20160148 Ver 1_USACE Permit_20160218

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2016-00328 County: Sampson U.S.G.S. Quad: NGFAISON
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: NCDOT - Division 3 Engineer
attn.: Ms. Karen Collette P.E.
Address: 5501 Barbados Blvd
Castle Havne, NC, 28429
Agent: NCDOT-Division 3 DEO
attn.: Mr. Stonewall Mathis
5501 Barbados Blvd
Castle Havne, NC, 28429
Size (acres) 0_5 Nearest Town Turkev
Nearest Waterway Tenmile Swamp River Basin Black
USGS HUC 03030006 Coordinates Latihtde: 35.0513804684995
Longitude: -781695620738222
Location description: The proiect area is located alon� SR 1906 (Thompson AveJ at 015 miles SW of SR 1905, NE of Turkev,
Sampson County.
Description of projects area and activity: The uroiect involves replacing an existin� 36' pipe bv 60' long with a new 66' box
culvert bv 50.5' total length. The project further involves channel work using rip rap fill and bank stabilization to correct a
current perched situation. The qroject is authorized consistent with the drawings dated 1/27/2016 and a waiver from pipe
burial and filter fabric is granted with this authorization.
Applicable Law:
Authorization:
� Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Regional General Permit Number or Nationwide Permit Number: NW-3
SEE ATTACHED RGP oN NWP GENERAL, REGIONAL AND SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and attached information dated application dated 2/12/2016 and drawings dated
1/27/2016. Any violation of the attached conditions or deviation from your submitted plans may subject the permittee to a
stop work order, a restoration order, a Class I administrative penalty, and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and/or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide permit. If the nationwide permit authorization expires or is suspended, revoked, or is modified, such that the
activity would no longer comply with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify, suspend or revoke the autharization.
Activities subject to Section 404 (as indicated above) may also require an individual Secrion 401 Water Quality Certificarion. You
should contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you must contact the N.C. Division of Coastal Management in Morehead City, NC, at [phone].
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program, please contact Brad Shaver at 910-251-4611 or Brad.E.Shaver(�u,usace.army.mil.
Dlgitally signetl by SHAVER.�PAD.E.12I6601ISfi
.f� DN�. r—U5, a=U.S. Government, ou=DoO, ou=Pxi,
Corps Regulatory Official: ��r`"'' �u-uSAcn-SHAVERBRADE12Jfi601J56 Date: 2/18/2016
Date: 201 fi.02.1811'.3850 -OS'00'
Expiration Date of Verification: 3/18/2017

Determination of Jurisdiction:
A. � Based on preliminary inforination, there appear to be waters of the US including wetlands within the above described project
area. This preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
( Reference 33 CFR Part 331).
B. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements of
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notificarion.
C. ❑ There are waters of the US and/or wetlands within the above described project area subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations,
this detennination may be relied upon for a period not to exceed five years from the date of this notification.
D. ❑ The jurisdicrional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional detennination issued . Action ID: SAW- .
Basls Fot' Detel'minatlon: The subject area exhibits an ordinary high water mark and drains toward Ten Mile
Swamp.
Remat'ks: Waiver from burial depth and flter fabric granted being that it would result in the least environmental
impact.
Digitally signed hy SHAVER.BRAD.E.727660175fi
� � DN: c=US, o=U.S. Govemment, ou=DoD,
� ou=PKl,ou=USA,
rn=SH AVER.BRAO.E.1276601756
C�,.„S 1�e�iat�� OfL�'Clal. Date:2076.02.7817:3931-OS'00'
1�1 i\ 1 11 1
Brad Shaver
Date of JD: 2/18/2016
Expiration Date of JD: None P7D
The Wilmington District is coinmitted to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete our customer Satisfaction Survey online at http://re_ug latory.usacesurvey.con�/.
Copy furnished (e-copy):
NCDEQ-DWR attn.: Mr. Mason Herndon

Action ID Number: SAW-2016-00328 County: Sampson
Permittee: NCDOT - Division 3
Karen Collette
Project Name: NCDOT / SR 1906 / Thompson Ave / Pipe replacement / Division 3
Date Verification Issued: 2/18/2016
Project Manager: Brad Shaver
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn: Brad Shaver
69 Darlington Ave
Wilmington, NC 28403
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee Date

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: NCDOT - Division 3 File Nuinber: SAW-2016-00328 Date: 2/18/2016
Karen Collette
Attached is: E
INITIAL PROFFERED PERMIT (Standard Permit or Letter of p
PROFFERED PERMIT (Standard Permit or Letter of nermission
PERMIT DENIAL
APPROVED JURISDICTIONAL DETERMINATION
PRELiMiNARY JURISDiCTIONAL DETERMINATiON
See Section below
�
:
0
0
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SECTION 1- 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.mil/Missions/CivilWorl<s/Rc�ilatoryProgramandPermits.aspx
or the Coms 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 inay sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you inay 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
pennit.
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 inust 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 t]Zat 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 Peimit, 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 tenns 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.

