20160291 Ver 1_Application_20160321

Transportadon
M��n io, zol6
Mr. Steve Kichefski
Asheville Regulatory Field OfPice
US Army Corp of Engineers
151 Patton Avenue
Asheville, NC 28801-5006
PAT McCRORY
co�er„o,
NICHOLASJ.TENNYSON
SecrePary
SUB7ECT: Two pipe replacements on SR 1150 (Bess Chapel Church Road), Lincoln County
Dear Mr. Kichefski:
The North Carolina Department of Transportation requests authorization to replace a two
deteriorating pipes on SR 1150 (Bess Chapel Church Road) in Lincoln County. At site 1, NCDOT
proposes to replace an e�siing 40-foot, 96" CMP with a 40-foot, 96" CMP with riprap bank
stabilization at inlet and outlet. There is an unnamed tributary entering the main channel on the
upstream side which will be impacted by the bank stabilization and therefore will result in � I S feet
of bank stabilization impacts to the adjacent tributary. At site 2, NCDOT proposes to replace to
replace an existing 45-foot, 72" CMP with a 50-foot, 54" CMP with riprap bank stabilizaYion at
inlet and outlet. Att adjacent jurisdictional ditchline (has eroded to groundwater seepage) on Yhe
upstream side will be reconstructed and filled for a distance of �15 feet. There will be a total of 67
feet of permanent impacts to Mill Creek and the UT to Little Creek, both of which aze classified as
a WS-II (HQW) watershed by the N.C. Division of Water Resources.
The project is not located within %z mile of the critical watershed area, nor is SR 1150 a rural or
urban arterial; therefore, hazardous spill basins are not required. Enclosed is the hazardous spill
basin checklist.
This office has conducted a GIS and field survey for the project for historical sites and
threatened/endangered species sites. There are no sites listed on the National Register oP Historic
Places are located in the vicinity of the project and the project occur within existing NCDOT right
of way. The federally listed species for Lincoln County (USPW S listed dated Apri12, 2015) include
the Dwarf-flowered Heartleaf (Hexastylis naniflora)- Threatened; the Northern Long Eared Bat
(NLEB) (Myotis septentrionalis)-ThreaYened; and the Michaux's sumac (Rhus michauxia�- E
(Historic). Natural Heritage Program records docusneut the nearest Dwarf-flowered Heartleaf
location approximately 1.5 northeast of the proposed project areas. The heartleaf is usually found
in acidic soils along bluffs and adjacent slopes, in boggy areas next to streams and creek heads, and
along the slopes of nearby hillsides and ravines. The project area is a roadway with adjacent
agricultural operation. There is no habitat within the proposed project area and no species were
obseroed during the site visit. No impact on this species is anticipated. National Heritage Program
records document the nearest Michaux's 5umac location approxixnately 45 miles southeast
(Mecklenburg County) of the proposed project area. There are no known sites of Michawc's sumac
in Lincoln County. The sumac is typically found in sandy or rocky, open woods and appears to
survive best in areas with some disturbance, such as artificially or nzturally maintained clearings.
There is little suitable habitat within the proposed project area and no species were observed. No
impact on this species is anticipated.

