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1 SOl 1VIAIL �ERVICE CENTER, T:ALEIGH, N.�. 2`���9-1 SQ 1
PAT MCCRORY �I�H(JLA� J. '�'ErTI�TY�OI�I
GOVERNOR �CTING SECRETARY
July 31, 2 a 1�
Mr. Stev� I�.ichefski
IJ. S..�►.r�ny Corps of Englneers
Ash�vill� Regulatory Field Office
151 P'attor� Avenue, Room 208
Ashevil�e, NC 28801-�006
Subj ect: Natianwid� Per�nit # 14
Replace Bridge #11 d on SR 11 �. n with a��ttoml�ss 3-�ide� .�.lum�n�:r.r�..
Culvert
Ashe Count�r, l`�Torth �arc�llna
Proj �ct Number: 17BPa 11 ¢R.B� {I)W+C� 1'ermit ee: $24 )
Dear 11�Ir. I�iche�ski:
The North �arolina Department of �'rans�oriatic�n is seh�duled �� r�pla�� Bridg� # 11 � i�
Ashe Caunty v�ith a new 3-sided alumir�um c��v�rt at the sa�me Iocatior�. Th� �xlsii�.�
structure is a 22' long single span bridge with steel I-b�ams. .�11 of t�.� r��a��.�ng
componer�ts are timber. The prc�posecl aluminum �ulvert �s �0'4'' v�1de � 4.�' tal� �. �3'
lc�n�. Th� culvert walls will spa� the creek b�.t �lass II riprap �vii1 be �au�t�r�u�k i�.s�d�
of the str�acture to maintain channel w�dth. Nc� mitigatian is pr��c�s�d. �'h� n��v c�.l��r�
will be stage constructed so we can maintai�. tr�.ffic. St�eanllrn.pacts ar� �abulat�d �be���d
Stream Impacts:
PHUNE 919-707-2800 FAX 919-'733-91 SQ
Ashe Bridge # 116 on SR 11 l4
July 31, 20 l 5
The repla�ement of the �xisting bridge with th� proposed n�w �ulv�rt �v�ll requir�
temporary dewatering. An im�ervious s�.ndba� dik.e w�ll b� �onstru�t�d �.psir��.:� c�f th�
existing structure �ta create a small poal. Clean water vvil� tempararil� be �u p�d ar�unc�
or piped thraugh the const�ructian area and wfll be discharg�d downstrearr�. .�.�.y dirity
water located lnside the canstructic�n area will be pum�aed lnto a silt bag if n���ssa .
Once the ne�r structure is in plac�, th� imperv��us di:ke �ri11 be �°�mo�� �.r��.
preconstru.ction streambed elevat��ns will b� re�tor�d.
Canstruct�on c�f this proj ect will requ�re �mp►act� ta waiers �f the �:Jnit�d Stat�s i� th� T���
River Basin. The existing bridge �rosses l��Iill �reek (Class: �, Trc��� �j. T'1��� p�°a�j���t
was reviewed for the presence o�` threatened and endanger�d spec��s by c��.r �T�.tural
Environm�nt Sectian. Bog turtles �.r� present in th� county but �c�n� ��r� �bser�e �.t th�
proj ect location. There will be sor�.� l�mited tr�e cutting at the �roj e�� lo�at�on, �rimari�y
on the w�st side. The NLEB is listed as a pratected s�ec�es in thi� �o�nt�r but n� bat
activity w�.s abserved in �he brldge. �Ne �vould recomme�.d a I�TL�A.� ��,1� ��. th�s pr�j �cte
Cultural resource compliance wor�. has been completed. Nc� archaeologfcal r�sou�°��s �r
historic properties fall v�i�th the AP� of this project (see att�c�.�d}Q
The proj ect impacts are not s�gnificant �n naiur� and sho�.ld �o� r�rr�ov� �r de�rade
existing water quality uses. Stormwater w�11 b� rout�d tl�rough gr�.s� o�° r�c� ���.�d
ditches, depending on the ditch line slope. Tota1 land disiurbar�c� will b� l�ss thar� 1�.cr�.
