20160617 Ver 1_401 Application_20160616

Kimley»>Horn
June 20, 2016
Ms. Tasha Alexander
U.S. Army Corps of Engineers
Raleigh Regulatory Field Office
3331 Heritage Trade Drive, Suite 105
Wake Forest, NC 27587
Ms. Karen Higgins
NC Division of Water Resources
401 & Buffer Permitting Unit
512 North Salisbury Street
Raleigh, NC 27604
20 16 0 6, T
t g7o-y
JUN 2 1 2016
RE: Nationwide Permit 12 Application — Rock Creek Sewer Improvements Project,
City of Raleigh, Wake County, North Carolina
Dear Ms. Alexander and Ms. Higgins,
On behalf of the City of Raleigh, Kimley-Horn is submitting the attached application for authorization
under Nationwide Permit (NWP) 12 for the above referenced project. The project proposes to
upgrade the existing, aging, and undersized sewer line currently servicing the North Hills area in
Raleigh in order to accommodate anticipated existing demand while reducing risk of overflows and
failures in Wake County.
The following information is included as part of the application
• PCN Application Form
• Signed Agent Authorization Forms
• Vicinity Map
• USGS Topographic Map
• Jurisdictional Features Map
• USDA/NRCS Sod Survey Map
• Wake County Property Parcels Map
• Stream Data Forms
• EBX Buffer Mitigation Banks Statement of Availability
• Permit Impact Drawings
• Plan Sheets
• NCDWR 401 Application Fee of $570
421 Fayetteville Street, Suite 600, Raleigh, NC 27601

KidepMorn
Page 2
If there is any additional information you need to assist in the processing of this NWP application,
please do not hesitate to contact me at 919-677-2104 or Ross. Sul Iivan@Kimley-Horn com.
Sincerely,,.
B
Ross Sullivan
Environmental Analyst

Office Use Only:
Corps action ID no
DWQ project no.
Form Version 1.3 Dec 10 2008
Page 1 of 13
PCN Form — Version 1 3 December 10, 2008 Version
Pre -Construction Notification CN Form
A. Applicant Information
1.
Processing
1a
Type(s) of approval sought from the
Corps
®Section 404 Permit ❑Section 10 Permit
1 b Specify Nationwide Permit (NWP) number. 12 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
1e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes ® No
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
® Yes
❑ No
1g
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a
Name of project:
Rock Creek Sewer Improvements
2b. County:
Wake
2c.
Nearest municipality / town
Raleigh
2d. Subdivision name
N/A
2e.
NCDOT only, T.I.P. or state
project no:
N/A
3.
Owner Information
3a
Name(s) on Recorded Deed
City of Raleigh Public Utilities Department (Linear Utility Easement)
3b
Deed Book and Page No.
N/A
3c.
Responsible Party (for LLC if
applicable).
Dennis Lassiter
3d
Street address-
222 W. Hargett Street
3e.
City, state, zip
Raleigh, NC 27601
3f
Telephone no.-
919-996-3477
3g.
Fax no.:
919-996-1866
3h.
Email address
dennis [e-mail]
Page 1 of 13
PCN Form — Version 1 3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is:
® Agent ❑ Other, specify:
4b. Name:
4c. Business name
(if applicable).
4d. Street address.
4e. City, state, zip.
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
Ross Sullivan
5b. Business name
(if applicable):
Kimley-Horn
5c. Street address:
421 Fayetteville Street, Suite 600
5d. City, state, zip*
Raleigh, NC 27601
5e. Telephone no
919-677-2104
5f. Fax no.:
5g. Email address
ross [e-mail]
Page 2 of 13
PCN Form — Version 1 3 December 10, 2008 Version

