 260 CY TOTAL CL I RIP RAP = 190 TONS TOTAL GEOTEXTILE FAB. = 200 SY TOTAL COIR FIBER MATTING = 78 SY CLEANOUT REQUIRED DUE TO EXCESSIVE EXCAVATION � ^ NATURAL GROUND CLASS I RI1.1 (2 ff.THICK) SEDIMENT BUILDUP IN EXISTING CULVERT NATURAL ` EXCAVATION _GROUND ry2' COIR FIBER COIR FIBER MATTING MATTING NATIVE BED NO SILLS TO BE INSTALLED LJ MATERIAL III FT CNANNFI LENGTH CHANNEL WIDTH 27'AT STRUCTURE FACE, VARIES T , NATURAL CHANNEL WIDTH AT TIE-IN LOCATION IMPROVEMENTS LOOKING UPSTREAM (NTS) = 75', SLOPE = 0.6]% NATIVE BED MATERIAL OI ITI FT CHANNFI IMPROVEMENTS LOOKING DOWNSTREAM (NTS) LENGTH = 15',SMPE = 0.32% NATIVE MATERIAL CONSISTS CULVERT CONSTRUCTION. MRREB. RIPRAP MAY LINE THE HIGH FLOW FOR ANIMAL PASSAGE. OF MATERIAL THAT IS EXCAVATED FROM THE ONLY MATERIAL THAT 15 EXCAVATED FROM THE BE USED TO SUPPLEMENT THE NATIVE MATERIAL IN CULVERT BARRELS, NATIVE MATERIAL SHOULD BE PLACED NATIVE MATERIAL IS SUBJECT TO APPROVAL BY THE ST MN%BED OR FLOODPLAIN AT THE PROJECT SITE DURING STREAMBED MAY BE USED TO LINE THE LOW FLOW CULVERT THE HIGH FLOW CULVERT BARRELS. IF UPRAP IS USED TO ON TOP TO FILL VOIDS AND PROVIDE A FLAT SURFACE ENGINEER AND MAY BE SUBJECT TO PERMR CONDITIONS. — L �L EO��U DETENTION 0 o dB• 155 PG IT I \ I➢ r Z i/ i O 10 h 10 CITY OF GREENSBORO 4 CIT F GREENSBOR i / 1 Q \ J \ 1 \ 1 � 0 \ ` \ e / p / 15'DRAINAGE. MAINTENANCE B UTRnY `, h g yG \ EASEMENT IDMBUEI OVER AM 15' /AO O ACCESS PERMANENTUTILTrB USEEXISTING EASEMENT PB 19] PG 3A `\ NTA HOLDINGS LLC ` TER RETENTION POND $ y . yy � � n t F,WOH T Sy / =t P=�� WC , D 4 I-_______ / S, ORNE 20' i T TO — 7_= is" RCP -IV' \�� LT— ) --- RE E \ \ -----T IFi �JII pE L C BST \ �TEa NTENNH4VOREEJkwpy \ — _TP—CSYS SC4i . 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Type of Liner= CL I Rip —Rap, Keyed —In b=2 Ft. O JNS PROPERTIES LLC A29D O CITY OF HIGH POINT PERMANENT CHANNEL EXCAVATION TOTAL CHANNEL EXCAVATION = 260 CY TOTAL CL I RIP RAP = 190 TONS TOTAL GEOTEXTILE FAB. = 200 SY TOTAL COIR FIBER MATTING = 78 SY —L— STA. 24+25 TO STA. 25+50 LT O \ TUTS PROPERTIES LLC CLEANOUT REQUIRED DUE TO EXCESSIVE EXCAVATION �^ NATURAL GROUND CLASS IRIPRAP SEDIMENT BUILDUP IN EXISTING CULVERT NATURAL ` EXCAVATION _GROUND (2 FF THICK) ry2' 171 i 1 1 1 COIR FIBER COIR FIBER MATTING NATIVE BED NO SILLS TO BE INSTALLED J MATERIAL III FT CHANNEL LENGTH CHANNEL WIDTH 2TAT STRUCTURE FACE, VARIES TO NATURAL CHANNEL WIDTH AT TIE-IN LOCATION IMPRQVFMFNTS LOOKING UPSTREAM (NTS) = 75', SLOPE = 0.67% NATIVE BED MATERIAL O"TLET CHANNEI IMPROVFMFNTS LOOKING DOWNSTREAM (NTS) LENGTH = 15',SLOPE = 0.32% NATIVE MATERIAL CONSISTS CULVERT CONSTRUCTION. MAIR I-S. RIPRAP MAY LINE THE HIGH FLOW FOR ANIMAL PASSAGE. OF MATERIAL THAT IS EXCAVATED FROM THE ONLY MATERIAL THAT 15 EXCAVATED FROM THE BE USED TO SUPPLEMENT THE NATIVE MATERIAL IN CULVERT BARRELS, NATIVE MATERIAL SHOULD BE PLACED NATIVE MATERIAL IS SUBJECT TO APPROVAL BY THE STREAMBED OR FLOODPLAIN AT THE PROJECT SITE DURING STREAMBED MAY BE USED TO LINE THE LOW FLOW CULVERT THE HIGH FLOW CULVERT BARRELS. IF RIPRAP IS USED TO ON TOP TO FILL VOIDS AND PROVIDE A FLAT SURFACE ENGINEER AND MAY BE SUBJECT TO PERMR CONDITIONS. LL T OEtE ON{IN S POrvOudB'l55 w RT I � 0 V 712 L / GE ? 