20150949 Ver 1_401 Application_20150915

THE
September 3, 2015
WOOTEN
COMPANY
Mr. Anthony Scarbraugh
NCDENR — Division of Water Resources
Environmental Senior Specialist
E N G I N E E R I N G
Washington Regional Office
943 Washington Square Mall
PLANNING
Washington NC, 27889
ARCHITECTURE
120 North Boylan Avenue
Raleigh NC 27603 -1423
919 828.0531
tax 919 834.3589
RECEIVED /NCDENR /DWR
SEP 8 2015
Water Quality Regional
Operations Section
Washington Regional Office
Re: NCDWQ Agent Authorization Letter
Washington County Water and Sewer Improvements Project
Washington County, North Carolina
TWC No. 2451 -AP
Mr. Scarbraugh:
On behalf of Washington County, we are submitting a PCN Application for the above
referenced project. I have included one copy of the following items for your review and
approval.
• PCN Application
• Agent Authorization Form
• PCN Exhibits (11x17 Construction Drawings)
• Email Correspondence from April 2015
• USGS and SCS Soils Maps
The scope of this project involves the construction of approximately 14,312 LF of 6"
PVC sanitary sewer force main, a 180 GPM sanitary sewer pumping station, 575 LF of
8" PVC sanitary sewer and 1,685 LF of 12" PVC water main.
Per our email correspondence in April 2015, no written concurrence will be required. I
am simply sending you a copy of the PCN Application for your records. Since there is
no review required, I have not included the $240.00 application fee.
If you should have any questions or require additional information, please do not hesitate
to contact us at (919) 828 -0531.
Sincerely,
Brian J.P. Oschwald, P.E.
THE WOOTEN COMPANY
Cc
Mr. Curtis Potter — Washington County Attorney (le
TWC File

ARCHITECTURE
120 North Boylan Avenue
Raleigh NC 27603 -1423
919.828 0531
fax [phone]
Re: NCDWQ Agent Authorization Letter
Washington County Water and Sewer Improvements Project
Washington County, North Carolina
TWC No. 2451 -AP
Mr. Scarbraugh:
The undersigned hereby authorizes The Wooten Company to proceed on behalf of the
' Washington County, as the agent for consulting and permitting purposes related to the
submittal of the Pre - Construction Notification for the Washington County Water and
Sewer Improvements Project, located in Washington County, North Carolina. This agent
authorization letter supersedes all previous agent authorizations.
If you should have any questions or require additional information, please do not hesitate
to contact us at (9 19) 828 -0531.
Sincerely,
Brian J.P. Oschwald, P.E.
THE WOOTEN COMPANY
Signature: �, 2 °' Signature
����� ' ey nal):
Printed Name:— Jerry Rhodes Printed Name:
Organization: Washington County Organization:
Mailing Address: P.0 Box 1007 Mailing
Plymouth, NC 27962 Address:
Phone No.: 252 -793 -5823 Phone No:

Brian Oschwald
From: Scarbraugh, Anthony <anthony scarbraugh @ncdenr.gov>
Sent: Tuesday, March 31, 2015 11:46 AM
To: Brian Oschwald
Subject: RE: Washington County Light Industrial Building Off -Site Utilities
Mr. Oschwald,
As long as the maintenance corridor is 15 or less than no written concurrence is required. You will still need to comply
with the conditions of the GC 3884.
Thanks,
Anthony Scarbraugh
Anthony Scarbraugh
Environmental Senior Specialist
Washington Regional Office
North Carolina Department of Environment and Natural Resources
Division of Water Resources — Water Quality Regional Operations Section
943 Washington Square Mall
Washington, NC 27889
(252) 948 -3924
********************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
E -mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties unless the content is exempt by statue or other regulation.
From: Brian Oschwald [mailto:boschwald @thewootencompany.com]
Sent: Tuesday, March 31, 2015 11:26 AM
To: Scarbraugh, Anthony
Subject: RE: Washington County Light Industrial Building Off -Site Utilities
Anthony,
Here is a clip of the CAD file in the area that I am referring to. Let me know if you need a bit more detailed.
Brian Oschwald, PE
Project Engineer
The Wooten Company
120 North Boylan Avenue
Raleigh, NC 27603
919.828.0531
Fax [phone]
www.thewootencomoanv.com
02
From: Scarbraugh, Anthony r mailto :anthonv.scarbrauah @ncdenr.gov1
Sent: Tuesday, March 31, 2015 10:54 AM