B.
Project Information and Prior Project History
1.
Property Identification
1a
Property identification no (tax PIN or parcel ID)-
N/A (Linear Utility Easement)
1b. Site coordinates (in decimal degrees)-
Latitude 35 829128 Longitude: - 78.636805
(DD DDDDDD) (-DD DDDDDD)
1c.
Property size:
2.85 acres
2.
Surface Waters
2a.
Name of nearest body of water (stream, river, etc.) to
Crabtree Creek
proposed project
2b. Water Quality Classification of nearest receiving water-
C,NSW
2c
River basin:
Neuse
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:
Land use in the vicinity of the project area is urbanized development with a combination of mixed-use commercial
development, high-density residential housing, and patches of natural bottomland forest along Crabtree Creek. The
project corridor follows an unnamed tributary to Crabtree Creek and is bounded on both sides by residential housing.
3b.
List the total estimated acreage of all existing wetlands on the property:
0.0 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property*
1,177 linear feet
3d.
Explain the purpose of the proposed project
The existing sewer line is cracked and failing in places and has experienced several overflows Further, the North Hills
area of Raleigh has experienced an increase in commercial/residential development that exceeds the capacity of the
existing sewer line. The proposed project will upgrade the existing, aging, and undersized sewer line currently servicing
the North Hills area in Raleigh in order to accommodate anticipated existing demand while reducing risk of overflows and
failures.
3e.
Describe the overall project in detail, including the type of equipment to be used.
The project proposes to replace the existing 8" gravity sewer lines with a 16" gravity sewer line mostly within the
boundary of the existing 20' utility easement. The project will stay within the existing 20' utility easement where possible;
however, site constraints require occasional temporary widening of the maintenance corridor by an additional 10' to allow
for a temporary construction easement. Upon completion of the project, the temporary construction easement will be
revegetated to pre-existing conditions The existing 20' utility easement varies from maintained (herbaceous cover) to
infrequently maintained (tree cover), but after completion of the project all of the utility easement will be maintained as
herbaceous cover into the future.
Temporary dewatering of three segments of an adjacent stream (S1) is proposed during construction in order to
minimize/avoid sedimentation to downstream waters Filter fabric will also be applied to the dewatered segments of S1 in
order to catch any sediment that may fall into S1 as a result of construction activities. The filter fabric, along with any
sediment, will be removed upon construction completion in order to minimize sedimentation to downstream waters. No
permanent impacts are proposed within S1 below ordinary high water mark (OHWM); however, impacts to the banks of
S1 will occur as a result of the project Rip rap armoring is proposed along several stretches of S1's bank where erosional
risk to the stream banks exist or where the utility line is close to the stream The rip rap will be keyed in above the OHWM
to match pre-existing contours Typical utility construction equipment will be used including backhoes, excavators, dump
trucks, bulldozers, cranes, and other utility construction equipment will be utilized by the proposed project.
Page 3 of 13
PCN Form — Version 1 3 December 10, 2008 Version

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?
Comments: A preliminary jurisdictional determination request
® Yes ❑ No ❑ Unknown
for the proposed project study area was submitted to the
USACE (Tasha Alexander) on April 5, 2016 and
documentation is pending
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 Kimley-Horn
Name (if known): Ross Sullivan and Jason Hartshorn
Other
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
A preliminary jurisdictional determination request for the proposed project study area was submitted to the USACE
(Tasha Alexander) on April 5, 2016 and documentation is pending
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.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ® No
6b. If yes, explain
Page 4 of 13
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
2 Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a
2b.
2c.
2d
2e
2f.
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P [-IT
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
2h. Comments: No wetland impacts will result from the proposed project
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
3a.
3b.
3c.
3d.
3e.
3f.
3g.
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
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
Site S1
T
Temporary
dewatering and
UT to Crabtree
PER
®Corps
20
381
❑ P ® T
stream bed protection
Creek (S1)
❑ INT
❑ DWQ
Site S2
T
Temporary
dewatering and
UT to Crabtree
PER
®Corps
20
270
❑ P ® T
stream bed protection
Creek (S1)
❑ INT
❑ DWQ
Site S3
Temporary
T
dewatering and
UT to Crabtree
PER
®Corps
20
215
❑ P ® T
stream bed protection
Creek (S1)
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
523
31. Comments: All proposed stream impacts are temporary. The proposed project will temporarily impact three sites along S1
by providing a bypass pump -around prior to and during construction work to replace the sewer pipe in existing City of Raleigh
Public Utilities Department easement adjacent to the stream. Once the stream bed is dry, filter fabric will be applied to the bed
of the stream and will remain until completion of work adjacent to the sites. The filter fabric is intended to catch any
sedimentation that falls into the stream bed during construction, making it easier to clean up upon completion of work and
prevent sedimentation impacts to downstream waters. Construction activities associated with the pump -around will be
conducted during dry weather conditions only. Pump -around operation will not be initiated if rain is forecasted within the time
period in which work is expected to be completed
Page 5 of 13
PCN Form — Version 1 3 December 10, 2008 Version

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U S then individually list all open water impacts below.
4a.
Open water
impact number
— Permanent
(P) or
Temporary (T)
4b.
Name of waterbody
(if applicable)
4c
Type of impact
4d
Waterbody type
4e
Area of impact (acres)
01 ❑P❑T
02 ❑ PEI T
03 ❑P❑T
04 ❑P❑T
4L Total open water impacts
4g. Comments: No open water impacts will result from the proposed construction
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below
5a
Pond ID
number
5b.
Proposed use or purpose of
pond
5c
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
R Total
5g. Comments: No ponds or lakes will be constructed as part of the proposed project
5h. Is a dam high hazard permit required?
❑ Yes ®No If yes, permit ID no.
5i. Expected pond surface area (acres)
N/A
5j. Size of pond watershed (acres)
N/A
5k. Method of construction.
N/A
Page 6 of 13
PCN Form — Version 1 3 December 10, 2008 Version