Pipe Replacements, SR 1150, Bess Chapel Church Road
Page 2
March 10, 2016
Natural Heritage Program records document the nearest Northern Long Eared Bat location
approximately 13.5 miles northwest (Burke County) of the proposed project area. During swxuuer,
northern long-eared bats roost singly or in colonies underneath bark, in cavities, or in crevices of
both live and dead trees. They may also roost in cooler places, like caves and mines. Tree species
may be used based on suitability to retain bark or provide cavities or crevices. It has also been
found, rarely, roosting in structures like barns and sheds. Northern long-eared bats spend winter
hibernating in humid caves and mines. Minimal roadside tree clearing will be done as part of these
pipe replacements project. There are no abandoned structures, barns or shed in close vicinity and
the closest underground mine (per NHP database) is the Doris Eaker mica mine (� 1-2 miles
southeast).
There are currently no known hibernaculum or maternity roost trees in Division 12 counries for
NLEB; therefore, the minor tree clearing associated with this DOT project would be exempted from
incidental take under the 4d ru1e. Attached is the U.S. Fish and Wildlife Service (USFWS) NLEB
4(d) Rule streamlined consultation form. Per �uidance from USFWS personnel, concurrence is
granted by citing the following website and a 30 day response period is waived.
fit�� i'wwu tc� s.eo��/ashecille/ht�nitii�r�ect re��iew/NI 1:13 in \�v'VC.html
I have enclosed a pre-construction notification for a NW#3, plan sheets, and a location map relative
to the project.
Project information for the 401 AutomaYed Payment Procedure is as follows:
• Work order number: 150463-55120005-12B.205511-3300
• TII'#: NA
• Project Category: $240.00 Fee
If you have any questions or concerns please feel free to contact me at [phone]. Thank you
for your time and consideration on this matter.
Sincerely,
Mark E. Stafford, P.E.
Division Engineer
Twelfth Division
BY: ��/� . ,�L_ � ct..°y�--.-
�„
Trish Beam
Division 12 Environmental Supervisar
Enclosures
cc:
Donna Hood, Division of WaYer Resources, Mooresville Regional Office
Andrew Henderson, U.S. Fish and Wildlife Service, Asheville Office

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCI� Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps: � Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NW P) number: 3 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ❑ Yes � No
1d. Type(s) of approval sought from the DWQ (check all that apply):
� 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e. Is this notification solely for the record For the record only for DWQ 401 For the record only for Corps Permit:
because written approval is not required? Certification:
❑ Yes � No ❑ Yes � No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation � Yes � No
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h ❑ Yes � No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concem (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project SR 1150 (Bess Chapel Church Road)
2b. County: Lincoln
2c. Nearest municipality / town: Crouse
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state 12B.205511
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: NC DOT Right of Way
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Streetaddress:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 12
PCN Form — Version 1.3 December 10, 2008 Version

4. P,��Bd�a�� Irs��r�ua�@ocaca (€� 0?�4���eo�4 Fcaova �erv�oeP�
4a. Applicant is: ❑ Agent ❑ Other, specify:
4b. Name: Mark E. Stafford
4c. Business name �,C. Department of Transportation, Division 12
(if applicable):
4d. Street address: 1710 East Marion Street
4e. City, state, zip: Shelby, NC 25151
4f. Telephone no.: 704-480-9020
4g. Fax no.: 704-480-5401
4h. Email address: [e-mail]
5. AgerotlConsulYarct 9rafarmaflion (if appficabie)
5a. Name: Trish Beam
5b. Business name N.C. Department of Transportation, Division 12
(if applicable):
5a Street address: 1710 East Marion Street
5d. City, state, zip: Shelby, NC 28151
5e. Telephone no.: 704-480-9044
5f. Fax no.: 704-480-5401
5g. Email address: [e-mail]
Page 2 of 12
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Iden4ification
1 a. Property identification no. (tax PIN or parcel ID): NA
Latitude: Site 1(South site): 35.445, -81.419
1b. Site coordinates (in decimal degrees): Longitude: -; Site 2(North site): 35.463 ,-81.418
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size: <0.10 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Site 1(South site): Mill Creek; Site 2(North site): UT to
proposed project: Little Creek
2b. Water Quality Classification of nearest receiving water: Mill Creek: WS-II(HQW); UT to Little Creek: WS-II (HQW)
2c. River basin: Catawba
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Deteriorating corrugated metal pipes; Surrounding landuse designation is cropland/pasture and forested.
3b. List the total estimated acreage of all existing wetlands on the property:
0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
100 feeUsite =total 200 ft
3d. Explain the purpose of the proposed project:
The purpose of the proposed work is to replace the deteriorating pipes for the safety of the travelling public.
3e. Describe the overall project in detail, including the type of equipment to be used:
The North Carolina Department of Transportation proposes to replace existing deteriorating pipes on SR 1150, Bess
Chapel Church Road in Lincoln County. Area affected by temporary cofferdam system will 6e restored to pre-project
conditions. The Project will be constructed using typical heavy equipment (trackhoe, backhoe, etc.)
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past? ❑ Yes � No ❑ Unknown
Comments: Jurisdictional stream determination made by
Division 12 DEO.
4b. If the Corps made the jurisdictional determination, what type � preliminary ❑ Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for � Yes � No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Page 3 of 12
PCN Form — Version 1.3 December 10, 2008 Version

