20240584 Ver 1_U-4713A supplemental information_20240422

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
April 11, 2024
Mr. Stephen Brumagin
Charlotte Regulatory Field Office
US Army Corps of Engineers
8430 University Executive Park Drive, Suite 615
Charlotte, North Carolina 28262
Re: Nationwide Permit #14 — NCDOT TIP# U-4713A
McKee Road Extension
Matthews, Mecklenburg County, NC
Dear Mr. Brumagin:
JAMES H. TROGDON, III
SECRETARY
The North Carolina Department of Transportation (NCDOT) is submitting the attached PCN application for
authorization under Nationwide Permit (NWP) #14 for the proposed extension of McKee Road from the
existing intersection at Pleasant Plains Road north to East John Street. The project area is located
approximately 0.76 miles northeast of the intersection of Pleasant Plains Road and McKee Road in the Town
of Matthews, Mecklenburg County, North Carolina. (TIP# U-4713A) (Figure 1). Project Coordinates
(Decimal Degrees): 35.089367' N,-80.705454' W. The following information is enclosed:
• Stormwater Management Plan
• Project Plan Sheets/Permit Drawings
• PJD
• NC Stream Assessment Method Forms
• Bat Questionnaire
The purpose of the project is to improve east -west connectivity in the area, to improve access to East John
Street and Pleasant Plains Road, and to promote community interconnectivity by providing an alternate route
to the Charlotte Outer Loop (I-485).
The proposed extension seeks authorization under NWP #14 for stream impacts associated with culvert
crossings necessary to construct approximately 0.91-mile of new location roadway through an undeveloped
area of Matthews, North Carolina. The proposed project will result in 355 LF/0.041-acre of permanent and
38 LF/0.003-acre of temporary impacts to Streams A and B.
• Impact Site 1 — Stream B
o Impact 1 —A 41 LF 8' x 6' reinforced concrete box culvert (RCBC) will be installed at
the crossing of Stream B. The culvert results in 185 LF/0.03-acre of permanent impacts to
Stream B. The culvert will be buried 12-inches to promote the passage of aquatic
organisms.
o Impact 2 — 18 LF/0.001-acre of temporary impacts associated with the crossing of Stream
B are necessary to install an impervious dike and pumped diversion to perform the
construction activity in dry conditions.
Mailing Address: Telephone: [phone] Location:
NC DEPARTMENT OF TRANSPORTATION Fax: [phone] WEST MAIN STREET
HIGHWAY DIVISION 10 Customer Service: 1-877-368-4968 ALBEMARLE, NC 28001
716 WEST MAIN STREET
ALBEMARLE, NC 28001 Website: www.ncdot.gov

p�F
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
7AmES H. TROGDON, III
SECRETARY
Impact Site 2 — Stream A
o Impact 3 —A 59 LF 60-inch reinforced concrete pipe (RCP) will be installed at the crossing
of Stream A. The culvert results in 155 LF/0.01-acre of permanent impacts to Stream A.
The culvert will be buried 12-inches to promote the passage of aquatic organisms.
o Impact 4 — 7 LF/0.001-acre of temporary impacts associated with the crossing of Stream
A are necessary to install an impervious dike and pumped diversion to perform the
construction activity in dry conditions.
• Impact Site 3 — Stream A
o Impact 5 — 15 LF/0.001-acre of permanent stream impacts associated with the installation
of a Standard Base Ditch at the crossing of Stream A.
o Impact 6 — 13 LF/0.001-acre of temporary impacts associated with the crossing of Stream
A are necessary to install an impervious dike and pumped diversion to perform the
construction activity in dry conditions.
Compensatory mitigation will be met by the purchase of credits through the NC Division of Mitigation
Services (NCDMS) in -lieu fee program. Based on an NCSAM quality assessment rating of high for Streams
A and B, compensatory mitigation is proposed at a 2:1 ratio for impacts to the streams on site, or 710 stream
credits. In total, 710 stream mitigation credits will be purchased to offset impacts associated with this project.
Existing channel morphology will be maintained at the proposed riprap embankment protection sites (Sites
1-3) and upstream/downstream of the proposed culvert. Riparian vegetation will be re-established along
disturbed areas associated with the project.
Kristi Lynn Carpenter, NC Division of Water Resources, Transportation Permitting Unit, and Beth Plummer,
NC DWR Mooresville Regional Office, will review the project through the electronic form
(https://edocs.deq.nc.gov/Forms/Pre-Construction_ Notification_ Form). Please charge the application fee of
$570.00 to WBS element # 42370.1.1. Please forward comments directly to the Corps with copy to Division
10 Environmental Officer.
Please feel free to contact me at [phone] if you have any questions or if additional information is
necessary.
Ancerel \
v,.
4111-4
M. Howard, PDEA
Division 10, Project Team Lead
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
HIGHWAY DIVISION 10
716 WEST MAIN STREET
ALBEMARLE, NC 28001
Telephone: [phone]
Fax: [phone]
Customer Service: 1-877-368-4968
Website: www.nedot.gov
Location:
716 WEST MAIN STREET
ALBEMARLE, NC 28001

I Iighway North Carolina Department of Transportation
Highway Stormwater Program
STORMWATER MANAGEMENT PLAN
(Version 2.07; Released October 2016) FOR NCDOT PROJECTS
WBS Element: 39077.1.2 TIP No.: U-4713A Coun ies : Mecklenburg Page 1 of 1
General Project Information
WBS Element:
39077.1.2
TIP Number: U-4713A
Project Type: New Location
Date: 11/10/2023
NCDOT Contact:
Travis J Preslar
Contractor / Designer:
Kimley-Horn & Associates
Address:
716 West Main Street
Address:
200 South Tryon St, Suite 200
Charlotte, NC 28202
Albemarle, NC 28001
Phone:
980-262-6290
Phone:
704-319-5683
Email:
t0presIarQncdgLgov
Email:
lason.lawing(a�kimley-horn.com
City/Town:
Matthews
County(ies):
Mecklenburg
River Basins :
Catawba
CAMA Coun ?
No
Wetlands within Project Limits?
No
Project Description
Project Length (lin. miles or feet):
0.91 surrounding Land Use: Residential and undeveloped
woods
Proposed Project
Existing Site
Project Built -Upon Area (ac.)
6.7 ac.
1.3 ac.
Typical Cross Section Description:
-L- STA 13+56.15 TO STA 16+30.00 widening to 3-lane paved shoulder with grass ditches, existing sidewalk
LT. -L- STA 16+30.00 TO STA 19+89.00 3-lane paved shoulder with grass ditches, multi -use path LT from -L-
STA 16+59.47 TO STA 19+89.00. -L- STA 19+89.00 TO STA 21+74.87 3-lane curb and gutter, multi -use path
LT. -L- STA 21+74.87 TO STA 61+55.00 3-lane paved shoulder with grass ditches, Multi -use path LT,
sidewalk RT, median and curb and gutter interspersed throughout.
McKee Road (-L-) - 3-lane shoulder section with grass ditches and existing sidewalk LT.
Annual Avg Daily Traffic (veh/hr/day):
Design/Future: 17,000 Year: 2040
Existing: 12,100 Year: 2017
General Project Narrative:
(Description of Minimization of Water
Quality Impacts)
• Minimized directly connected impervious surfaces where possible. Runoff from road in shoulder section will drain through grassed ditches prior to outfall connection.
• Grassed shoulder typical section utilized as much as possible throughout the project to encourage sheet flow off of the roadway.
• Burying box culverts and circular cross pipes at jurisdictional streams. Pipe burial allows for wildlife passage and helps minimize channel erosion at inlet and outlet of pipes.
• Maintaining existing drainage patterns to best extent practical.
• Avoiding direct discharges where practical.
• Bank stabilization used at culvert inlets and outlets to help minimize erosion.
• Use of low flow sills set at stream bed elevation in box culverts.
• Culvert barrels with sills will be back filled with native material or class A rip rap to sill height. Native material will consist of material that is excavated from the stream bed or
floodplain at the project site during culvert construction. Native material is subject to approval by the engineer and may be subject to permit conditions. Class A rip rap may be
used to supplement the native material. If rip rap is used, native material should be placed on top to fill voids and provide a flat surface for animal passage.
Waterbody Information
Surface Water Body (1):
UT to Fourmile Creek
NCDWR Stream Index No.:
11-137-9-4
NCDWR Surface Water Classification for Water Body
Primary Classification:
Class C
None
Supplemental Classification:
Other Stream Classification:
None
Impairments:
None
Aquatic T&E Species?
No Comments:
NRTR Stream ID:
SA and SB
Buffer Rules in Effect:
N/A
Project Includes Bridge Spanning Water Body?
INo
I Deck Drains Discharge Over Buffer? N/A
Dissi ator Pads Provided in Buffer? N/A
Deck Drains Discharge Over Water Body?
INo
(If yes, provide justification in the General Project Narrative)
(If yes, describe in the General Project Narrative; if no, justify in the
General Project Narrative)
(If yes, provide justification in the General Project Narrative) I