6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form
6a.
® Neuse ❑TarrPamlico El Other
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f
6g.
Buffer impact
number—
Reason for impact
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P)
Stream name
mitigation
(square feet)
(square feet)
or Temporary
required?
(T)
Replacing Existing
Site B1
Sewer Line in
E] Yes
F-1 P ®T
Existing
Crabtree Creek
No
0
706
Maintained
Easement
Replacing Existing
Site 62
Sewer Line in
Existing
Unnamed Tributary to
El Yes
23785
6598
❑ PH T
Maintained
Crabtree Creek
® No
Easement
Replacing Existing
Site B2
Sewer Line in
Unnamed Tributary to
El Yes
❑ P ® T
Existing
Crabtree Creek
® No
15116
2643
Unmaintained
Easement
Site B2
Temporary
Construction
Unnamed Tributary to
El Yes
17121
7889
❑ P ®T
Easement
Crabtree Creek
® No
Proposed New
Permanent
Site B2
Easement Outside
Unnamed Tributary to
® Yes
437
174
® P ❑ T
of the Existing
Crabtree Creek
❑ No
Easement
(Forested)
Proposed New
Permanent
Site B2
Easement Outside
Unnamed Tributary to
❑ Yes
92
192
❑ P ® T
of the Existing
Crabtree Creek
® No
Easemtent
(Maintained Lawn)
Replacing Existing
Site 63
Sewer Line in
Unnamed Tributary to
El Yes
❑ P ® T
Existing
Crabtree Creek
® No
5099
10
Unmaintained
Easement
Site B3
Temporary
Construction
Unnamed Tributary to
El Yes
2305
684
❑ P ® T
Easement
Crabtree Creek
® No
6h. Total buffer impacts
65212
19046
6i. Comments: A majority of the proposed buffer impacts are temporary impacts for construction access in order to replace a
non -electric utility line within the footprint of an existing 20' maintenance corridor (utility easement). The existing 20'
maintenance corridor varies from maintained lawns to infrequently maintained forested areas An extra 10' of temporary
construction easement is proposed in areas throughout the corridor to allow for additional space to work due to steep
topography and uneven terrain. The only permanent impacts to riparian buffers in the corridor will be due to the creation of
new permanent easement outside of the existing 20' utility easement The proposed new permanent easement is the result of
two shifts to the existing alignment The first alignment shift moves a section of the sewer west and away from S1 to Rock
Page 7 of 13
PCN Form — Version 1.3 December 10, 2008 Version

Creek Drive (STA 22+00) abandoning the old section of the pipe in place The second alignment shift moves the utility
easement west slightly to avoid a recently built retaining wall (STA 26+00). The temporary buffer impacts outside of the
existing 20' utility easement will be restored and revegetated to pre-existing conditions upon completion of the proposed
project. The maintenance corridor and additional new permanent easement will be replanted with herbaceous cover
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Whenever feasible, the proposed project was designed within the existing 20' maintenance easement in order to limit the
amount of new impacts to riparian buffer zones The temporary construction easement will be limited to 10' and will be
revegetated upon project completion Aerial crossings have been utilized to avoid stream impacts and have been elevated to
avoid impacts to normal baseflow in the stream.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Temporary dewatering of three stretches of stream S1 is proposed, through bypass pumping, during construction in order to
minimize sedimentation impacts to downstream waters. The temporary dewatering will occur in locations where the
construction is proposed in close proximity to the stream and there is potential for sediment runoff or impacts to the stream.
Along with temporary dewatering, filter fabric will be placed over the stream bed in temporarily dewatered areas in order to
catch any sediment/fill material that may fall into the stream during construction Upon completion of the work, the filter fabric
along with any sediment/fill material will be removed
A 10' temporary construction easement outside of the existing 20' utility easement was necessary in several locations
throughout the project corridor for construction equipment access, however, the temporary construction easement areas will
be restored and revegetated to pre-existing conditions upon completion of the project. The existing 20' utility easement varies
from maintained grassy lawns to unmaintained forested areas All of the 20' utility easement will be revegetated and
maintained into the future
Erosion and sediment control measures will be utilized throughout the construction process to protect surface water resources
in the project vicinity. All disturbed areas will be returned to pre -construction contours once construction is complete
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
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, mitigation is required by (check all that 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. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: See the attached Statement of Availability from Resource Environmental Solutions, LLC (RES)
3b Credits Purchased (attach receipt and letter)
Type Riparian
Buffer
Quantity 1311
Page 8 of 13
PCN Form — Version 1 3 December 10, 2008 Version

