20150269 Ver 1_USACE Permit_20150409

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2015-00507 County: Robeson U.S.G.S. Quad: NC-SOUTHWEST LUMBERTON
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: NC DOT, Division 6 Division Engineer
Mr. Greg Burns
Address: P.O Box 1150
Fayetteville, NC 28302
Size (acres) n1a Nearest Town Lumberton
Nearest Waterway Lumber River River Basin Lumber. North Carolina, South Carolina.
USGS HCTC 3040203 Coordinates Latitude: 34.6077
Longitude: -79.0234
Location description: The project site is located in waters of the U.S. (speci�cally Gum Branch), along NC Highway 41, in
Lumberton, Robeson County, NorEh Carolina.
Description of projects area and activity: This verification authorizes impacts to waters of the U.S. in association with an NC
DOT brid�e replacement proiect over Gum Branch, on NC Awv 41. Permanent impacts autliorized tota1761inear feet of Gum
Branch for installation of a sin�le 19'10"X 7'8" aluminum box culvert, and 421inear feet of bank stabilization for culvert
inlet/outlet nrotection.
Applicable Law:
Authorization:
� Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbars Act, 33 USC 403)
Regional General Permit Number or Nationwide Permit Number: 14
SEE ATTACHED RGP or 1VWP GENERAL, REGIONAL AND SPECIAL CONDITIONS
Your worlc 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 March 13, 2015. Any violation of the attached
conditions or deviation fram 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 andlor
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide pei�nit. If the nationwide permit authorization expires or is suspended, revoked, or is modified, such that the
activity would no longer compiy with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are
under construction) or are undet• contract to commence in reliance upon the nationwide pei�rnit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionaiy 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 individua] Section 401 Water Quality Certification, You
should contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
For activities occun�ing 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 [phone].
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/pei�nits.
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 or Sarah.E.Hair(�a,usace.armv.mil.
HAlR.SARAH.EA.14;���,����^�4 35�
Corps Regulatoiy Official: 054693512 r�r ����_<`'�'�`�"""� Date: Apri18, 2015
Expiration Date of Verification: March 18, 2017

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 ofthe 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 . Action ID: SAW- .
Basis For Determination: The site contains a stream channel which exhibits an Ordinaty High Water Mark.
Additional indicators observed included the presence of wracic, sediment deposition, base flow. Field verified on March 10,
2015 by representatives from the Corps, NC DOT and NC DWR.
Remarks:
E. Attention USDA Program Participants
This delineation/deteimination 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 conseivation 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 InfoPmation (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 34303-8801
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 rnust be received at the above address by June 1, 2015.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
C Digitally signed by
Corps Regulatory Official: HAI R.SARAH.L' HAIR.SARAH.EA.1054693512
ment,
Sarah Haii' �.1054693512 on=HAR.SARANIEA7054693512
Date: 2015.04.08 17:24:32 -04'00'
Date of JD: April 8, 2015
Expiration Date of JD: April $, 2020

The Wilmington District is committed to providing the highest level of support to the public. Ta help us ensure we
continue to do so, please complete our customer Satisfaction Survey online at http:/!i'egulatorv.usacesurvev.co�n/.
E-Copy furnished:
Mr. Jim Rerko, Division 6 DEO
Mr. Mason Herndon, NC DENR-DWR

SAW-2015-00507
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 reyun•ements of this form, including any special conditions listed on this form, are hereby incorporated as special
conditions of this permit authorization.
2) All worlc must be perfonned in sn•ict compliance with the plans received by this office on March 13, 2015, which are a
part of this permit. Any modification to the permit plans must be approved by the USACE prior to implementation
3) Failure to institute and carry out the details of these special conditions will result in a directive to cease all ongoing and
permitted work within waters and/or wetlands associated with the permitted project, or such other remedies and/or fines
as the District Engineer or his authorized representatives may seek.
4) The permittee shall require its contractors and/or agents to comply with the terms and conditions of this permit in the
construction and maintenance of this project, and shail provide each of its contractors and/or agents associated with the
consh•uction or maintenance of this project with a copy of this permit, and any authorized modifications. A copy of this
permit, and any authorized modifications, including all conditions, shall be available at the project site during
construction and maintenance of this project.
5) This permit daes not autharize temporary placement or double handling of excavated or fill material within waters or
wetlands outside the permitted area.
6) The permittee will report any violation of these conditions or violations of Section 404 of the Clean Water Act or Section
10 of the Rivers and Harbors Act in writing to the Wilmington District, U. S Army Corps of Engineers, within 24 hours
of the pei7nittee's discovery of the violation.