See Sheet 1A For Index Of Sheets
See Sheet 1B For Conventional Symbols
INTERSTATE 43
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/
CHARLOTTE
END
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PROJECT
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BEGIN TIP PROJECT U-4713A
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STATE OF NORTH CAROLIN
DIVISION OF HIGHWAYS
MECKLENBURG COUNTY
LOCATION: SR 3448 (PLEASANT PLAINS RD) TO SR 1009 (JOHN STREET)
TYPE OF WORK: GRADING, PAVING, DRAINAGE, AND CULVERT
WETLAND AND SURFACE WATER IMPACTS PERMIT
BEGIN CONSTRUCTION
-Yl- Sta. 18+50.89
MATTHEWS /�
PLANTATION `'t
END CONSTRUCTION
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OBBCRIPTION
39077.1.2
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UTILITIES
39077.2.2
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39077.3.2
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END TIP PROJECT U-4713A
—L— Sta. 60 + 81.09
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SITE 2
SITE 3
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END CONSTRUCTION /
* TRAFFIC SIGNAL -Y1- POT Sta. 22+52.14
NCDOT CONTACT:
TRAVIS J PRESLAR, P.E.
NCDOT —DIVISION 10 SUPERELEVATION FOR CURVES LOCATED BETWEEN
DOCUMENT NOT CONSIDERED FINAL
716 W. MAIN STREET PLEASANT PLAINS AND EAST JOHN STREET TO MEET UNLESS ALL SIGNATURES COMPLETED
ALBEMARLE, NC 28001 A 35 MPH DESIGN SPEED
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DESIGN DATA
PROJECT LENGTH
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ADT 2017 = 12,100 VPD
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K = g%
D = 45%
LENGTH ROADWAY TIP PROJECT U-4713A = 0.895 MILES
TOTAL LENGTH TIP PROJECT U-4713A — — 0.895 MILES
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L= 44726' r v1 e i, / 1I 1j 1 1 1 i l l I / /Fy�nll
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o R = 1J80DU LEGEND
cV DS = 40 MPH
SE = 3207•05 MPH) ® DENOTES IMPACTS IN ® DENOTES TEMPORARY
RO = 60 SURFACE WATER IMPACTS IN SURFACE WATER

DETAIL 1
SPECIAL LATERAL 'V' DITCH
( Not to Scalel
Natural oS t Fill
Ground Fop;je p Slope
oge �
Min. D= 1.0 Ft.
FROM STA. 13+56 TO STA. 15+25 —L— (LT)
FROM STA. 15+25 TO STA. 17+00 —L— (LT)
FROM STA. 54+00 TO STA. 56+50 —L— (RT)
FROM STA. 56+50 TO STA. 57+50 —L— (RT)
DETAIL 5
LATERAL 'V' DITCH
(Nat to Scale)
b
Natural �— Fill
Ground D, 1"iFt. Slope
d
Geatextile
Min. D= 1.5 Ft.
Max. d= 1.5 Ft.
Type of Liner= Class 'B' Rip —Rap b= 5 Ft.
FROM STA. 42+00 TO STA. 43+60 —L— (RT)
FROM STA. 42+75 TO STA. 43+55 —L— (LT)
FROM STA. 43+75 TO STA. 44+75 —L— (RT)
FROM STA. 43+67 TO STA. 45+50 —L— (LT)
DETAIL 2
FALSE SUMP
( Not to Scale)
Outside Ditch
Traffic Flow
S=Ditch Slope CL Proposed Ditch
STA.26+68 -L- (LT)
STA. 30+28 -L- (RT)
DETAIL 6
LATERAL 'V' DITCH
(Not to Scale)
b
Natural
Ground :) p� 1"iFt. Slope
Min. D= 1.5 Ft.
b= 5 Ft.
FROM STA. 57+75 TO STA. 59+85 —L— (LT)
DETAIL 9
EXIST INLET CHANNEL IMPROVEMENTS
GROUND 1Not to Scale)
_ PROPOSED 1 @ 8' X b'
\ RCBC
<2GEOTEXTILE
6'
8• —�P RAP (W/GFD)
COUNTER —SUNK INTO
1' CONCRETE SILL IN BARREL UPSTREAM CHANNEL BANKS
IS' INSET INTO UPSTREAM FACE)
STA. 43 + 70 -L- (RT)
NOISE DETAIL 11
WALL LATERAL 'V' DITCH
(Nat to Scale)
EXIST
GROUND b
Natural
1'SFt. D Ground
Min. D= 1.0 Ft.
b= 2 Ft.
FROM STA. 30+40 TO STA. 34+50 -L- (RT)
FROM STA. 34+50 TO STA. 35+95 -L- (RT)
FROM STA. 35+95 TO STA. 37+50 -L- (RT)
FROM STA. 37+50 TO STA. 40+25 -L- (RT)
DETAIL 3
CUT DITCH w/PSRM
( Not to Scale)
Fpryopr\a;io(
SW OR MUP D ROADWAY
SHOULDER SHOULDER
POINT PSRM POINT
Min. D= 1.5 Ft.
FROM STA. 38+00 TO STA. 42+40 -L- (LT)
DETAIL 7 = a
FALSE SUMP �£
( Not to Scale)
Or —
Outside Ditch
_ 12 0
20:1
Traffic Flow
I
S —
GI
etc.
S=Ditch Slope
Proposed Ditch
STA. 30+28 -L- (LT)
STA. 36+15 -L- (RT)
DETAIL 10
OUTLET CHANNEL IMPROVEMENTS
( Not to Scale)
PROPOSED 1
RCBC
@ 8' X 6' — —
/
EXIST
I1•
GROUND
6'
2,
2' GEOTEXTILE
L•�— g ��
CLASS I RIP RAP (W/GFD)
COUNTER —SUNK INTO
1' CONCRETE SILL IN BARREL
UPSTREAM CHANNEL BANKS
(5' INSET INTO DOWNSTREAM FACE)
STA. 43+55 -L- (LT)
DETAIL 4
BERM 'V' DITCH
1 Not to Scale)
D L.
Min. D= 1.5 Ft.
b= 5 Ft.
FROM STA. 25+00 TO STA. 28+70 —L— (RT)
FROM STA. 28+70 TO STA. 30+00 —L— (RT)
FROM STA. 30+00 TO STA. 30+40 —L— (RT)
FROM STA. 51+50 TO STA. 54+00 —L— (RT)
DETAIL 8
STANDARD BASE DITCH
( Not to Scale)
Natural Natural
Group 2� .y� Grouper
d D
Georeatile g Min. D= 4.0 Ft.
on .1 Max. d= 2.0 Ft.
Only
B= 4.0 Ft.
STA. 60+50 -L- (RT)
Kimley)))Horn
200 S. TRYON ST. • CHARLOTTE, NC 28202
PROJECT REFERENCE NO.
SHEET NO.
U-4713A
2D-1
P,W SHEET NO.
ROADWAY
HYDRAULICS
ENGINEER
ENGINEER
�N cARot •'.
............�
=�� CARpG %
01;
SEAL `'
SEAL `
037923
032615 •`
sa
••..•
nuuno
DOCUMENT NOT CONSIDERED FINAL
UNLESS ALL SIGNATURES COMPLETED
PERMIT DRAWING
SHEET 7 OF 8

