20140806 Ver 2_USACE Permit_20150212

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW- 2009 -01696 County: Montgomery U.S.G.S. Quad: NC- MORROW MOUNTAIN
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: NC DOT, Mr. Richard Hancock
1598 Mail Service Center
Address: Raleigh, NC 27699
Size (acres) n/a Nearest Town Mount Gilead
Nearest Waterway Pee Dee River River Basin Upper Pee Dee. North Carolina, South Carolina.
USGS RUC 3040104 Coordinates Latitude: 35.2541
Longitude: - 80.0718
Location description: The proposed project site is located on SR 1111 (Lilly's Bridge Road), at Bridge Number 22,
over Richland Creels, in Montgomery County North Carolina.
Description of projects area and activity: This verification authorizes impacts to waters of the U.S. related to utility line
relocation in association with an NC DOT bridge replacement project (B- 4780). Impacts are temporary in nature and total 10
linear feet of Richland Creek to be open cut and backfilled once utility lines (12 -inch water line to be located downstream of
the previously authorized new culvert and 8- in force main sewer line to be located upstream) are in place.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number or Nationwide Permit Number: 12
SEE ATTACHED RGP 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 dated February 12, 2015. 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 authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide 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 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 permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide 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 Quality (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 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 Sarah Hair at 910 - 251 -4049 oar• Sarah.E.Hairna,usace.army.mil.
HAIR SARAH'' Digitally signed by
Corps Regulatory Official: " "'R.SARAH.EA.,o54693 -, Date: February 12, 2015
P g ' ..nu.�=iiS, —,,, � mant,
Expiration Date of Verifica ' 1' . =D. D, ou= PKl,ou =USA,
rn =HAIR.SA RAH.EA.1054693512
12 Date: 2015.02.12 16:36:26- 05'00'

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 determination 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 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.
D. ® The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued September 15, 2009. Action ID: SAW- 2009 - 01696.
Basis For Determination: see previous determination
Remarks:
E. 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.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B
and C above).
This correspondence constitutes an approved jurisdictional determination for the above described site. 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: Jason Steele, Review Officer
60 Forsyth Street SW, Room 1OM15
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 n/a.
* *It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence. **
HAIR.SARAH.EA. Digitallysignedhy HAIRSARAHEA .1054693512
Corps Regulatory Official: DN: --_USA, o469351o� =PV,
_ ou =USA, cn= HAIRSAflAH.FA1054693512
Date: 2015.02.1216:36.41 05'00'
� r
Date of JD: September 15, 2009
Expiration Date of JD: N/A

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 online at http: / /regu�latory.usacesurvev.com /.
Copy furnished (e- copy):
James Mason, NC DOT, PDEA
Art King, NC DOT Division 8 DEO
David Wainwright, NC DENR, DWR

SAW - 2009 -01696
Action ID Number: SAW -2009 -01696 County: Montgomery
Permittee: NC DOT, Mr. Richard hancock
Project Name: NCDOTB- 4780Bridf!e No. 22 on SR 1111 (Lilly's Bridge Road) over Richland
Creek/Div. 8/ Montgomery County
Date Verification Issued: February 12, 2015
Project Manager: Sarah Hair
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: Sarah Hair
69 Darlington Avenue
Wilmington, North Carolina 28403
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