Pipe sizes used will be the minimum necessary t� �rea.t� �. safe rc��;d�w��s � uiil��ir�� th�
�rosion control measures outlined in. the aitac�ments t� thls applicatic�n, dc�wr�sir��.
water quallty standards will be pratected. All a�propri�.te �MP'S '�VVl��. �� US�C� t�.L�.�'1I1�
construction.
By capy of th�s electronic letter, it is requested that Mrs. ��Iarla �;hamb��s wi�th th� I�Tc�rt
�arolina Wildlife Resource� Carr�missior� cc�mment directl� t� yc��. ��n�ernin� �1�� 4�i4
Nationwide Permit application wit� a copy sent to r.��.
By capy of this electranic letter, it is reque�ted ihat the :I)ivisia� o�` ��.te�° �.ality,
401 /Wetlands LTnit, issu� the appropriaie per�nit for c�nstruction �f �his praj ect. I� �s
requested that any comments related to the 401 certif cation be for�a:rd�d d�re�tl� �� r.r��
with a copy sent to the LJS Army �or�as of ��glneers.
We �vauld like ta begin canstru�tian as sc��n as posslbl�. I� fu:rt�.e� ��fc�r�n�.tic�� i�
required, please let me kno�. �o�r early revie�vv and considerat�c�n v�ill b� a�pr�ciat� .
�ir�cerely,
�
:�-I�ath Slaught�r
L�ivisior� 11 Env�ra�.�ne�:t�.� S�p�rvisc�r
Enclosures
Ashe Bridge # 116 on SR 1110
July 31 � 2015
cc: I1�Iarla Chambers, ItiTCWR.�
Am� Chapman, D�vision c�f Wate�° C�uality
Dave Wanucha, D1V1S1()�'l t�f W`clt��` C�LI��l�1
Marella Buncick, �JSFWS
1��1ike Pett�jahn, PE, D1V1SlOYl. E11�111�'�:C
I�a�id Wayne, PE, Bridge 1Vlaint�enance En��n�er
Ja�ni �uynn, I�xvision Bridge Program ���.nag�r
I-�eath Slaughter, Li1V1S10�"1 EI1V1iC1�'Lx11�'11ta.� C���1C�'�
Neil rI'rivett�, Raacls�de Environme�tal Fie1d C)pe�rations ��.g�ne�r
/��,,,�� �� � ��'�� t�ffice Use On ly:
�.
��w/+�'�:. y�,:. �
�+ $i
� � ��t� �orp� action ID na.
� � '""" �r.�rr�E' X:'xt�',..�%t�:�'r����'aN�'a,'`' _•,�
� � � � �' � ��.���� f , `� DWC� pCOJ�Ct r�0.
�� frr.;��
.{�c ~,�,..�?'.�s'.��''.
Form Versior� 1.3 Dec 1 q 2Q�8
Pre-t�onstruction Notification PCN or
A. �. licant Info�-rnatit�n
1. Processing
1a. Type(s) ofi approval sought from the
�Qr �` � Section 4�4 P'errr�it ❑ Sectian 1 C} Permit
p
1 b. Specify Nationwide Permit (NWP) number: 14 or General IPermit {GP} number:
'Ic. Has the NWP ar GP number been verified by the Corps? 0 Yes ��
1 d. Type(s) of approvai sought from the DWQ (check ali that �ppl�}:
� 401 Water Quality Certification — Regular [� Non-4a4 Jurisdictional t�ener�l Permit
� 401 iNater Quality Certification -- Express [_] Riparian �uffer Ruth�rizatic�n
1 e. Is this notification salely fior the record For the rec�rd or�ly f�r DWQ 4�01 For th� r�cord only f�r �orps F��rr�it:
because written approval is not required? Gerkification:
Q ves I�I �o � ��� � ��
1 f. Is payment into a mitigation bank or in-lieu fee pragram propQ�ed for mitigation ���s ���
of impacts? If so, attach the acceptance letter frc�m mitigatiQn bar�k c�r in-lieu
fee program.
1 g. Is the praject lacated in any of NC's twenty coasta! counties. �f yes, answer 1 h ���� ��a
below.