WETLAND AND SURACE WATER IMPACTS SUMMARY
WETLAND IMPACTS SURFACE WATER IMPACTS
Site
No.
Station
(From/To)
Structure
Size / Type
Permanent
Fill In
Wetlands
(ac)
Temp.
Fill In
Wetlands
(ac)
Excavation
in
Wetlands
(ac)
Mechanized
Clearing
in Wetlands
(ac)
Hand
Clearing
in
Wetlands
(ac)
Permanent
SW
impacts
(ac)
Temp.
SW
impacts
(ac)
Existing
Channel
Impacts
Permanent
(ft)
Existing
Channel
Impacts
Temp.
(ft)
Natural
Stream
Design
(ft)
1
43+46/43+87 -L-
8' x 6' RCBC & Fill
0.03
< 0.01
185
18
2
59+82/60+41 -L-
60" RCP & Fill
0.01
< 0.01
155
7
3
60+50/60+64 -L- (RT)
Standard Base Ditch
< 0.01
< 0.01
15
13
TOTALS*:
1
1 0.05
1 < 0.01
1 355
1 38
1 0
*Rounded totals are sum of actual impacts
NOTES:
2018 02 26

PRELIMINARY JURISDICTIONAL
REQUEST

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2018-01530 County: Mecklenburg U.S.G.S. Quad: NC- Matthews
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Property Owner: North Carolina Department of Transportation
Mr. Larry Thompson
Address: 716 W. Main Street
Albemarle, NC 28001
Telephone Number: 704-301-4881
E-mail: lthompson(a,ncdotxov
Size (acres) 1,305 acres Nearest Town Matthews
Nearest Waterway Four Mile Creek River Basin Catawba
USGS HUC 0305010301 Coordinates Latitude: 35.089367
Longitude:-80.705454
Location description: McKee Road Extension from Pleasant Plains Road to East John Street
Indicate Which of the Following Apply:
A. Preliminary Determination
® There appear to be waters including wetlands, on the above described project area/property, that may be subject to Section 404
of the Clean Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). The
waters including wetlands, have been delineated, and the delineation has been verified by the Corps to be sufficiently accurate
and reliable. The approximate boundaries of these waters are shown on the enclosed delineation maps, Figures 1-3 dated
5/1/2018. Therefore this preliminary jurisdiction determination may be used in the permit evaluation process, including
determining compensatory mitigation. For purposes of computation of impacts, compensatory mitigation requirements, and other
resource protection measures, a permit decision made on the basis of a preliminary JD will treat all waters and wetlands that
would be affected in any way by the permitted activity on the site as if they are jurisdictional waters of the U.S. This preliminary
determination is not an appealable action under the Regulatory Program Administrative Appeal Process (Reference 33 CFR Part
331). However, you may request an approved JD, which is an appealable action, by contacting the Corps district for further
instruction.
❑ There appear to be waters including wetlands, on the above described project area/property, that may be subject to Section 404
of the Clean Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403).
However, since the waters including wetlands, have not been properly delineated, this preliminary jurisdiction determination
may not be used in the permit evaluation process. Without a verified wetland delineation, this preliminary determination is
merely an effective presumption of CWA/RHA jurisdiction over all of the waters including wetlands, at the project area, which
is not sufficiently accurate and reliable to support an enforceable permit decision. We recommend that you have the waters
including wetlands, on your project area/property delineated. As the Corps may not be able to accomplish this wetland
delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that can be verified by the Corps.
B. Approved Determination
❑ There are Navigable Waters of the United States within the above described project area/property subject to the permit
requirements of Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403) and Section 404 of the Clean Water Act
(CWA)(33 USC § 1344). Unless there is a change in 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.
❑ There are waters including wetlands, on the above described project area/property 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.
❑ We recommend you have the waters including wetlands, on your project area/property delineated. As the Corps may not be
able to accomplish this wetland delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that
can be verified by the Corps.

SAW-2018-01530
❑ The waters including wetlands, on your project area/property have been delineated and the delineation has been verified by
the Corps. The approximate boundaries of these waters are shown on the enclosed delineation map dated DATE. We strongly
suggest you have this delineation surveyed. Upon completion, this survey should be reviewed and verified by the Corps. Once
verified, this survey will provide an accurate depiction of all areas subject to CWA jurisdiction on your property which, provided
there is no change in the law or our published regulations, may be relied upon for a period not to exceed five years.
❑ The waters including wetlands, have been delineated and surveyed and are accurately depicted on the plat signed by the
Corps Regulatory Official identified below on DATE. 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.
❑ There are no waters of the U.S., to include wetlands, present on the above described project area/property which are subject to the
permit requirements of Section 404 of the Clean Water Act (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.
❑ The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act (CAMA).
You should contact the Division of Coastal Management in Morehead City, NC, at [phone] to determine their
requirements.
Placement of dredged or fill material within waters of the US, including wetlands, without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). Placement of dredged or fill material, construction or
placement of structures, or work within navigable waters of the United States without a Department of the Army permit may
constitute a violation of Sections 9 and/or 10 of the Rivers and Harbors Act (33 USC § 401 and/or 403). If you have any questions
regarding this determination and/or the Corps regulatory program, please contact Ms. Nicholle Braspennickx at 704-510-0162 or
Nicholle.M.Braspennickx(a)usace.army.mil.
C. Basis For Determination: Basis For Determination: See the Preliminary jurisdictional determination
form dated 10/19/2018.
D. Remarks: None.
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.
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 10M15
Atlanta, Georgia 30303-8801
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 Not applicable.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
Corps Regulatory Official:
Date of JD: 10/19/2018 Expiration Date of JD: Not applicable

SAW-2018-01530
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 the Customer Satisfaction Survey located at
http: //corpsmapu.usace .army.mil/cm_apex/f?p=13 6:4: 0