�. ��axcae� �e�J��k Pa�cos
6a. Is this a phased project? ❑ 1'es � No
6b. If yes, explain.
Page 4 of 12
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
❑ Wetlands � Streams-tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
Page 5 of 12
PCN Form — Version 1.3 December 10, 2008 Version

2. Wetland Impacts
If Yhere are weiland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type ofjurisdiction
number — Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ— non-Q04, other) (acres)
Temporar T
W 1 � P❑� ❑ Yes ❑ Carps
❑ No ❑ DWQ
W2 � P� T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W3 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W4 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W5 ❑ P � T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W6 ❑ P � T ❑ Yes ❑ Corps
❑ No ❑ DWQ
2g. Total wetland impacts
2h. Comments
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3 a. 3 b. 3 c. 3 d. 3 e. 3f. 3 g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ — non-404, width Qinear
Temporary (T) (INT)? other) (feeY) feet)
S1 � P❑ T Site 1: Riprap Mill Creek � PER � Corps $ ��
bank stabilization ❑ INT � DWQ
S2 ❑ P� T Site 1: Temporary Mill Creek � PER ' � Corps g 25
Bypass Pumping ❑ INT � DWQ
Site 1: Fill in � pER � Corps
S3 � P 0 T jurisdictional UT to Mill Creek � INT � DWQ 0.5 15
ditchlin�- _
S4 � P � T Site 2: Increase in UT to Little Creek � PER � Corps 2 5
pipe length ❑ INT � DWQ
Site 2: Riprap
bank stabilization UT to Little Creek
2 10
S5 � P 0 T � PER � Corps
Riprap bank Z�d UT to Little � INT � DWQ
stabilization to Creek 0.5 15
adjacent ditchline
groundwater seep
S6 ❑ P� T Site 2: Temporary UT to Little Creek � PER � Corps Z 25
Bypass pumping ❑ INT � DWQ
3h_ TotaY stream and triba�taryiangn�ets � _ �67
3i. Comments: �Total permanent impacts at both sites:
Page 6 of 12
PCN Form — Version 1.3 December 10. 2008 Version

4. Open Wa4er Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number— (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Tempora T
01 ❑P❑T
02 ❑POT
03 ❑P❑T
04 ❑P❑T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction pro osed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose (acres)
number of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
Sf. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the cha�t below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar-Pamlico ❑ Other:
Project is in which protected basin? ❑ Catawba ❑ Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number — Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Tempora T im act re uired?
B1 ❑P❑T ❑Yes
❑ No
B2 ❑P❑T ❑Yes
❑ No
B3 ❑P❑T ❑Yes
❑ No
6h. Total buffer impacts
6i. Comments:
Page 7 of 12
PCN Form — Versio� 1.3 December 10, 2008 Version

�. 9aregaa�i.�aa�4i�ac�flia� a¢em VUdo46gaaa�¢u
�. f�voEe4�eac� aa��] 4��o�fieniaa€uc�¢�
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Pipe burial based upon upstream/downstream reference points outside of existing inlet/outlet scourholes.
1 b. Specifically describe measures taken to avoid or minimize the proposed impac4s through construction techniques.
2. C�eaa�eeesaflarv �Viet%ga4don �oe €engrac4s @� VVa@ees o4 Eh� CS.S. oe 9JVa¢e�s oi 4Fo� 5@a��
2a. Does the project require Compensatory Mitigation for ❑ Yes � No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, nvtigarion is cequired by (check all tbat apply): ❑ DWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this
project? ❑ Payment to in-lieu fee program
❑ Permittee Responsible Mitigation
3. Covnplete if lJsing a fJlitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Correplete if Making aPaymen@ 4oln-lieu Fee Progeam
4a. Approval letter from in-lieu fee program is attached. ❑ Yes
4b. Stream mitigation requested: linearfeet
4c. If using stream mitigation, stream temperature: ❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland�mitigation requested: acres
4h. Comments
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 8 of 12
PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires ❑ Yes � No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3(2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsi6le riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 9 of 12
PCN Form — Version 1.3 December 10, 2008 Version