1 h. Is the project located within a NC DCM Area of Environmental Cor�cern (AECj� [� Yes � Nc�
2. Project Information
2a. Name of project: Bridge #116 on SR 1110
2b. Cc�unty: Ashe
2c. Nearest municipality / town. Mili Creek
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state �76P.11.R.85
praject no:
3. Owner Information
3a. Name(s) on Recorded �eed: NGD4T
3b. Deed Book and Page No.
3c. Responsible Party (for LLG i f
applicable):
3d. 5treet addr�ss: 801 Statesville Road
3e. City, state, zip: North Wilkesboro, NC 28659
3f. Telephone no.: 336-903-92U2
3g. F�x no.: 336-667-4�49
3h. Email addres�: hslaughter�z7�ncdot.gov
Page 1 csf 1 �
F'CN F�rm -- �lersion 1.3 C�ecember 1�, 2��8 �f�rsi��
4. Applicant Information �if different from awner) �
4a. Applicant is: ❑ Agent [� Qther, specify:
4b. Name:
4c. Busines s name
{if applicable}:
4d. Street address:
4e. City, state, zip:
4f. T�lephone no.:
4g. Fax no.:
4h. Ema'rl address:
5. A�ent/Gonsultant Information (if applicable)
5a. N�me:
5b. Business name
(if applicable):
5c. Street address:
5d. �ity, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. E�nail address.
Page 2 of 1 Q
PCN F�rm -- �/ersiar� 1.3 L�ecember 1U, 2C�Q� �/er�i�n
B. Pr+�ject Information and Prior Praject Histc�ry
1. Property Identification
1 a. Property identification no. (tax PIN ar parcel ID}:
1 b. Site coordinates in decima! de rees : Latitude: 36.30876 Lc�ngitude: ��1.5�4�9�
C g � (DD.DDDDDD}
{-D[J. �3QCJDD[�)
� c. Property size: 0.� acre�
2. Surface Waters
2�. Name of nearest bc�dy of water (stream, river, etc:} to Mill Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: C; Trou� +
2c. River basin. N�w
3. Project Descripti+�n
3a. Describe the existing conditions on the site and the general land use in the vicinity of the p�oject at �he tir�e of thi�
application:
�ubstandard bridge to be replaced in a rural area
3b. List the total estimated acreage of all existing wetlands on the properky:
0 acres
3c. List the total estimated linear feet of all existing streams (interr�it�er�t and perenr�ial� on the prc�perty.
� � 00 linear feet
3d. Explain the purpose of �he proposed project:
Upgrade substandard stre�m crossing
3e. Describe the overalf project ir� detail, including the type af equ�pr�ent to be used:
See attached cover letter.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
ro'ect includin alf rior hases in the ast? ���s �� ❑ Ur�k�ovvn
p 1 C � p p ) K�
Comments:
4b. If the Corps mad� the jurisdictional determinatian, vvhat type
� �� Preliminary ❑ Final
of determination was made .
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if knawn): tJther:
4d. If yes, list the dates of the Corps jurisdictional determinations �r S�ate defierminatic�ns �nd attach docum�ntatior�.
5. Project History
5a. Have permits or certifcations been requested or obtained for � Yes � No [� lJr�kr�ovvn
this praject {in�luding all prior phasesj in the past?
5b. If yes, explain in detail according to "help file" instructians.
6. Future Project Plans
6a. Is this a phased project? ❑ Yes ��la
6b. If yes, explain.
�age 3 c�� 1�
P�N F�rm — Version 1.3 C�ec�mber 10, 2�C�8 �/ersior�
C. Proposed Impacts Inventory
1. lmpacts Summary
1 a. Which secti�ns were completed below for yQUr project (check �II ti�at appl�}:
� Wetlands � Streams - tributaries ❑ Buffers
❑ C�pen Waters [� Pond Construction
2. Wetland Impacts
if there are wetland impacts proposed on the site, then complete this questian for each wetland area imp�cted.
2a. 2b. 2c. 2d. Ze. 2f.