SAW-2018-01530
NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: North Carolina Department of
File Number: SAW-2018-01530
Date: 10/19/2018
Transportation, Mr. Larry Thompson
Attached
is:
See Section below
❑
INITIAL PROFFERED PERMIT (Standard Permit or Letter of permission)
A
❑
PROFFERED PERMIT (Standard Permit or Letter of permission)
B
❑
PERMIT DENIAL
C
❑
APPROVED JURISDICTIONAL DETERMINATION
D
®
PRELIMINARY JURISDICTIONAL DETERMINATION
E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or http://www.usace.army.mit/Missions/CivilWorks/Re ug latoiyProgramandPermits.aspx
or the Corps regulations at 33 CFR Part 331.
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 Permission (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 entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district 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 permit 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 final
authorization. If you received a Letter of Permission (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 entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations 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 Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form 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 Corps 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 Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

SAW-2018-01530
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
SECTION II - REQUEST FOR APP L or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps 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 record. 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 CONTACT FOR QUESTIONS OR INFORMATION:
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 Regulatory Division
Mr. Jason Steele, Administrative Appeal Review Officer
Attn: Ms. Nicholle Braspennickx
CESAD-PDO
Charlotte Regulatory Office
U.S. Army Corps of Engineers, South Atlantic Division
U.S Army Corps of Engineers
60 Forsyth Street, Room 10M15
8430 University Executive Park Drive, Suite 615
Atlanta, Georgia 30303-8801
Charlotte, North Carolina 28262
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations 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 have the opportunity to participate in all site investigations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: Ms. Nicholle Braspennickx, 69 Darlington Avenue, Wilmington,
North Carolina 28403
For Permit denials, Proffered Permits and Approved Jurisdictional Determinations send this 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]

PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PJD: 10/19/2018
B. NAME AND ADDRESS OF PERSON REQUESTING PJD: North Carolina Department of Transportation, Mr.
Larry Thompson, 716 W. Main Street,Albemarle, NC 28001
C. DISTRICT OFFICE, FILE NAME, AND NUMBER: Wilmington District, McKee Road Extension, from
Pleasant Plains Road to East John Street, SAW-2018-01530
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION: McKee Road Extension from Pleasant
Plains Road to East John Street
(USE THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC RESOURCES AND/OR
AQUATIC RESOURCES AT DIFFERENT STIES)
State: NC County: Mecklenburg City: Matthews
Center coordinates of site (lat/long in degree decimal format): Latitude: 35.089367 Longitude:-80.705454
Universal Transverse Mercator:
Name of nearest waterbody: Four Mile Creek
E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
® Office (Desk) Determination. Date: October 15, 2018
❑ Field Determination. Date(s):
TABLE OF AQUATIC RESOURCES INREVIEWAREA WHICH "MAY BE" SUBJECT TO REGULATORY
JURISDICTION.
Estimated amount of
Geographic authority to
Type of aquatic
Latitude (decimal
Longitude (decimal
aquatic resources in
resources (i.e.,
which the aquatic resource
Site Number
review area (acreage
"may be" subject (i.e.,
degrees)
degrees)
wetland vs. non -
and linear feet, if
Section 404 or Section
wetland waters)
applicable
10/404)
Stream A
35.093264
-80.702601
923 linear feet
Non -wetland
404
(SA)
Stream B
35.089451
-80.705499
883 linear feet
Non -wetland
404
(SB)
Stream C
35.088696
-80.705071
302 linear feet
Non -wetland
404
(SC)
Wetland A
35.092366
-80.703483
0.05 acres
wetland
404
(WA)
1) The Corps of Engineers believes that there may be jurisdictional aquatic resources in the review
area, and the requestor of this PJD is hereby advised of his or her option to request and obtain an
approved JD (AJD) for that review area based on an informed decision after having discussed the
various types of JDs and their characteristics and circumstances when they may be appropriate.
2) In any circumstance where a permit applicant obtains an individual permit, or a Nationwide General
Permit (NWP) or other general permit verification requiring "pre- construction notification" (PCN), or
requests verification for a non -reporting NWP or other general permit, and the permit applicant has
not requested an AJD for the activity, the permit applicant is hereby made aware that: (1) the permit
applicant has elected to seek a permit authorization based on a PJD, which does not make an official

determination of jurisdictional aquatic resources; (2) the applicant has the option to request an AJD
before accepting the terms and conditions of the permit authorization, and that basing a permit
authorization on an AJD could possibly result in less compensatory mitigation being required or
different special conditions; (3) the applicant has the right to request an individual permit rather than
accepting the terms and conditions of the NWP or other general permit authorization; (4) the applicant
can accept a permit authorization and thereby agree to comply with all the terms and conditions of that
permit, including whatever mitigation requirements the Corps has determined to be necessary; (5)
undertaking any activity in reliance upon the subject permit authorization without requesting an AJD
constitutes the applicant's acceptance of the use of the PJD; (6) accepting a permit authorization (e.g.,
signing a proffered individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a PJD constitutes agreement that all aquatic resources in the review area
affected in any way by that activity will be treated as jurisdictional, and waives any challenge to such
jurisdiction in any administrative orjudicial compliance or enforcement action, or in any
administrative appeal or in any Federal court; and (7) whether the applicant elects to use either an AID
or a PJD, the JD will be processed as soon as practicable. Further, an AID, a proffered individual
permit (and all terms and conditions contained therein), or individual permit denial can be
administratively appealed pursuant to 33 C.F.R. Part 331. If, during an administrative appeal, it
becomes appropriate to make an official determination whether geographic jurisdiction exists over
aquatic resources in the review area, or to provide an official delineation of jurisdictional aquatic
resources in the review area, the Corps will provide an AJD to accomplish that result, as soon as is
practicable. This PJD finds that there "may be" waters of the U.S. and/or that there "may be"
navigable waters of the U.S. on the subject review area, and identifies all aquatic features in the
review area that could be affected by the proposed activity, based on the following information:
SUPPORTING DATA. Data reviewed for PJD (check all that apply)
Checked items should be included in subject file. Appropriately reference sources below where
indicated for all checked items:
® Maps, plans, plots or plat submitted by or on behalf of the PJD requestor: Figures 1-3(a-
b) prepared by Kimley Hom, dated May 2018.
® Data sheets prepared/submitted by or on behalf of the PJD requestor.
® Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report. Rationale:
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological Survey Hydrologic Atlas:
❑ USGS NHD data.
❑ USGS 8 and 12 digit HUC maps.
❑ U.S. Geological Survey map(s). Cite scale & quad name:
❑ Natural Resources Conservation Service Soil Survey. Citation:
❑ National wetlands inventory map(s). Cite name:
❑ State/local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑ 100-year Floodplain Elevation is: (National Geodetic Vertical Datum of 1929)
❑ Photographs: ❑Aerial (Name & Date):
or ❑Other (Name & Date):
❑ Previous determination(s). File no. and date of response letter:

® Other information (please specify):
Streams A-C flow to Four Mile Creek. Four Mile Creek flows to McAlpine Creek, an interstate
water of the U.S. Corps of Engineers regulations at 33 CFR Part 328.3(a)(5) assert Clean Water
Act (CWA) jurisdiction over tributaries to other waters of the U.S. Therefore, Streams A — C
may be waters of the U.S.
Wetland A is adjacent to Stream A. Corps of Engineers regulations at 33 CFR Part 328.3(a)(7)
assert CWA jurisdiction over wetlands adjacent to waters of the U.S. Therefore, Wetland A may
be a water of the U.S.
IMPORTANT NOTE: The information recorded on this form has not necessarily been
verified by the Corps and should not be relied upon for later iurisdictional determinations.
Signature and date of Regulatory
staff member completing PJD
10/19/2018
Signature and date of person requesting PJD
(REQUIRED, unless obtaining the signature is
impracticable)1
1 Districts may establish timeframes for requester to return signed PJD forms. If the requester does not respond within the
established time frame, the district may presume concurrence and no additional follow up is necessary prior to finalizing an
action.