Action ID Number: SAW-2015-00507 County: Robeson
Permittee: � NC DOT/Division 6/Mr. Jim Rerko
Project Name: NCDOT/NC41/SR2415/DIVISION 6
Date Veri�cation Issued: April 8, 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

_ _ _ _ . _ __
_ __
_
NO`TIFICATION OF ADIVIIlVI�Titr�'I'�Vi'. �SI'�'EAL �PTIONS AND PROCESS AND
TtEQL7G�T i+t�l2 k1F'k'�AL
�pplicant: NC llOT Divisiou 6, Division Engineer � I'ile Nurnber: SAW-2015-00507 Date: Apri18, 2015
Mr. Greg Burns
Attached is: See Section below
❑ INITIAL PROFFEIZED PERMIT Standard Peimit or Letter of permission) A
❑ PROFFERED PERMIT (Standard Peimit or Letter of permiSsion) B
❑ PERMIT DENIAL C
� APPROVED JURISDICTIONAL DETERMINATION D
❑ PRELIlVIINARY JI.IRISDICTIONAL DETERMINATION E
I- The following identifies youi° rights and optians xegarding an adrninist��ative appeal of the above decision:
informationlnay be found at or http: ;=��r���,usaca.��•�i3� �nal``�iission�,'�i�r�1�'a�ks;Regula�or�3Fro�ra�andPe�•r��its as�k
�s re�ulations a� 33 CPR Part 33 L
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 Pernussion (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 entu�ety, and waive all
rights to appeal the pertnit, including its terms and conditions, and approved jurisdictional determinations associated with the
pernut.
OBJECT: If you object ta the permit (Standard or LOP) because of certain tenns and conditions therein, you may request
that the peimit be modified accordingly. You must complete Section II of this form and retutn the foi�n to the district
engineer. Your objections must be received by the dishict engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the peimit in the future. Upon receipt of your letter, the dish•ict 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 perinit 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 fmal
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Pelmit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the peitinit, including its terms and conditions, and approved jurisdictional detei�rninations 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 Adminisn•ative Appeal Process by completing Section II of
this form and sending the foim to the division engineer. This form must be received by the divisian engineer within 60 days
of the date of this notice. _
C: PERNII'I' DENIAL: You may appeal the denial of a permit under the Corps of Engineers Adtninistrative Appeal Process by
completing Section II of this foim and sending the form to the division engineer. This foi�rn 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 Cotps 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 Coips of Engineers
Administrative Appeal Process by completing Section II of this form and sending the foim to the distcict engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

E: PRELIlVIINARY JIJRISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminaiy JD. The Preliminaty JD is not appealable. If you wish, you may r•equest an approved JD (which may be appealed),
by contacting the Corps dish�ict for fui�ther instruction. Also you may provide new infoi7nation for further consideration by the
Corps to reevaluate the JD.
SEGTION II- REQITEST FOR Al'PEAL or OBJECTIONS TO AN TMTIF.L PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered pei7nit in clear cancise stateinents. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the adrninish•ative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Caips 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 r•ecor�d. 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 GONTACT �OIZ:Q[JESTIONS OR,INFORIvIATION':
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 Regulatoxy Division, Attn: Mr, Jason Steele, Adminish�ative Appeal Review Officer
Sarah Aair CESAD-PDO
69 Darlington Avenue U.S. Army Coi�s of Engineers, South Atlantic Division
Wilmington, North Carolina 28403 60 Forsyth Street, Room 1OM15
Atlanta, Georgia 30303-8801
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of ent�y to Corps of Engineers personnel, and any government
consultants, to conduct invesfigations 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 ha�e the opportunity to pal�ticipate in all site investigations.
Date: Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffererl Permits send tliis form to:
District Engineer, Wilmington Regulatory Division, Attn: Sarah Hair, 69 Darlington Avenue, Wilmington, North Carolina
28403
Fo�� Perrrrit denials, Proffef�e�l Permits and rrpproved Jurrsdretional Deter�ninatiorzs send tlzrs form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele, Administrative Appeal
Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]