Wetland impact i"ype of jurisdicti�n
number — Type of impact Type af wetiand For�sted {�arps - 4�04�, 1� �re� �f ir�p�c�
Permanent (P) or (if known) DWC� -- no�-444�, other) (�cre�}
Tem c�ra T
� Yes [� Corps
w� C� �❑ T ❑ No ❑ Qv�v�
� Yes ❑ �orps
W2 []P❑T �Nc� ❑�7WC�
❑ Y�s ❑ Corps
W3 ❑ P L,] T Nc� [�WC�
� Q
C� Y�s ❑ corps
V1/4 �] P❑ T [� Nc� ❑ C�WQ
❑ Y�s ❑ corps
W5 ❑ P❑ T �] Nca C� DVVC�
❑ Y�s � �orps
W6 [� P � T Nc� �WQ
❑ ❑
2g. Tatal wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including tempor�ry impact�) proposed o� the �ite, the� complete thi�
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. �g.
Stream impact Type of impact Stream name Perennial Type c�f jurisdic�ior� A�rerag� ��p���
number - (PER) �r (Corps - 4�Q4�, 1� s�rea�n Ieng�h
Permanent (P) ar interrr�ittent �W(� -- n�n-4��, �idth (line�r
TemporarY iT) (It�T)? other} (feet} feet)
Stone inside � PER � �orps
S1 � P� T culvert & Mill Creek 16 143
Dewaterir�g
[� I NT � C�WGF
� PER � Corps
S2 ❑ P❑ T [�] I NT ❑ �WC�
� PER 0 �orp�
S3 ❑P❑T ❑INT [�DWQ
❑ PER C] Corps
S4 C� P❑ T [� I NT C�] DWQ
C] P�R [� Corps
S 5❑ P❑ T �j I(� T ❑�UVQ
[] PER [� Corps
S�i ❑ P❑ T [,� INT ❑ DWC�
3h. Tatal stream and tributary impacts 143
3i. Comments: Riprap 62', 81' temporary dewatering
Page 4 �f 10
PGN Fc�rm —�l�r�i�n 1.3 G�ecer�b�r 1C�, 2�Q8'�ersian
4. Open Water Impa�ts
If ther� are proposed impacts to Iakes, ponds, estuaries, tributarie�, sa�nds, the ,�tlanti� Oc�an, or �ny �th�r �pen r�r�ter �f
the U.S. then individually Iist all open water impacts below.
4a. 4b. 4c. 4�d. 4�.
Open water Narne of waterbody
impact number -- {if applicable) Type of impac� V�iaterbod� tYp� �rea �f ir�np�ct (�cres�
Perm�nent (P) or
Tem arar T
CJ 1 �] P ❑ �"
02 �P❑T
03 ❑P❑T
04 �P❑T
4f. Total open water impacts
4g. Camments:
5. Pond +�r Lake Construction
If ond ar lake construction ro osed, then com Iete the chart bel�w.
5a. 5b. 5c. 5d. 5e.
V1/etland Impacts (�cre�) �tream impact� (feet) l�pi�nd
Pand ID Proposed use or purpose (acres}
number of pond
Flooded Filled Exc�vated Flr�oded F�II�d Excavat�d Flo�d��
P1
P2
5f. Total
5g. Comments: N/A
5h. Is a dam high hazard permit required?
❑ Yes � No If yes, permit ID r�o.
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres}:
5k. Method of consfiruction:
6. Buf�er Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart belaw. If yes, then individually list �II b�1�er impacts
below. If an impacts require miti ation, then ou MUST fill out S�ction D of this farm.
6a.
❑ N�use ❑ Tar-Pamlic� � +ather:
Project is in which protected basin? Q Catawb� ❑ I�andlemar�
6b. 6�. 6d. 6�. 6f. 6g.
BufFer impact
r�umber -- Reas�on Buffer �ane 1 impac� ���e 2 imp�ct
Permanent (P) or for Stream name mitig�tion (square feefi} (�quare ����)
Tem orar T im act r� uired'?
C] ��s
B� oPo,- ❑��
o Y�s
B2 ❑P❑T ❑Nt�
� Yes
B3 �]POT ���
6h. Total buffer �mpacts
6i. Comments:
F'age S of 1 Q
PCN Fc�rm -- Versi�r� 1.3 C�ecember 1 C�, 2�08 ��rsic�r�
D. Impact Justificatio� and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken ta avoid c�r minimize the praposed impacts in d�signing prc�ject.
The culvert Iength is the minimum needed to improv� safety at this loc�tion. Floadpl�ins will be c�nstructed ir�side the
structure to maintain channel width.