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user rvianuai version i. i
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic
quadrangle, and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same
property, identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User
Manual for detailed descriptions and explanations of requested information. Record in the "Notes/Sketch" section if any supplementary
measurements were performed. See the NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT / SITE INFORMATION:
1. Project name (if any): U-4713A McKee Road Ext. 2. Date of evaluation:
3. Applicant/owner name: NCDOT 4. Assessor name/organization: Chris Tinklenberg, PWS (Kimley-Horn)
5. County: Mecklenburg 6. Nearest named water body
7. River Basin: Catawba on USGS 7.5-minute quad: Fourmile Creek
8. Site coordinates (decimal degrees, at lower end of assessment reach): 35.089367 N,-80.705454 W.
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): SA 10. Length of assessment reach evaluated (feet): 100
11. Channel depth from bed (in riffle, if present) to top of bank (feet): 0.5 F- Unable to assess channel depth.
12. Channel width at top of bank (feet): 4 13. Is assessment reach a swamp stream?i-
14. Feature type: i Perennial flow is Intermittent flow f` Tidal Marsh Stream
STREAM RATING INFORMATION:
15. NC SAM Zone: i Mountains (M) is Piedmont (P) r Inner Coastal Plain (1) i Outer Coastal Plain (0)
16. Estimated geomorphic \ J
valley shape (skip for i a Co b
Tidal Marsh Stream): (more sinuous stream, flatter valley slope) (less sinuous stream, steeper valley slope)
17. Watershed size: (skip f: Size 1 (< 0.1 mi`) Size 2 (0.1 to < 0.5 mi`) Size 3 (0.5 to < 5 mi`) k` Size 4 (>> 5 mil)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? Co Yes No If Yes, check all that appy to the assessment area.
F- Section 10 water F- Classified Trout Waters F- Water Supply Watershed ( k- I k- II i III k- IV k- V)
Essential Fish Habitat F- Primary Nursery Area F- High Quality Waters/Outstanding Resource Waters
Publicly owned property F- NCDWR riparian buffer rule in effect F- Nutrient Sensitive Waters
Anadromous fish F- 303(d) List F- CAMA Area of Environmental Concern (AEC)
Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
F Designated Critical Habitat (list species):
19. Are additional stream information/supplementary measurements included in "Notes/Sketch" section or attached? i Yes Co No
1. Channel Water - assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
is A Water throughout assessment reach.
i B No flow, water in pools only.
i C No water in assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
i A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
is B Not A
3. Feature Pattern - assessment reach metric
i A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
is B Not A.
4. Feature Longitudinal Profile - assessment reach metric
i A Majority of assessment reach has a substantially altered stream profile (examples: channel down -cutting, existing damming,
over widening, active aggradation, dredging, and excavation where appropriate channel profile has not reformed from any of
these disturbances).
1: B Not A
5. Signs of Active Instability - assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down -cutting (head -cut), active widening, and artificial hardening (such as concrete, gabion, rip -rap).
s* A < 10% of channel unstable
i B 10 to 25% of channel unstable
C > 25% of channel unstable
6. Streamside Area Interaction - streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
f: A s: A Little or no evidence of conditions that adversely affect reference interaction
k` B k- B Moderate evidence of conditions (examples: berms, levees, down -cutting, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
k- C k- C Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision,
disruption of flood flows through streamside area] or too much floodplain/intertidal zone access [examples:
impoundments, intensive mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a
man-made feature on an interstream divide
7. Water Quality Stressors -assessment reach/intertidal zone metric
Check all that apply.
r A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
r B Excessive sedimentation (burying of stream features or intertidal zone)

r C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
r D Odor (not including natural sulfide odors)
r E Current published or collected data indicating degraded water quality in the assessment reach. Cite source in the "Notes/Sketch"
section.
r F Livestock with access to stream or intertidal zone
r G Excessive algae in stream or intertidal zone
T H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
F- I Other: (explain in "Notes/Sketch" section)
r J Little to no stressors
8. Recent Weather - watershed metric
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a
drought.
i A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
i- B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
is C No drought conditions
9 Large or Dangerous Stream - assessment reach metric
Yes . No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In -stream Habitat Types -assessment reach metric
10a. t Yes No Degraded in -stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in -stream hardening [for example, rip -rap], recent dredging, and snagging)
(evaluate for size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if> 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
F-7 A Multiple aquatic macrophytes and aquatic mosses N r- F 5% oysters or other natural hard bottoms
o (include liverworts, lichens, and algal mats) F- 0 G Submerged aquatic vegetation
r B Multiple sticks and/or leaf packs and/or emergent o in H Low -tide refugia (pools)
vegetation 0 1 Sand bottom
F- C Multiple snags and logs (including lap trees) m ,� J 5% vertical bank along the marsh
F- D 5% undercut banks and/or root mats and/or roots v 2 r K Little or no habitat
in banks extend to the normal wetted perimeter
F- E Little or no habitat
*********************************REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS****************************
11. Bedform and Substrate - assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
11 a. is Yes t- No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11 b. Bedform evaluated. Check the appropriate box(es).
r A Riffle -run section (evaluate 11 c)
F_ B Pool -glide section (evaluate 11d)
F- C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In riffles sections, check all that occur below the normal wetted perimeter of the assessment reach - whether or not submerged.
Check at least one box in each row (skip for Size 4 Coastal Plain Streams and Tidal Marsh Streams). Not Present (NP) _
absent, Rare (R) = present but <- 10%, Common (C) _ > 10-40%, Abundant (A) _ > 40-70%, Predominant (P) _ > 70%. Cumulative
percentages should not exceed 100% for each assessment reach.
NP R C A P
r f- k__ ( Bedrock/saprolite
l- c (" k- {- Boulder (256 - 4096 mm)
l- l• �(+" i {� Cobble (64 - 256 mm)
Gravel (2 - 64 mm)
Sand (.062 - 2 mm)
Silt/clay (< 0.062 mm)
( ( ( (. ( Detritus
(: (' r r (' Artificial (rip -rap, concrete, etc.)
11 d. ( Yes ( No Are pools filled with sediment? (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12. Aquatic Life - assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12a. k- Yes Co No Was an in -stream aquatic life assessment performed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. i- No Water (` Other:
12b. k- Yes is No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check
all that apply. If No, skip to Metric 13.
1 >1 Numbers over columns refer to "individuals" for size 1 and 2 streams and "taxa" for size 3 and 4 streams.
F_ F- Adu _
F_ f- Aquatic reptiles
F_ r Aquatic macrophytes and aquatic mosses (include liverworts, licheii6, and algal mats)
F_ f- Beetles (including water pennies)
F_ r Caddisfly larvae (Trichoptera [T])
F_ f- Asian clam (Corbicula )
F_ r Crustacean (isopod/a m phipod/crayfish/sh rim p)
F_ f- Damselfly and dragonfly larvae
F_ r Dipterans (true flies)
F_ f- Mayfly larvae (Ephemeroptera [E])
F_ r Megaloptera (alderfly, fishfly, dobsonfly larvae)
F_ r Midges/mosquito larvae
F_ r Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
F_ r Mussels/Clams (not Corbicula )
F_ r Other fish
F_ r Salamanders/tadpoles
F_ r Snails
F_ r Stonefly larvae (Plecoptera [P])
F_ r Tipulid larvae