�e ��Q�a�twa,q¢r V11da,eoag�e¢aoe�o8 arsdl �df�°ua�Q r[��ne �&a�ua (e��uuwe�c1 �y [�lfil�}
9. �dS-�u�� [�€�w �Va�
1 a. Does the project include or is it adjacent to protected riparian buffers identified � yes � No
within one of the NC Ripa�ian Buffer Protection Rules?
1 b. If yes, fhen is a diffuse flow plan included? If no, e>cplain why.
Comments ❑ Yes ❑ No
2. Stormwater ilAanagemenk Plan
2a. What is the overall percent imperviousness of this project? no in�crease in impervious surface
/o
2b. Does this project require a Stormwater Management Plan? ❑ Yes � No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Repiacement of existing pipes with
similar size with no increase of built upon area nor change of stormwater management. Complies with NCDOT's
individual NPDES permit NCS00025Q
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ❑ DWQ Stormwater Program
� DWQ 401 Unit
3. Certified Local Government Sformwater Review
3a. In which local governmenYs jurisdiction is this project? NA
❑ Phase II
3b. Which of the following locally-implemented stormwater management programs ❑ NSW
apply (check all that apply): ❑ USMP
❑ Water Supply Watershed
❑ Other.
3c. Has the approved Stormwater Management Plan with proof of approval been ❑ Yes ❑ No
attached?
4. DWQ Stormwater Program Review
❑ Coastal counties
� HQW
4a. Which of the following state-implemented stormwater management programs apply � ORW
(check all that apply): ❑ Session Law 2006-246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ❑ Yes � No
5. D@r�4 40R Uruit Storrnwater Revfiew
5a. Does the Stormwater Management Plan meet the appropriate requirements? � yes ❑ No
5b. Have ail of the 401 Unit submittal requirements been met? � Yes ❑ No
Page 10 of 12
PCN Form — Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the � Yes ❑ No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ❑ Yes � No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ❑ Yes ❑ No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ❑ Yes � No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ❑ Yes � No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in � Yes � No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
The project is a minimum criteria project which has low potential for cumulative/indirect impacts and will not result in
additional development which could impact water quality.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
No wastewater is generated from project.
Page 11 of 12
PCN Form — Version 1.3 December 10, 2008 Versio�

�. ��s�aru�eeem S�ecdcs a�o�1 ��sog�aa6e�1 �roff��a0 G���a4a�t Q��r�s ��€�¢noe�orv�o�2)
5a. W ill this project occur in or near an area with federally pro4ected species or � Yes � Rlo
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act � yes ❑ No
impacts?
❑ Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
� Asheviile
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program dataliase and onsite surveys.
6. Essential Fish 6iabitat (Corps Requiremeni)
6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes � No
6b. W hat data sources did you use to determine whether your site would impact Essential Fish Habitat?
No salt marshes, oyster reefs, or seagrass beds located in vicinity of project.
7. Fiistoric or Prehisioric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation � Yes � No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
Natural Heritage Program database and visual survey; however, project to be done on existing DOT Right of Way.
8. Flood Zone Designation (Corps Requirement)
8a. W ill this project occur in a FEMA-designated 100-year floodplain? � Yes � No
8b. If yes, explain how project meets FEMA requirements: NCDOT Hydraulics coordination with FEMA
8c. W hat source(s) did you use to make the floodplain determination? http://www.ncfloodmaps.com/ FEMA FfRM Map #
3710266200K (Site 1 in AE flood zone); Map # 3710268200J (Site 2 not in flood zone)
i ; � . � ; r.,h
,
' i: �- � ��' � ' �' r �`" � �'' � '`'_
� .� , �
i � � � .,, f � ,�-- ; � ,'�,,,
e. �_ �kv, . — - �e^�_, s �7 �,t
� < <,
ApplicanUAgen£s Printed Name ` Applicant/AgenP ignature Date
� (AgenYs signature is valid only if an authorization letterfrom the applicant
is rovided.
Page 12 of 12
PCN Form — Version 1.3 December 10. 2008 Version