1 b. Specifically describe measures taken to avoid ar minimize the proposed imp�cts througi� cor�struc�ior� techni�ue�.
All �ppropriate BMPs will be used during construction
2. Campensatory Mitigation for Impacts to Waters of the UeStl or VVaters o� the atate
2a. Daes the project require Compensatory Mitigation for � Yes � No
impacts to Waters af the U.S. or V1/aters af the �tate'?
2b. If yes, mitigatiQn is requir�d by (check all that apply): ❑ DWQ ❑ Cor'ps
C,] Mitig�rtion bank
2c. If yes, which mitigat ion option will be used far this
� ❑ P�yr�ent fio in-lieu fee pr�gram
prc��ect .
[� Permittee Responsible Mitigatic�r�
3. Complete if Using a Mitigation Bank
3a. Name af Mitigatian Bank.
3b. Credits Purchased (attach reeeipt and letter) Typ+� C�uantity
3c. Comments:
4. C�mplete ifi Making a Payment to In-Iieu Fee Prar�rar�
4a. Approval letter from in-lieu fee prograrn is attached. � Yes
4b. Stream mitigation requested: Iinear feet
4c. If using stream mitigation, stream ternperature: C] warm ❑ cool ❑c�ld
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wefiland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Goastal (tidal} wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Pla
5a. lf using a permittee responsible mitigation plan, provide a descriptian of the prapc�sed mitigation plar�.
P�ge � t�f 10
PCN F�rm --�lersion 1.3 December 1�, �Q08 �l�rsi�r�
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) �- required by �WQ
6a. Will the project result in an impact within a protected riparian b�ffer that requires ❑ Yes ��lo
buffer mitigafiion'?
6b. If yes, th�n identify the square feet af impact ta ea�h zone of the riparian buffer that require� mi�iga�ior�. �Icul�te th�
amaunt of mitigation required.
6c. 6d. 6e.
Zone Reasan for impact Total impact �flultiplier Requir�d rni�igation
(square feet) �s��aare f�e��
Zone � 3 (2 for ��ta�nrb�)
Zane 2 1.5
6f. Total buffier mitigat�on requirede
6g. Ifi buffer mitigation is required, discuss what type of rnitigatiQn is pr�posed (e.g., payment to priv�te mitigati�r� b�r�k,
permittee responsible riparian buffer restaration, payment into an �pproved in-Iieu f�e fund).
6h. Comments:
Pag e "7 0� '! 0
P�N F�rm — Versic�n 1.3 C�ecember 1 a, 2�Q8 i/er��ic��
E. Stc�rmwater Management and Diffuse Flow Plan {required by D1NC�)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent t� protected riparian buff+�rs identified �,�� ���
within one of the NC Ri arian Buffer Protection Rules? �
�
1 b. If yes, then is a diffuse flow plan included? If na, e�cplain why.
C� �e� � �
Comments:
2. Stormwater I�lana ement Plan
2a. What is the overall percent imperviousness of this praject? °Io
2b. Does this project require a Stormwater Management Plan? ❑°�e� Nc�
2c. If this praject DOES NUT require a Stormwater Management Plan, expl�in why: Disturbing less thar� 1 acr�
2d. If this project Dt�ES require a Stormwater Management Plan, ther� provide a brief, narrati�e descriptior� of �he plan:
❑ Certi��d L���al Governmer�t
2e. i/�lho will be respnnsible for the review of the Starmwater Man�gement F'I�n? ❑ DWQ �tormw�ter Progr�nn
❑ DWC� 4�Q1 lJni�
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this praject?
❑ Phase I i
0 NSW
3b. Which af the following locally-implemented stormwater m�nagem�nt pr�grams 0�SM�
apply (check all that applY):
�j V�/�ater ��upply atershed
❑ �ther:
3c. Has �he approved Starmwater Management Plan with proof of �pproval been ❑�'es [�] i�c�
attached�
4. DWQ Starmwater P'ro ram Review
� �o��tal countie�
C] H QW
4a. Which of the following state-implemented stormwater manag�ment programs apply (� p��
(check all that apply): � Sessi�n L�� 200�r24��
�1 Cith�r:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? � ��s �] �
5. DWt'� 401 lJnit Stormwater Review
5a. Does the Stormwa�er Management Plan meet the appropriate req�irements? ���� ���
5b. Have all of the 401 Unit submittal requirements been met? 0��s ��
P�ge � of 1 a
PC�I Form — Version �.3 CJecember 1�, 2��� �'ersi�r�
F. Supplementary Information
1. Environmental Documentation (QWQ Requirement)
1 a. Does the project invaive an expenditure of public (fiederalistat�/local) fiunds or �he �,��� ���
use of public (federal/state} land?