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 instrucrion. Also you may provide new informarion for further consideration by the
Corps to reevaluate the JD.
SECTION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
R�ASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision ar your objections to an initial
proffered pennit in clear concise statements. You may attach additiona] 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 far 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 informaiion or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the adininistrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If yoLi 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, Attn: Mr. Jason Steele, Administrative Appeal Review Officer
Brad Shaver CESAD-PDO
69 Darlington Ave U.S. Army Corps of Engineers, South Atlantic Division
Wilmington, NC 28403 60 Forsyth Street, Room 1OM15
Atlanta, Georgia 30303-8801
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct invesrigations 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 opportuni to participate in all site investi ations.
Date: Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: Brad Shaver, 69 Darlington Avenue, Wilmington, North Carolina
28403
For Permit denials, Proffered Permits and approved Jurisdictional Deterrr�inations send this f'orm 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]

ATTACHMENT A
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD):02/12I2016
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
Stonewall Mathis - NCDOT - Div. 3/DEO 5501 Barbados Bivd. Castle Hayne, NC 28429
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
USACE Wilmington District
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
Sampson County - SR 1906 Thompson Ave Pipe Replacement at 0.15 miles South of SR 1905
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT
SITES)
State: NC County/pat'ish/bo�ough: sarnPson Clty: Faison/Turkey
Center coordinates of site (lat/long in degree decimal format):
Lat. 35.051553 °(�J; LOng. 78.169444 °W,
Universal Transverse Mercator. GCS_North_American_t983_NAD_1983_StatePlane North_Carolina_fIPS 3200_Feet
Name of nearest waterbody: uT �o Te�M�ie sWamP s�o#,s-ss-z-a
Identify (estimate) amount of waters in the review area:
Non-wetland waters:
-�50 linear feet: - s t� � width (ft) and/or acres.
Cowardin Class: Riverine Lower Perennial Unconsolidated Bottom Sand
Strgarp F�OW: Perennial (Permanently Flooded)
Wetlands: o acres.
Cowardin Class:
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal: NA
Non-Tidal: NA
1

E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
� Office (Desk) Determination. Date:
� Field Determination. Date(s): 12is�zo�s by r,cowR
SUPPORTING DATA. Data reviewed for preliminary JD
(check all that apply - checked items should be included in case file and,
where checked and requested, appropriately reference sources below):
� Maps, plans, plots or plat submitted by or on behalf of the
applicant/consultant: NcooT
❑ Data sheets prepared/submitted by or on behalf of the
appli nt/consultant.
Office concurs with data sheets/delineation report.
Office does not concur with data sheets/delineation report.
❑ 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: Fa�so� �S�aie as snoW��
❑ USDA 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 Geodectic Vertical Datum of 1929)
❑✓ Photographs: ✓0 Aerial (Name & Date): A��c�s �oos or
Q Other (Name & Date): A��c�s ��da�
� Previous determination(s). File no. and date of response letter:
� �tilel' Iflf01'C11at1011 �p�@aS@ SpeClfy�: Permit Drawings and Permit Application
2

1. The Corps of Engineers believes that there may be jurisdictional waters of the
United States on the subject site, and the permit applicant or other affected party
who requested this preliminary JD is hereby advised of his or her option to
request and obtain an approved jurisdictional determination (JD) for that site.
Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the option to obtain an approved JD in
this instance and at this time.
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
approved JD for the activity, the permit applicant is hereby made aware of the
following: (1) the permit applicant has elected to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional waters; (2) that the applicant has the option to request an approved
JD before accepting the terms and conditions of the permit authorization, and
that basing a permit authorization on an approved JD could possibly result in less
compensatory mitigation being required or different special conditions; (3) that
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)
that 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) that undertaking
any activity in reliance upon the subject permit authorization without requesting
an approved JD constitutes the applicant's acceptance of the use of the
preliminary JD, but that either form of JD will be processed as soon as is
practicable; (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 preliminary JD constitutes agreement that all
wetlands and other water bodies on the site affected in any way by that activity
are jurisdictional waters of the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative appeal or in any Federal court; and (7) whether
the applicant elects to use either an approved JD or a preliminary JD, that JD
will be processed as soon as is practicable. Further, an approved JD, 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,
and that in any administrative appeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary
to make an official determination whether CWA jurisdiction exists over a site, or
to provide an official delineation of jurisdictional waters on the site, the Corps will
provide an approved JD to accomplish that result, as soon as is practicable.

This preliminary JD finds that there "may be"waters of the United States on the
subject project site, and identifies all aquatic features on the site that could be
affected by the proposed activity, based on the following information:
IMPORTANT NOTE: The information recorded on this form has not
necessarilv been verified bv the Corps and should not be relied upon for
later iurisdictional determinations.
�,p.� ou9'tally signed by SHAVER.BRAD.E.127660n56
�� DN: r-U5, o=U.S. Government, ou=DoD, ou=PKl,
=USA,cn=SHAVER.BRAD.E1276601756
Date: 207 6D2.18 1126:OJ -OS'00'
Signature and date of
Regulatory Project Manager
(REQUIRED)
�
ZI�ZI��
Signature and ate of
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)

Estimated
amount of
aquatic Class of
Cowardin resource in Aquatic
Site Latitude Longitude Class review area Resource
Riverine Lower Non-section 10 -
Perennial non-wetland
SR 1906 Unconsolidated (Perennial
Thompson Ave 35.051553 N 78.169444 W Bottom Sand �150 feet Stream)