Propased
Exisiing Hec
% �
�—
BANK STABILIZATION
IS FEET
��
m
c�
cn
n
2
D
-v
fll
r
n
S
A
�
CL
RD
� _ —
Existing 96" CMP x 40'
Existing Headwall
UP $IDE $TREAM -�y � r^ �CV � Pla<e Class II Rip Rap @ all
� v� V four rorners being approx.
E -�7 5' out in front of proposed
� � N headwall ut all fow corners
� �
,� � Praposed Headwall
DO NOT GET � O .�. � � �
. IN� SiDE STREAM _
� � � . . . . .<.
I) Pumping system to be used to
divert the stream araund the
construction site as needtd. .- ""- �� �
2)AYfy:coMamina#ed.wa#er_wiihin.- _ . . �
. the construction site is to be � - � . ��� � � .
pumped into a silt bag -
Mag Nail set in CL Rd apprax. .
3) Silt fences is to be placed nraund 129.5' from CL Culvert and �
stockpile�and project as it allows. Stream
�
4) Uperccompletion of the project all . .*I�IOT TO SCALE*
silt fences are to be placed as .
needed. Also'seeding and mulching
af disturbed uceas - __._. _ _ �� - - � �
5) Divert runoff inta storage basins or inta
TRSC-A's before leaving the praject. Place . . - �
contaminated devices at the end of silt fence.
6)Place TRSC-A'S or Special Sediment Cantrol �
Fence�in theiow points with weep�holes in ._ _ _, _
fence as needed. . � - � � � -
7) Reference The Best Management Practices
far Construction and�Maintenance Activifies .
by theNCDOT Chapter 4. . - -
.. . �§.��-8 -:

A
N
R
����W�m�Wm�
. o�-rowa�nm�m�oo
_. o V o
Oo
__
. ..dy�.T _ . _ . __ ..
J Olp
" d3 � . ��� . .
�F V
S Sln
� m � �
-'". ^ � f
m
. � m' � 3 - - � +
3� v cn
= m
��O O . ..._.
o p -
4 O N
� X �
.. . OW NwAcn
V
O- A
.. .. V - - "�9, �
U
b �
'�i.
A
9
°' "3.
� �3
do . d,
w
0
V 8
P g ��
p 2d.
8
. �n � � 2�', ..
'l� T \
I�
V
Y
J cn
N �D
P 2J
NH O d2
d.
OW NwAcn

DITCH STABILIZATION
IS FEET FROM
INTERSECTiON W�TH STRI
SEE DETAiL A
1) Pumping System to be used to
divert the stream oround the
construction site as needed.
2) Any contaminated water within
the construciian site is to be
pumped into a sik bag. .
3) Silt fence is to be placed around
stockpile and project as it allows.
4)Upon completion of the project all
silt fences are to be placed as
needed. Also seeding and mulching
of disturbed areas.
I
�
s P�
'+ Q-
3 -
r
P CL
� RQ
-� n
21.5' —
��
u
� N
�
�
�
0
5)Divert runoff into storage basins or into
TRSC-A's before leaving the praject. Place
contaminoted devices at the end of the silt fence.
6) Place TRSC-A's ar special Sediment Contral
Fence in the low points with weep holes in silt
fence as needed.
7) Reference the Best Management Practices far
Construction and Maintenance Adivities
by the NCDOT Chapter 4.
PP
Guy Wire
Guy Wire
DETAIL A
SPEQAL DITCH GRADE
INene s�m�) Han,m
�y ���
°hef D
Min. D- 1 Fl.
Gea�etlile
rpe af Gner— Clo.cs 2 Ri�Rap fird 5' from ztreom
w�re
Assume spike Elevation
to be set at f00.0
PP
Class II Rip Rap to be placed
at all faur corners approx. 5'
out in frant of the retaining wall.
��-��
( Narth of Flay Rd)
12th Div NCDOT
Bridge Maintennnce
Pipe Repincment
Bess Chapel Ch Rd
(NORTH)
SR 1150
Lincoln County