U.S. ARMY CORPS OF ENGINEERS
Wilmington District
Compensatorv Miti�ation Responsibilitv Transfer Form
Permittee: NC DOT, Mr. Greg 8urns, Division 6 Engineer Action ID: SAW-2015-00507
Project Name: NC 41%SR 2415/ bridge 446 over Gum Swamp County: Robeson
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 Ecosystem Enhancement Program (NCEEP), 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 to the U.S. Army Corps of Engineers (USACE) 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 Nydrologic 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 must verify that the mitigation requirements (credits) shown 6elaw are available at
the identified site. 8y signing below, the Sponsor is accepting full responsibility for the identified mitigation, regardless of
whether or not 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 bank ledger to the Permittee, the USACE Project
Manager, and the Wilmington 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: 03040203, Lumber River Basin
Stream Impacts ilinear
Warm � Cool � Cold
76
Wetland Impacts (acres)
n Riverine Riparian Non-Riverine Non-Riparian Coastal
*If more than one mitigation sponsor will be used for the permit, only include impacts to be mitigated by this sponsor.
ipensatory Mitigation Requirements:
Stream Mitigation (credits)
Warm Cool Cold
76
HUC and Basin
Wetland M
Lumber River Basin
ion (credits)
Riparian Riverine � Riparian Non-Riverine � Non-Riparian � Coastal
Mitigation Site Debited: NC DMS
(List the name of the bank to be debited. For umbrella banks, also list the specific site. For NCEEP, list NCEEP. If the NCEEP
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 NCEEP), as approved by the USACE, are
currently availabfe 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 of Sponsor's Authorized Representative:
Signature of Sponsor's Authorized Representative Date of Signature
Page 1 of 2 Form Updated 12 September, 2014

USACE Wilmington District
Campensatory Mitigation Responsibility Transfer Form, Page 2
Conditions for Transfer of Compensatory Mitigation Credit:
• Once this document has been signed by the Mitigation Sponsor and the USACE 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 USACE 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. 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 the Sponsor must be provided to the USACE within 30 days of
permit issuance. NCDOT remains fully responsible for the mitigation until the USACE 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 USACE 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 USACE, the 5ponsor must obtain case-by-case approvai from the USACE 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 USACE adminis#rative records for both
the permit and the Bank/ILF Instrument.
Comments/Additional Conditions:
This form is not valid unless signed below by the USACE Project Manager and by the Mitigation Sponsar on Page 1. Once
signed, the Sponsor should provide copies of this form along with an updated bank ledger to: 1) the Permittee, 2J the
USACE Project Manager at the address below, and 3) the Wilmington District Mitigation Office, Attn: Todd Tugwell,
11405 Falls of Neuse Road, Wake Forest, NC27587 (email: todd.tugwell�a usace.army.milJ. Questions regarding this form
or any of the permit conditions may be directed to the USACE Project Manager below.
USACE Project Manager: Liz Hair
USACE Field Office: Wilmington Regulatory Field Office
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, NC 28403
Email: C' Digitally signed by
HA I R. SA RA H. C� HAIR.SARAH.EA.1054693512
DN: c=US, o=U.S. Government,
A.1054693512 °�=HAR,SARAH'EA; 54693512
Date:2015.04.0817:30:09-04'00' Ap1'll 8, 2015
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:Ilribits.usace,arrr3v.mil.
Page 2 of 2
The Wilmington District is committed to providing the highest Ievel of support to the public. To help us ensure we continue to do so, please complete the
Customer Satisfaction Survey located at our website at http:I/re�ulatorv.usacesurvev.coml to complete the survey online.