r r Worms/leeches
13. Streamside Area Ground Surface Condition - streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and
upland runoff.
LB RB
t- A k- A Little or no alteration to water storage capacity over a majority of the streamside area
k` B k- B Moderate alteration to water storage capacity over a majority of the streamside area
k` C k- C Severe alteration to water storage capacity over a majority of the streamside area (examples include: ditches, fill,
soil, compaction, livestock disturbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage - streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
k` A k- A Majority of streamside area with depressions able to pond water >_ 6 inches deep
i B i B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
i C i C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence - streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the
normal wetted perimeter of assessment reach.
LB RB
k- Y i Y Are wetlands present in the streamside area?
Co N is N
16. Baseflow Contributors - assessment reach metric (skip for size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
r A Streams and/or springs (jurisdictional discharges)
r B Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
r C Obstruction that passes some flow during low -flow periods within assessment area (beaver dam, bottom -release dam)
r D Evidence of bank seepage or sweating (iron oxidizing bacteria in water indicates seepage)
r E Stream bed or bank soil reduced (dig through deposited sediment if present)
r F None of the above
17. Baseflow Detractors - assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
F- A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
F_ B Obstruction not passing flow during low flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
F- C Urban stream (>> 24% impervious surface for watershed)
F- D Evidence that the stream -side area has been modified resulting in accelerated drainage into the assessment reach
F- E Assessment reach relocated to valley edge
F None of the above
18. Shading - assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
i. A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
i B Degraded (example: scattered trees)
i C Stream shading is gone or largely absent
19. Buffer Width - streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately for left bank (LB) and right bank (RB) starting at the top
of bank out to the first break.
Vegetated Wooded
LB RB LB RB
i+ A k' A is A k` A > 100-feet wide or extends to the edge of the watershed
i B Co B i B f: B From 50 to < 100-feet wide
i C 4__ C i C r C From 30 to < 50-feet wide
k` D k- D k` D k- D From 10 to < 30-feet wide
k- E k- E k- E k- E < 10-feet wide or no trees
20. Buffer Structure - streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RB
k- A k- A Mature forest
is B is B Non -mature woody vegetation or modified vegetation structure
�- C C Herbaceous vegetation with or without a strip of trees < 10 feet wide
i D i D Maintained shrubs
s- E s- E Little or no vegetation
21. Buffer Stressors - streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but
is within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22: F_
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
i A i A i A i A i A i A Row crops
i B i B i B i B i B i B Maintained turf
i C i C i C i C i C i C Pasture (no livestock)/commercial horticulture
i D i D i D i D i D i D Pasture (active livestock use)
22. Stem Density - streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
is A is A Medium to high stem density
i B i B Low stem density
i C i C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer - streamside area metric (skip for Tidal Marsh Streams)

Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10-feet wide
LB
RB
f: A
is A
The total length of buffer breaks is < 25 percent.
i- B
i- B
The total length of buffer breaks is between 25 and 50 percent.
i- C
i- C
The total length of buffer breaks is > 50 percent.
24. Vegetative Composition — First 100 feet of streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominant vegetation within 100 feet of each bank or to the edge of the watershed (whichever comes first) as it contributes
to assessment reach habitat.
LB RB
i A i A Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native
species, with non-native invasive species absent or sparse.
Co B Co B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear -cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
s- C s- C Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large portion of expected strata or communities composed of planted
stands of non -characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity — assessment reach metric (skip for all Coastal Plain streams)
25a. k- Yes is No Was a conductivity measurement recorded?
If No, select one of the following reasons. (` No Water (` Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
(` A <46 r B 46 to < 67 r C 67 to < 79 r D 79 to < 230 r E >> 230

user rvianuai version i. i
INSTRUCTIONS: Attach a sketch of the assessment area and photographs. Attach a copy of the USGS 7.5-minute topographic
quadrangle, and circle the location of the stream reach under evaluation. If multiple stream reaches will be evaluated on the same
property, identify and number all reaches on the attached map, and include a separate form for each reach. See the NC SAM User
Manual for detailed descriptions and explanations of requested information. Record in the "Notes/Sketch" section if any supplementary
measurements were performed. See the NC SAM User Manual for examples of additional measurements that may be relevant.
NOTE EVIDENCE OF STRESSORS AFFECTING THE ASSESSMENT AREA (do not need to be within the assessment area).
PROJECT / SITE INFORMATION:
1. Project name (if any): U-4713A McKee Road Ext. 2. Date of evaluation:
3. Applicant/owner name: NCDOT 4. Assessor name/organization: Chris Tinklenberg, PWS (Kimley-Horn)
5. County: Mecklenburg 6. Nearest named water body
7. River Basin: Catawba on USGS 7.5-minute quad: Fourmile Creek
8. Site coordinates (decimal degrees, at lower end of assessment reach): 35.089367 N,-80.705454 W.
STREAM INFORMATION: (depth and width can be approximations)
9. Site number (show on attached map): SB 10. Length of assessment reach evaluated (feet): 100
11. Channel depth from bed (in riffle, if present) to top of bank (feet): 1 r Unable to assess channel depth.
12. Channel width at top of bank (feet): 8 13. Is assessment reach a swamp stream?i-
14. Feature type: Co- Perennial flow i Intermittent flow f` Tidal Marsh Stream
STREAM RATING INFORMATION:
15. NC SAM Zone: i Mountains (M) is Piedmont (P) r Inner Coastal Plain (1) i Outer Coastal Plain (0)
16. Estimated geomorphic \ J
valley shape (skip for i a Co b
Tidal Marsh Stream): (more sinuous stream, flatter valley slope) (less sinuous stream, steeper valley slope)
17. Watershed size: (skip f: Size 1 (< 0.1 mi`) Size 2 (0.1 to < 0.5 mi`) Size 3 (0.5 to < 5 mi`) k` Size 4 (>> 5 mil)
for Tidal Marsh Stream)
ADDITIONAL INFORMATION:
18. Were regulatory considerations evaluated? Co Yes No If Yes, check all that appy to the assessment area.
F- Section 10 water F- Classified Trout Waters F- Water Supply Watershed ( k- I r II i III k- IV k- V)
Essential Fish Habitat F- Primary Nursery Area F- High Quality Waters/Outstanding Resource Waters
Publicly owned property F- NCDWR riparian buffer rule in effect F- Nutrient Sensitive Waters
Anadromous fish F- 303(d) List F- CAMA Area of Environmental Concern (AEC)
Documented presence of a federal and/or state listed protected species within the assessment area.
List species:
F Designated Critical Habitat (list species):
19. Are additional stream information/supplementary measurements included in "Notes/Sketch" section or attached? i Yes Co No
1. Channel Water - assessment reach metric (skip for Size 1 streams and Tidal Marsh Streams)
is A Water throughout assessment reach.
i B No flow, water in pools only.
i C No water in assessment reach.
2. Evidence of Flow Restriction - assessment reach metric
i A At least 10% of assessment reach in -stream habitat or riffle -pool sequence is adversely affected by a flow restriction or fill to the
point of obstructing flow or a channel choked with aquatic macrophytes or ponded water or impounded on flood or ebb within
the assessment reach (examples: undersized or perched culverts, causeways that constrict the channel, tidal gates).
is B Not A
3. Feature Pattern - assessment reach metric
i A A majority of the assessment reach has altered pattern (examples: straightening, modification above or below culvert).
is B Not A.
4. Feature Longitudinal Profile - assessment reach metric
i A Majority of assessment reach has a substantially altered stream profile (examples: channel down -cutting, existing damming,
over widening, active aggradation, dredging, and excavation where appropriate channel profile has not reformed from any of
these disturbances).
1: B Not A
5. Signs of Active Instability - assessment reach metric
Consider only current instability, not past events from which the stream has currently recovered. Examples of instability include
active bank failure, active channel down -cutting (head -cut), active widening, and artificial hardening (such as concrete, gabion, rip -rap).
s* A < 10% of channel unstable
i B 10 to 25% of channel unstable
C > 25% of channel unstable
6. Streamside Area Interaction - streamside area metric
Consider for the Left Bank (LB) and the Right Bank (RB).
LB RB
f: A s: A Little or no evidence of conditions that adversely affect reference interaction
k` B k- B Moderate evidence of conditions (examples: berms, levees, down -cutting, aggradation, dredging) that adversely affect
reference interaction (examples: limited streamside area access, disruption of flood flows through streamside area,
leaky or intermittent bulkheads, causeways with floodplain constriction, minor ditching [including mosquito ditching])
k- C k- C Extensive evidence of conditions that adversely affect reference interaction (little to no floodplain/intertidal zone access
[examples: causeways with floodplain and channel constriction, bulkheads, retaining walls, fill, stream incision,
disruption of flood flows through streamside area] or too much floodplain/intertidal zone access [examples:
impoundments, intensive mosquito ditching]) or floodplain/intertidal zone unnaturally absent or assessment reach is a
man-made feature on an interstream divide
7. Water Quality Stressors -assessment reach/intertidal zone metric
Check all that apply.
r A Discolored water in stream or intertidal zone (milky white, blue, unnatural water discoloration, oil sheen, stream foam)
r B Excessive sedimentation (burying of stream features or intertidal zone)