ooa.6000000,0.00000
000rnmr.6iciv�nti�oa:air�
O�PUN�O�NO�mC1Rl
r
m
O
r
V
O
m
�
�
�
N
w
v
m
mo
w
m,n
�
m
d -:
O O O O Op O O O O O O �,O O O
000 Tar'��pm�i.+O�UiI�
O�TUO�O�O�PO�CIR]m
� �
O V
� (J � � }
t � z � � V = O o
h{ o C O a� ti U
�'wf � 'o a a � � s
,..�, s >� d' U z � i
o �
� L � � D_ N J
{� z } � � m
�--I m a
m1
O O O O O O O O 00 O O,O O O O,
OOOa�n��[t V'mN�OTOJh
O� T O� O�P O� O� Q� 61 Sl oJ
O
N
O
�
O
�
O

! � i'� " � � • '�, .
� �.� i � . ��:..^ � #�. . ��. ��.:
! �
Vicinity Map
�
0 0.5 1 2 Miles
�_ _ , � �
, � �

�•
i . ..�� ;.
Division: 12 County: T,;ncnln Project ID: 12B.2055ll
River Basin: Catawba Bridge No: NA
Route: Pipe Replacements on SR ll 50 Bess Chapel Church Road�
Stream: Mill Creek(WS-II: HQW) and UT to Little Creek (WS-II: HQVV�
Water Quality Criteria:
Stream Crossing Blue Line On USGS
ORW
WSI i�� �`r
WS II,III OR N, Crossing Within O.Smi of W.S. Critical Area � �
Roadway Criteria:
Route Designation-
Additional Site Information:
Yes No
Arterial Urban R�" �
Arterial Rural r �
Is a Hazardous Spill Basin Required?
Yes No
� �
Criteria Based Upon NCDOT `Best Management Practices for the
Protection of Surface Waters" (March, 1997).

Northern d,onQ-Eared Bat 4(d) Rule Streamlined Consultation Form
Federal agencies should use this fonn for Yhe optional streamlined consultation frunework fox the northern long-eared
bat (NLEB). This framework allows federal agencies to rely upon the U.S. Fish and Wildlife Service's (USFWS) January
5, 2016, intra-Service Pxogainmatic Biological Opinion (BO) on the fina14(d) rule for the NLEB for secrion 7(a)(2)
compliance by: (1) notifying the USFWS that an action agency will use the streaznlined framework; (2) descriUing the
pxoject with sufficient detail to support the required deCermination; and (3) enabling the USFWS to Yrack effects and
determine if reinitiation of consultarion is requ�red per 50 CFR 40216.
This fonn is not necessary if an agency deYermines that a pxoposed action will have no effect to the NLEB ox if the
USFW S has concurred in wriring with an agency's determination that a proposed acUon may affect, but is not likely to
adversely aifect the NLEB (i.e., the stand�d informal consultadon process). Actions that may cause prohibited incidental
take require separate fonnal consulffition. Providing this information does not address secUon 7(a)(2) compliance for any
other listed species.
InformaCion to Determine 4(d) Rule Compliance: YES NO
1. Does the project occ� wholly outside of the WNS Zone'? ❑ �
2. Have you contacted the appropriate agency� to determine if yoar pxoject is near � �
known hibernacula or maternity roost trees7
3. Could the project disturb hibernating NLEBs in a known hibernaculmn? ❑ Li3
4. Could the project alter the enYxance ox interiar enviromnent of a known � �
hibernaculum?
5. Does the pxoject remove any Yrees within 0.25 miles of a known hibernaculum at � �/
any dme of year?
6. Would the project cut or destroy l�own occupied maternity roost trees, or any �
other irees wiYhin a 150-fooY radius from the maternity roost Yree from June 1 ❑
through July 31.
You are eligible to use this form if you have answexed yes to quesfion #1 or yes to question #2 and no to questions 3, 4,
5 and 6. The xeinainder of the fonn will be used by the USFW S to track our assumptions in the BO.
Agency and Applicani3 (Name, Email, Phone No.): ���°� �' `� «`i ����`��� �� ��`�� ��T �
•—la4 -�l$� T`i �y`t
ProjectName: �'� {�5"� (��cyr, �.��P�( Lh�re� 2c��
} 5�- s� �P-1-z ° � :� o y �3' , — 2� r .. ti � �
Proj ect Location (include coordinates if known): _
� rv,�`� i r �-z ': `� � . LI La 3 � — `� f . `-r I �
Basic Project Description (provide nairative below or attach additional information):
` ' � -�
�V�{� 1�c��' ;`.�'47)C�C-('l'�''ltir'i� �n ��15�'�r'1' 1\�
General Proiect Information YES NO
' htYp://www.fws.govhnidwest/endangered/mammals/nleb/pdf/WNSZone.pdf
� See bttp://www.fws.gov/midwest/endangered/mammals/nleb/nhisites.html
3If applicable - only needed for federal actions with applicants (e.g., for a permit, etc.) who are party to the consultarion.

