20151126 Ver 1_Application_20151029

Attachment G: Low/Minimal Impact Bridge Prc�je�t C��ta Sheet
1 TfP NO C 203509
2 WBS Element No. 1713P.1 �1.R.'115
3 County Surry
4 Bridge Number 213
S Description Replace Brg.# 213 ouer Gully Creek
6 Basin Yadkin
7 Glassification WS-II, Traut
8 Stream SIN 12-63-2
9 Type inland
10 Size 15
11 Type BRIDGE
12 Existing Structure Size 30.5' x 19'
13 Suff. Rating 36.2
14 Proposed Structure ��pe ' BRIDGE
15 Size 45' x 24'
16 USACE (LF) �3' tTemporary)
17 Stream NCDWQ Impacts (�F) N/A
�.g USACE Impacts (AC) N/A
19 Wetlands Non 404 Impacts (AC) N/A
20 CAMA Impacts (SF} N f A
21 NC D'WQ Bu#fers impacts {SF� N f A
22 Buffer Applicaton Required {Y/N) No
23 State Starmwater Permit Required (Y/N) No
Yes- Schw�intz's Sunflower & Small
24 Habitat V�fhorled Pogonia
�� T&E Species Present None
26 Bio Conclusion No Effect
27 Moratorium Type No
28 Dates N/A
29 Native/Hatchery N/A
3� Trout Waters Trout Species Present None
31 Trout Canditions (Y1Nj N
32 WRG Reviewer MJ Chambers
33 GAMA AECs ' N/A
34 Essential Fish Habitat No
35 Nav. Opening N/A
36 U�CG Permit No
37 Historic Properties No
38 Archaeological Resources Rlo
39 Tribai Lands No
40 4(f) Resources No
41 6(f) [LWCF] Resources No
42 Wild and Scenic River No
43 Federal Lands No
44 TVA Area N o
45 FEMA Buyout N/A
46 FEMA Flood Study Not in �EMA Study Area
47 USTs Haz Mats No
48 Reiocatees No
49 LAT 36.53189
Location
50 LONG -80.86691
�1 Project Comments
Completed by: Brian N. Elam, PE Dat�: 2/23/2015
Lead Engineer
- °� t� : �
Division Environmental O ' er