1 b. If you answered "yes" ta the above, does the project require p�eparati�n of an
environmental document pursuant ta the requirements of the National or St�te ��'�s ��a
(North Carolina) Er�vironmental Policy Act {NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review beer� finalized by the
State Clearing House? (If so, attach a copy of the NEPA or S�PA �nal approvai
letter.} � �''�s � ��
Comments:
2. V�olations (DWQ Requirernent)
2a. Is the site in vialation of DWQ Wetland Rules {15A NCAC 2FI .050�), Isolated
Wetiand Rules (15A NCAC 2N .� 30�), DWQ SurF�ce Water or iN�tland St�ndards, [� Y�s � Rlo
or Riparian Buffer Rules (15A NCAC 26 .Q200)7
2b. Is fihis an after-the-fact permit applicatian? ❑�es ��0�
2c. If you answered "yes" ta one or b�th of the ab►ove questions, provide an explanatic�� of the violatian(s}:
3. Cumulative Impacts (QWQ Requirement)
3ae Will this praject (b�sed on past and reasonably anticipated future impac�s} result ir� ���� ���
additianal development, which could impact nearby downstre�m water quality?
3be If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact �n�lysi� ir� �c�ord�nce �ri�h �he
most recent aWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non�discharge or discharge) of wa�tewater generated from
the proposed project, or available capacity c�f the subject facility.
N/a
Page9ofla
PCN F�rm -- Version 1.3 December 14, 2008 iler�i�r�
5. En�dangered Species and Designated Gritical Habitat (Corps I�equirerr�er�t�
5a. Will this proje�t accur in or near an area with federally prQtecfied species or ��� ��
habitat? � �
5b. Have you checked with the tJSFWS concerning Endangered �pecies Act ��.�� ���
impacts? � �
[� Ra��edgh �
5c. !f yes, ind i�cate the US�FWS� Fieid 4ffi�ce you have� contacted. �
� Asheville �
5d. 1Nhat data sc�urces d�id you use� to determ�in�e whether you�r sit� woul�d�� im�pact Enda�ngered Sp�ci�� or Desigr�ate� �riti�c�l
H�bitat?
�I� and visual observation. U�FWS will be copied an this p�rmit application. Requestir�g that the �orp� cc�ardina�e with
USFW� regarding the NLEB.
6. Essential Fish Habitat (Corps Requiremen�t)
6a. VVill this praject �ccur in or near an area designated as essential fish habitat? �] Yes � I��
6b. What data sources did you us�e to determine whether your sit� would imp�ct Essential Fish �abitat�
V�RC will comment
7. Historic or Prehistoric Cultural Resources (Carps Requir+�mer�t}
7a. Will this praject qccur in or near an area that the state, federa� or tribal
governments have designated as having historic or cultural prese�vatian � Y�� ���
status (e.g., National Historic Trust designatior� or prnperties �ignificant in
North Carolina history and archaealogy)?
7b. What data sources did you use to determine whether your sit� would impact historic or archet�lc�gic�l res�urces'?
Project was reviev�ed by the CJHE. See attached fc�rms.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 10�-year flaadpl�in? [] Yes ��9c�
8b. If yes, explain �aw project meets FEMA requirements:
8c. What source(s} did yau use to make the floc�dplain deterr�ination? FRIS
J. I-�eath �laughter �f3� i15
� ��
A licant/A ent's Printed Name Applicant/Ager�t's Signat �a��
�p � (Agent's signature is valid only if an authc�rizatie� tter frr�m the applican�
is rovided.}
P�ge l� c�f 1 Q
P�N Form -� ilersion �I .3 De�ember 1�, �q�8 �ler�io