To: Brian Oschwald
Subject: RE: Washington County Light Industrial Building Off -Site Utilities
Mr. Oschwald,
Could you send me a figure of the proposed impacts?
Thanks,
Anthony
Anthony Scarbraugh
Environmental Senior Specialist
Washington Regional Office
North Carolina Department of Environment and Natural Resources
Division of Water Resources — Water Quality Regional Operations Section
943 Washington Square Mall
Washington, NC 27889
(252) 948 -3924
E -mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties unless the content is exempt by statue or other regulation.
From: Brian Oschwald I -mai Ito: boschwaIdCdithewootencom panv.coml
Sent: Tuesday, March 31, 2015 9:55 AM
To: Scarbraugh, Anthony; 'Kyle.W.Barnes @usace.army.mil'
Cc: Brian Johnson
Subject: RE: Washington County Light Industrial Building Off -Site Utilities
Anthony,
The width of the easement will be approximately 11 feet wide (measured along the centerline of the stream). The way I
interpret this means that we are not required to obtain written concurrence and therefore do not need to submit a
PCN. In addition, the utility line will be installed by trenchless methods.
Please inform if I am not interpreting this correctly.
Brian Oschwald, PE
Project Engineer
The Wooten Company
120 North Boylan Avenue
Raleigh, NC 27603
919.828.0531
Fax [phone]
www.thewootencompanv.com
fly 1 HE WOOTEN Ct.3M.` -MANY
From: Scarbraugh, Anthony ( mailto: anthonv.scarbrauahC0ncdenr.aov1
Sent: Tuesday, March 31, 2015 9:48 AM
To: Brian Oschwald; 'Kyle.W.Barnes @usace.army.mil'
2

Cc: Brian Johnson
Subject: RE: Washington County Light Industrial Building Off -Site Utilities
Mr. Oschwald,
Per the water quality certification 3884 that corresponds with the NW 12, any permanent impacts to any wetlands
and /or waters, including streams or impacts to any wetlands and /or waters if the maintenance corridor in a wetland or
at a stream crossing is greater than 15 wide requires written concurrence.
Thanks,
Anthony
Anthony Scarbraugh
Environmental Senior Specialist
Washington Regional Office
North Carolina Department of Environment and Natural Resources
Division of Water Resources — Water Quality Regional Operations Section
943 Washington Square Mall
Washington, NC 27889
(252) 948 -3924
E -mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties unless the content is exempt by statue or other regulation.
********************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
From: Brian Oschwald fmai Ito: boschwaId @thewootencompanv.comj
Sent: Tuesday, March 31, 2015 9:37 AM
To: 'Kyle.W.Barnes @usace.army.mil'; Scarbraugh, Anthony
Cc: Brian Johnson
Subject: Washington County Light Industrial Building Off -Site Utilities
Anthony /Kyle,
I just left both of y'all a voicemail, but wanted to follow up with an email as well. I am working on a project in
Washington County, designing a 6" sanitary sewer force main to serve the County's Light Industrial Building. I am
crossing a perennial stream, partially in the ROW and partially out of the ROW, and will be acquiring new easement at
the crossing, into the stream. I am curious as to whether we need to submit a PCN for this crossing, since it is an
allowable crossing with no mitigation required. Can y'all shed some light on this for me?
Thanks,
Brian Oschwald, PE
Project Engineer
The Wooten Company
120 North Boylan Avenue
Raleigh, NC 27603
919 828.0531
Fax [phone]
www.thewootencompanv.com
WIT It HE WOOTEN COMPANY