r C Noticeable evidence of pollutant discharges entering the assessment reach and causing a water quality problem
r D Odor (not including natural sulfide odors)
r E Current published or collected data indicating degraded water quality in the assessment reach. Cite source in the "Notes/Sketch"
section.
r F Livestock with access to stream or intertidal zone
r G Excessive algae in stream or intertidal zone
T H Degraded marsh vegetation in the intertidal zone (removal, burning, regular mowing, destruction, etc.)
F- I Other: (explain in "Notes/Sketch" section)
r J Little to no stressors
8. Recent Weather - watershed metric
For Size 1 or 2 streams, D1 drought or higher is considered a drought; for Size 3 or 4 streams, D2 drought or higher is considered a
drought.
i A Drought conditions and no rainfall or rainfall not exceeding 1 inch within the last 48 hours
i- B Drought conditions and rainfall exceeding 1 inch within the last 48 hours
is C No drought conditions
9 Large or Dangerous Stream - assessment reach metric
Yes . No Is stream is too large or dangerous to assess? If Yes, skip to Metric 13 (Streamside Area Ground Surface Condition).
10. Natural In -stream Habitat Types -assessment reach metric
10a. t Yes f: No Degraded in -stream habitat over majority of the assessment reach (examples of stressors include excessive
sedimentation, mining, excavation, in -stream hardening [for example, rip -rap], recent dredging, and snagging)
(evaluate for size 4 Coastal Plain streams only, then skip to Metric 12)
10b. Check all that occur (occurs if> 5% coverage of assessment reach) (skip for Size 4 Coastal Plain streams)
F-7 A Multiple aquatic macrophytes and aquatic mosses N r- F 5% oysters or other natural hard bottoms
o (include liverworts, lichens, and algal mats) F- 0 G Submerged aquatic vegetation
r B Multiple sticks and/or leaf packs and/or emergent o in H Low -tide refugia (pools)
vegetation 0 1 Sand bottom
F- C Multiple snags and logs (including lap trees) m ,� J 5% vertical bank along the marsh
F- D 5% undercut banks and/or root mats and/or roots v 2 r K Little or no habitat
in banks extend to the normal wetted perimeter
F- E Little or no habitat
*********************************REMAINING QUESTIONS ARE NOT APPLICABLE FOR TIDAL MARSH STREAMS****************************
11. Bedform and Substrate - assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
11 a. is Yes t- No Is assessment reach in a natural sand -bed stream? (skip for Coastal Plain streams)
11 b. Bedform evaluated. Check the appropriate box(es).
r A Riffle -run section (evaluate 11 c)
F_ B Pool -glide section (evaluate 11d)
F- C Natural bedform absent (skip to Metric 12, Aquatic Life)
11 c. In riffles sections, check all that occur below the normal wetted perimeter of the assessment reach - whether or not submerged.
Check at least one box in each row (skip for Size 4 Coastal Plain Streams and Tidal Marsh Streams). Not Present (NP) _
absent, Rare (R) = present but <- 10%, Common (C) _ > 10-40%, Abundant (A) _ > 40-70%, Predominant (P) _ > 70%. Cumulative
percentages should not exceed 100% for each assessment reach.
NP R C A P
f r: k__ k- ((+ Bedrock/saprolite
C col- l- }�+ Boulder (256 - 4096 mm)
C col- l- } Cobble (64 - 256 mm)
C i CO Gravel (2 - 64 mm)
C i C is {� Sand (.062 - 2 mm)
C i (` f: (` Silt/clay (< 0.062 mm)
C c r f ( Detritus
C C r r (' Artificial (rip -rap, concrete, etc.)
11 d. (" Yes ( No Are pools filled with sediment? (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12. Aquatic Life - assessment reach metric (skip for Size 4 Coastal Plain streams and Tidal Marsh Streams)
12a. k- Yes Co No Was an in -stream aquatic life assessment performed as described in the User Manual?
If No, select one of the following reasons and skip to Metric 13. i- No Water (` Other:
12b. k- Yes is No Are aquatic organisms present in the assessment reach (look in riffles, pools, then snags)? If Yes, check
all that apply. If No, skip to Metric 13.
1 >1 Numbers over columns refer to "individuals" for size 1 and 2 streams and "taxa" for size 3 and 4 streams.
F_ F- Adu _
F_ f- Aquatic reptiles
F_ r Aquatic macrophytes and aquatic mosses (include liverworts, licheii6, and algal mats)
F_ f- Beetles (including water pennies)
F_ r Caddisfly larvae (Trichoptera [T])
F_ f- Asian clam (Corbicula )
F_ r Crustacean (isopod/a m phipod/crayfish/sh rim p)
F_ f- Damselfly and dragonfly larvae
F_ r Dipterans (true flies)
F_ f- Mayfly larvae (Ephemeroptera [E])
F_ r Megaloptera (alderfly, fishfly, dobsonfly larvae)
F_ r Midges/mosquito larvae
F_ r Mosquito fish (Gambusia) or mud minnows (Umbra pygmaea)
F_ r Mussels/Clams (not Corbicula )
F_ r Other fish
F_ r Salamanders/tadpoles
F_ r Snails
F_ r Stonefly larvae (Plecoptera [P])
F_ r Tipulid larvae