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Fill In Wetlands (ac) Excavation in Wetlands (ac) Mechanized Clearing in Wetlands (ac) Hand Clearing in Wetlands (ac) Permanent SW impacts (ac) Temp. SW impacts (ac) Existing Channel Impacts Permanent (ft) Existing Channel Impacts Temp. (ft) Natural Stream Design (ft) -L- 24+03 to 25+45 LT JB w/ MH & 54" RCP -III Roadway Fill < 0.01 153 1 -L- 25+30 to 25+89 Culvert Extension & Improvements East Deep Fork River 0.05 < 0.01 49 11 -L- 25+15 to 26+46 Bank Stabilization 0.05 < 0.01 98 11 -L- 26+84 to 26+96 LT Ditch Construction - WC < 0.01 2 -Y2- 10+48 to 11+12 RT 42" RCP -IV - SC / WB < 0.01 < 0.01 < 0.01 10 6 3 -L- 39+93 to 40+08 RT 66"/2 @ 48" RCP -IV - SD < 0.01 < 0.01 36 9 TOTALS*: < 0.01 < 0.01 0.11 0.02 346 38 0 *Rounded totals are sum of actual impacts NOTES: Site 1: Wetland WC will be a total take. Site 2: Stream SC and Wetland WB have been obliterated within project limits by recent development on Parcel 14. Totals for Site 2 represent theoretical project impacts under conditions present prior to this development. 2018 Feb Action ID Number: SAW-2019-00840 Permittee: NCDOT (Attn: Jerry Parker) County: Guilford Project Name: NCDOT / U-4015A / Gallimore Dairy Road Improvements / Guilford County Date Verification Issued: 12/02/2022 Project Manager: David E. Bailey 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: David E. Bailey Raleigh Regulatory Office U.S Army Corps of Engineers 3331 Heritage Trade Drive, Suite 105 Wake Forest, North Carolina 27587 or David.E.Bailey2@usace.army.mil 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 A. Determination of Jurisdiction: ❑ 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). This determination may be relied upon for a period not to exceed five years from the date of this notification, provided there is no change in law or our published regulations or new information that warrants revision of this determination. ❑ 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). This determination may be relied upon for a period not to exceed five years from the date of this notification, provided there is no change in law or our published regulations or new information that warrants revision of this determination. 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 jurisdictional areas within the above -described project area have been identified under a previous action. Please reference jurisdictional determination issued 10/20/2022. Action ID: SAW-2019-00840.