w.
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P Y
A. Applicant Information
1, Processing
201 50949
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre - Construction Notification (PCN) Form I
1 a. Type(s) of approval sought from the Corps: I
I ❑ Section 404 Permit ❑
❑ Section 10 Permit
1b. S
Specify Nationwide Permit (NWP) number: 12 or General Permit (GP) number:
1c. H
Has the NWP or GP number been verified by the Corps? I
I ❑
❑X Yes ❑ No
1d. T
Type(s) of approval sought from the DWQ (check all that apply):
M 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer A
Authorization
1e. I
Is this notification solely for the record For the record only for DWQ For the record only for Corps Permit:
because written approval is not required? 401 Certification:
❑X Yes ❑ No ❑
❑ Yes Q No
1f. I
Is payment into a mitigation bank or In -lieu fee program proposed for
mitigation of impacts? If so, attach the acceptance letter from mitigation bank ❑
❑ Yes M No
or in -lieu fee program.
1g. I
Is the project located in any of NC's twenty coastal counties. If yes, answer 1h I Y
Yes ❑ No
below.
+ 1h. I
Is the project located within a NC DCM Area of Environmental Concern (AEC)? I ❑
❑ Yes [XQ No
2. P
Project Information
2a. N
Name of project: Washington County Water and Sewer Utilities
2b. C
County: I Washington County F
2c. N
Nearest municipality / town: + Washington County and Town of Plymouth
Fyi
2d. S
Subdivision name: I n/a
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent ❑ Other, specify:
4b. Name: Same as owner
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: Brian J.P. Oschwald, P.E.
5b. Business name The Wooten Company
(if applicable):
5c.
Street address:
120 N. Boylan Avenue
5d.
City, state, zip:
Raleigh, NC 27603
5e.
Telephone no.:
919- 828 -0531
5f.
Fax no.:
919 - 834 -3589
5g.
Email address:
boschwald @thewootencompany.com
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): Linear Project
1b. Site coordinates (in decimal degrees): I Latitude: Longitude:
1 c. Property size: acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Canoby Creek
2b. Water Quality Classification of nearest receiving water: C; Sw
2c. River basin: Roanoke River Basin
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Linear project along the shoulder of Plymouth Airport Road, Morratock Road, NC Highway 32 and Roosevelt Avenue. Some impacts are in the ROW
and some are within new permanent utility easement.
3b. List the total estimated acreage of all existing wetlands on the property:
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 44.5
3d. Explain the purpose of the proposed project:
To serve the Washington County Industrial Commerce Building with water and sewer utilities.
3e. Describe the overall project in detail, including the type of equipment to be used:
The creek crossings, regardless of whether in the ROW or new utility easement, will be installed by directional drill. The sanitary
sewer force main will be 6 -inch fusible PVC.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the ❑ Yes M No ❑ Unknown
Corps or State been requested or obtained for this property / Comments:
project (including all prior phases) in the past?
4b. If the Corps made the jurisdictional determination, what type ❑ preliminary n/a ❑ Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency /Consultant Company:
Name (if known): n/a Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
n/a
5. Project History
5a. Have permits or certifications been requested or obtained for I ❑ Yes ❑ No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Erosion Control, Stormwater Permit, NCDENR Fast Track Application, NCDOT Encroachment Agreement, Public Water Supply
6. Future Project Plans
6a. Is this a phased project?
6b. If yes, explain.
n/a
❑ Yes ❑X No
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
I
1. Impacts Summary
1
3a. 3b. _
1 a. Which sections were completed below for your project (check all that
apply):
Stream impact Type of impact
Stream name Perennial (PER) or Type of Average
❑ Wetlands ❑X Streams — tributaries ❑ Buffers
❑ Open Waters
❑ Pond Construction
2. Wetland Impacts
Permanent (P) or
width
j
If there are wetland impacts proposed on the site, then complete this question for each wetland
area impacted.
I
2a. 2b. 2c.
2d.
2e.
2f.
Wetland impact Type of impact Type of wetland
Forested
Type of jurisdiction
Area of
number
S4 P Directional Drill 6" FM
Corps (404,10) or
impact
Permanent (P) or
DWQ (401, other)
(acres)
Temporary (T)
I
W1 Choose one Choose one
Yes /No
-
3i. Comments:
W2 - Choose one Choose one
Yes /No
-
I
W3 - Choose one Choose one
Yes /No
-
W4 _ Choose one Choose one
Yes /No
-
W5 - Choose one Choose one
Yes /No
-
W6 - Choose one Choose one
Yes /No
-
2g. Total
Wetland Impacts:
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
1
3a. 3b. _
3c. 3d. _ 3e. 3f.
3g.
Stream impact Type of impact
Stream name Perennial (PER) or Type of Average
Impact
number
intermittent (INT)? jurisdiction stream
length
Permanent (P) or
width
(linear
Temporary (T)
(feet)
feet)
S1 P Directional Drill 6" FM
Canoby Creek PER Corps 2
.5
S2 P Directional Drill 12" WL
Canoby Creek PER Corps 6
23
S3 P Directional Drill 6" FM
Canoby Creek PER Corps 18
10
S4 P Directional Drill 6" FM
Canoby Creek PER Corps 8.5
11
S5 - Choose one
I
11
S6 - Choose one
I
3h. Total stream and tributary impacts
44.5
3i. Comments:
See attached map for impact locations. S1 and S2 are within existing Right of Way. S3 and S4 are within new utility easements.
Page 4 of 10
PCN Form — Version 1.4 January 2009