F_ r Worms/leeches
13. Streamside Area Ground Surface Condition - streamside area metric (skip for Tidal Marsh Streams and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB). Consider storage capacity with regard to both overbank flow and
upland runoff.
LB RB
t- A k- A Little or no alteration to water storage capacity over a majority of the streamside area
k` B k- B Moderate alteration to water storage capacity over a majority of the streamside area
k` C k- C Severe alteration to water storage capacity over a majority of the streamside area (examples include: ditches, fill,
soil, compaction, livestock disturbance, buildings, man-made levees, drainage pipes)
14. Streamside Area Water Storage - streamside area metric (skip for Size 1 streams, Tidal Marsh Streams, and B valley types)
Consider for the Left Bank (LB) and the Right Bank (RB) of the streamside area.
LB RB
k` A k- A Majority of streamside area with depressions able to pond water >_ 6 inches deep
i B i B Majority of streamside area with depressions able to pond water 3 to 6 inches deep
i C i C Majority of streamside area with depressions able to pond water < 3 inches deep
15. Wetland Presence - streamside area metric (skip for Tidal Marsh Streams)
Consider for the Left Bank (LB) and the Right Bank (RB). Do not consider wetlands outside of the streamside area or within the
normal wetted perimeter of assessment reach.
LB RB
k- Y i Y Are wetlands present in the streamside area?
Co N is N
16. Baseflow Contributors - assessment reach metric (skip for size 4 streams and Tidal Marsh Streams)
Check all contributors within the assessment reach or within view of and draining to the assessment reach.
A Streams and/or springs (jurisdictional discharges)
r B Ponds (include wet detention basins; do not include sediment basins or dry detention basins)
r C Obstruction that passes some flow during low -flow periods within assessment area (beaver dam, bottom -release dam)
r D Evidence of bank seepage or sweating (iron oxidizing bacteria in water indicates seepage)
r E Stream bed or bank soil reduced (dig through deposited sediment if present)
F None of the above
17. Baseflow Detractors - assessment area metric (skip for Tidal Marsh Streams)
Check all that apply.
F- A Evidence of substantial water withdrawals from the assessment reach (includes areas excavated for pump installation)
F_ B Obstruction not passing flow during low flow periods affecting the assessment reach (ex: watertight dam, sediment deposit)
F- C Urban stream (>> 24% impervious surface for watershed)
F- D Evidence that the stream -side area has been modified resulting in accelerated drainage into the assessment reach
F- E Assessment reach relocated to valley edge
F None of the above
18. Shading - assessment reach metric (skip for Tidal Marsh Streams)
Consider aspect. Consider "leaf -on" condition.
f A Stream shading is appropriate for stream category (may include gaps associated with natural processes)
B Degraded (example: scattered trees)
C` C Stream shading is gone or largely absent
19. Buffer Width - streamside area metric (skip for Tidal Marsh Streams)
Consider "vegetated buffer" and "wooded buffer" separately for left bank (LB) and right bank (RB) starting at the top
of bank out to the first break.
Vegetated Wooded
LB RB LB RB
Ci A is A is A f: A > 100-feet wide or extends to the edge of the watershed
{ B (- B (` B r B From 50 to < 100-feet wide
# C r C r C r C From 30 to < 50-feet wide
{� D { D (` D r D From 10 to < 30-feet wide
# E C E r' E r E < 10-feet wide or no trees
20. Buffer Structure - streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Vegetated" Buffer Width).
LB RB
k- A i A Mature forest
Co B is B Non -mature woody vegetation or modified vegetation structure
C C Herbaceous vegetation with or without a strip of trees < 10 feet wide
( D i D Maintained shrubs
C E s- E Little or no vegetation
21. Buffer Stressors - streamside area metric (skip for Tidal Marsh Streams)
Check all appropriate boxes for left bank (LB) and right bank (RB). Indicate if listed stressor abuts stream (Abuts), does not abut but
is within 30 feet of stream (< 30 feet), or is between 30 to 50 feet of stream (30-50 feet).
If none of the following stressors occurs on either bank, check here and skip to Metric 22: F_
Abuts < 30 feet 30-50 feet
LB RB LB RB LB RB
{` A ( A k` A (` A 4__ A k— A Row crops
C B C B B r B r- B r' B Maintained turf
r C r C C r C C' C r' C Pasture (no livestock)/commercial horticulture
C D C` D k' D r D (- D k— D Pasture (active livestock use)
22. Stem Density - streamside area metric (skip for Tidal Marsh Streams)
Consider for left bank (LB) and right bank (RB) for Metric 19 ("Wooded" Buffer Width).
LB RB
(: A is A Medium to high stem density
( B i B Low stem density
C C i C No wooded riparian buffer or predominantly herbaceous species or bare ground
23. Continuity of Vegetated Buffer - streamside area metric (skip for Tidal Marsh Streams)

Consider whether vegetated buffer is continuous along stream (parallel). Breaks are areas lacking vegetation > 10-feet wide
LB
RB
f: A
is A
The total length of buffer breaks is < 25 percent.
i- B
i- B
The total length of buffer breaks is between 25 and 50 percent.
i- C
i- C
The total length of buffer breaks is > 50 percent.
24. Vegetative Composition — First 100 feet of streamside area metric (skip for Tidal Marsh Streams)
Evaluate the dominant vegetation within 100 feet of each bank or to the edge of the watershed (whichever comes first) as it contributes
to assessment reach habitat.
LB RB
i A i A Vegetation is close to undisturbed in species present and their proportions. Lower strata composed of native
species, with non-native invasive species absent or sparse.
Co B Co B Vegetation indicates disturbance in terms of species diversity or proportions, but is still largely composed of native
species. This may include communities of weedy native species that develop after clear -cutting or clearing or
communities with non-native invasive species present, but not dominant, over a large portion of the expected strata or
communities missing understory but retaining canopy trees.
s- C s- C Vegetation is severely disturbed in terms of species diversity or proportions. Mature canopy is absent or communities
with non-native invasive species dominant over a large portion of expected strata or communities composed of planted
stands of non -characteristic species or communities inappropriately composed of a single species or no vegetation.
25. Conductivity — assessment reach metric (skip for all Coastal Plain streams)
25a. k- Yes is No Was a conductivity measurement recorded?
If No, select one of the following reasons. (` No Water (` Other:
25b. Check the box corresponding to the conductivity measurement (units of microsiemens per centimeter).
(` A <46 r B 46 to < 67 r C 67 to < 79 r D 79 to < 230 r E >> 230

BAT QUESTIONNAIRE

(TIP U-4713A) Questionnaire: PM Terry Burleson LET 10/24
Existing Structure:
Can the existing bridge/culvert be removed during the winter months (November 16 - March 14)?
Trees:
Can the trees in the project footprint be cut during the winter months (November 16 - March 14)?
With current let schedule, yes, we can cut trees between Nov -May.
Blasting:
Will blasting be used for this project? If so, will it occur between March 15 and November 15?
Don't expect blasting but if encountered we could blast during summer months.
Percussive Activities:
What type of percussive activities will occur? (e.g., pile driving, guardrail installation)
Guardrail Installation
Lighting:
Will temporary lighting for nighttime construction be necessary between March 15 and November 15?
Does permanent lighting exist in the project area and if so, will it be removed, or will new lighting be
added as a result of the project?
Expect project to be constructed during the daylight hours. There is one or two existing lights at each
end of the project that will be remain.