I�oes the proj ect occur ��✓ithin 0.25 miles of a kno�vn hibernaculum? ❑ C�`
Does the project occur within I50 feet of a lmown mateinity xoost tree? ❑
I}oes die pxoject include forest coilversion4? (if yes, xeport acreage below) ❑
Estimated total acres of forest coi2version
If known, estimated acress of forest conversion from April 1 to OcYober 31
If known, esfimated acres of forest conversion from June 1 to July 3I6
I3oes the project include rimber haivest? (if yes, report acreage Uelow) ❑
�stimated total acres of timber hazvest
If known, estimated acres of timber harvest from Aprill to� Octobex 31 �
If lmown, estimated acres of timbex harvest fi�om June 1 to 7uly 31
Does the project include prescnbed fire? (if yes, repoit acreage below) ❑
Estilnated total acres of prescribed fire
If known, estimated acres of prescribed fire from April 1 to October 31
If known, estimated acres of prescrlbed fire from June 1 to July 31
Does the proj ect install new wind turbines? (if yes, report capacity in MW below) ❑
Estimated wind capacity (MW)
Agencv Deteimuiation:
By signing this form, the action agency detennines that this �roject may affect the NLEB, but that any
resulting incidental take of the NLEB is not prohibited Uy the fival4(d) rule.
If the USFWS does not respond within 30 days from submittal of this form, the action agency may presume
that ifs detennination is informed by tbe best available uiformation and that its project responsibilities under
7(a)(2) with respect to tke NLEB are fulfilled through the iJSFWS 7anuary 5, 2016, Progranunatic BQ. The -
action agency will update this determination annually for niulti-year activities.
The action agency understands that the USFWS �resumes that a11 activiries are implemented as described
herein. The action agency wi11 promptly report any deparlures from tke described activines to ihe appropriate
USFWS Field Office. The action agency will provide the appropriate USFWS Field Office with the results of
any surveys conducted for the NLEB. Involved parties will prompily notify tl�e a}�propriate USFWS Field
Office upon finding a dead, injured, or sick NLEB.
Signature: ��%�6�
Date Submitted: � � �� � � l"
° Any acrivity that temporarily or pennuienlly reinoves suiTable forested habitat, vicluding, but not limited tq tree removal fiom
development, energy production aiid transn7ission, mining, agriculYure, etc. (see page 48 of the BO).
s If ffie proj ect removes Iess than 10 trees and tlie acreage is unknown, report the aereage as less than 0.1 aere. �
e If the activity includes tree clearing in 7une and July, also includa those acreage in April to October.