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
If project will impact a protected riparian buffer,
4a. 4b. 4c.
Open water Name of waterbody
4d. 4e.
impact number (if applicable) Type of impact
Permanent (P) or
Waterbody Area of impact (acres)
Temporary (T)
type
01 -
I
Choose one
I Choose
02 -
J Choose one
Choose
O3 -
I Choose one
I Choose
04 - I I Choose one
I Choose
4f. Total open water impacts I
4g. Comments:
Permanent (P) or
5. Pond or Lake Construction
(square
If pond or lake construction proposed, then complete the chart below.
Temporary (T)
5a. 5b.
5c.
5d. 5e.
Pond ID number Proposed use or
Wetland Impacts (acres)
Stream Impacts (feet) Upland
purpose of pond
B2 I
(acres)
Flooded
Filled Excavated
Flooded
Filled Excavated
P1 I Choose one I
i
I i
P2 I Choose one
Yes /No
I 5f. Total:
5g. Comments:
I
5h. Is a dam high hazard permit required? I ❑ Yes [❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer,
then complete the chart below. If yes, then individually list all buffer
impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a. Project is in which protected basin?
I ❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman
IIII
❑ Other:
6b. 6c.
6d. 6e. 6f.
6g.
Buffer Impact Reason for impact
Stream name Buffer
Zone 1
Zone 2
number—
mitigation
impact
impact
Permanent (P) or
required?
(square
(square
Temporary (T)
feet)
feet)
I BI - +
I + Yes /No
B2 I
I ( Yes /No
I B3 - I
I
Yes /No
B4 - I
I
Yes /No
B5 -
I
I I Yes /No
I
I
I
I 86 - I
( I Yes /No
I6h.
Total Buffer Impacts:
6i. Comments:
1
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed utilities were designed to minimize environmental impacts by staying within the existing Right of Way as much as possible.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
All 4 impacts /crossings will be installed by trenchless installation in order to avoid open cutting the stream or existing culvert. Proper erosion control
techniques will be utilized throughout the project to minimize sediment run -off along the project corridor.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
12a. Does the project require Compensatory Mitigation for [] Yes FX� No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply): ❑ DWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this
project? El Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: n/a
Type: Choose one Quantity:
3b. Credits Purchased (attach receipt and letter) Type: Choose one Quantity:
Type: Choose one Quantity:
3c. Comments:
n/a
4. Complete if Making a Payment to In -lieu Fee Program n/a
4a. Approval letter from in -lieu fee program is attached. ❑ Yes
4b. Stream mitigation requested: I linear feet
4c. If using stream mitigation, stream temperature: I Choose one
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: I acres
4f. Non - riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: I acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10
PCN Form — Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ n/a
6a. Will the project result in an impact within a protected riparian buffer that requires ❑ Yes ❑ No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1
3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e,g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified ❑ Yes ❑X No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
1 2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? %
2b. Does this project require a Stormwater Management Plan? ❑ Yes 0 No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
No impervious area is created. The Erosion and Sedimentation Control Permit and the Stormwater Permit will be the two stormwater discharge
permits applied for.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
n/a
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review n/a
3a. In which local government's iurisdiction is this project?
3b. Which of the following locally - implemented stormwater management programs
apply (check all that apply):
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
4. DWQ Stormwater Program Review
4a. Which of the following state - implemented Stormwater management programs apply
(check all that apply):
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
5. DWQ 401 Unit Stormwater Review n/a
5a. Does the Stormwater Management Plan meet the appropriate requirements?
5b. Have all of the 401 Unit submittal requirements been met?
❑ Phase II
❑ NSW
❑ USMP
❑ Water Supply Watershed
❑ Other:
❑ Yes ❑ No
ZCoastal counties
❑HQW
❑ORW
❑Session Law 2006 -246
❑Other:
❑X Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal /state /local) funds or the ❑X Yes ❑ No
use of public (federal /state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ❑ Yes Z No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (if so, attach a copy of the NEPA or SEPA final approval
letter,) Yes F1 No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ❑ Yes ❑ No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after - the -fact permit application? ❑ Yes ❑X No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in I ❑ Yes ❑X No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
This project is intended to serve the Washington County Industrial commerce Building, which is already built. This project could spur additional
growth and development along Plymouth Airport Road, but there is none planned at the time of this permit submittal. If additional development
occurs, all appropriate environmental permits will be required to be submitted.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non- discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
The new pump station and force main will discharge to existing Town of Plymouth Paylor Court Pump Station. This pump station eventually
discharges to the Town of Plymouth's Wastewater Treatment Facility, which has sufficient capacity to handle the wastewater generated from the
project being permitted.
Page 9 of 10
PCN Form — Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Yes ❑X No
❑X Yes ❑ No
Raleigh
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
United States Fish and Wildlife Service (USFWS)
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ' ❑ Yes ❑X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
United States Fish and Wildlife Service (USFWS)
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 ❑X 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?
State Historic Preservation Office (SHPO)
B. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain? Q Yes ❑ No
8b. If yes, explain how project meets FEMA requirements:
The areas of the project occuring in 100 -year floodplain are all underground pressure pipe. The pump station is not in the floodplain.
8c. What source(s) did you use to make the floodplain determination?
www.ncfloodmaps.com
U5c �WAld
Applicant/Agent's Printed Name
3—�l
plicanAgent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10
y3leels-
Date

Washington County Water and Sewer Improvements Project
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