3c. Comments: Riparian buffer credits have been secured through RES banks within the project watershed. See the attached
SOA
4. Complete if Making a Payment to In -lieu Fee Program
4a Approval letter from in -lieu fee program is attached
❑ Yes
4b. Stream mitigation requested:
linear feet
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.
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
buffer mitigation?
Z Yes ❑ No
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
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e
Required mitigation
(square feet)
Zone 1
Proposed New Permanent
Easement Outside of the
Existing Easement (Forested)
437
3 (2 for Catawba)
1311
Zone 2
0
0
1.5
0
6f Total buffer mitigation required:
1311
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e g , payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
Mitigation for unavoidable impacts to the riparian buffer of S1 have been proposed through payment into a private
mitigation bank sponsored by RES The SOA for 1311 riparian buffer credits is attached, and credits will be purchased
prior to construction.
6h Comments: N/A
Page 9 of 13
PCN Form — Version 1 3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified
® Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes No
Comments: No stormwater will be collected or discharged as a result of this project
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
<1% %
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: The impervious area along the sanitary
sewer easement is existing. No new impervious area will be added as a result of the sewer upgrade.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
N/A
® 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 Stormwater Review
3a. In which local government's jurisdiction is this project?
Raleigh
® Phase II
3b. Which of the following locally -implemented stormwater management programs
® NSW
El USMP
apply (check all that apply)
❑ 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. DWQ 401 Unit Stormwater Review
5a Does the Stormwater Management Plan meet the appropriate requirements?
® Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
® Yes ❑ No
Page 10 of 13
PCN Form — Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. 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)?
1c 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
❑ Yes ❑ No
letter)
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) N/A
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 will not result in any additional development. The project is upsizing an undersized sewer line from 8" to 16" in
order to meet the current needs in the North Hills area of Raleigh
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.
Wastewater will not be generated as a result of the proposed project. The sewer line improvement will carry existing flows
to meet current demand.
Page 11 of 13
PCN Form — Version 1 3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
® Yes ❑ No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
[:1 Raleigh
5c If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
According to the NC Natural Heritage Program Element Occurrence Database (updated October 2015), no known
occurrences of any federally threatened or endangered species are present in or within 1.0 mile of the project area.
Suitable habitat is not present within the project area for red -cockaded woodpecker. The natural areas observed within
the project corridor have a canopy dominated by a mix of pine and hardwood trees and a dense understory of hardwood
species Suitable habitat for dwarf wedgemussel is also not present within the project corridor. The stream in the project
area is severely impacted by runoff and sedimentation, and the stream is fragmented by natural (bedrock) and man-made
(sewer pipe, perched culverts) barriers that prevent the migration of fish through the channel. Further, the stream drains
to Crabtree Creek which is a 303(d) listed stream for a degraded benthic community and for PCB fish tissue advisory.
Suitable habitat is present within the project corridor for Michaux!s sumac. Kimley-Horn biologists conducted pedestrian
surveys within the corridor on October 26, 2015 and observed no Michaux's sumac within the project corridor. It has been
determined that the proposed project will have no effect on Michaux s sumac
There is also suitable roosting habitat for the northern long-eared bat within the project corridor, however there are no
known hibernacula sites or known maternity roosts within 1 mile of the project corridor. Due to the lack of known
hibernacula or maternity roosts, and the lack of known occurrences within 1.0 mile of the study area, the proposed project
will have no effect on northern long-eared bat.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
The NOAA Essential Fish Habitat Mapper (reviewed February 2016) was reviewed and no essential fish habitat or habitat
areas of particular concern were found within the project area
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
® Yes ❑ 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?
The NCDENR State Historic Properties Office (SHPO) HPOWEB GIS service records were reviewed (March 2, 2016),
and no historic resources occur within the project area The closest historic resource (HPO Site ID: WA4523; Status. SL)
is located approximately 1,700 feet west from the project study area. Since the proposed project will replace an existing
underground utility line in a highly developed area, the proposed project will have no effect on the historic property or any
other cultural or historic site
Page 12 of 13
PCN Form — Version 1 3 December 10, 2008 Version

8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain*
® Yes ❑ No
8b If yes, explain how project meets FEMA requirements: The proposed project will not alter existing contours, existing
percent of impervious surface, or the vegetation cover type within the FEMA regulated floodway.
8c What source(s) did you use to make the floodplain determination? FEMA DFIRM Panel 3720170500J (Eff. 5/2/2006) was
reviewed and the southern length of the project corridor is within the FEMA mapped flood hazard zone
Ross Sullivan
June 20, 2016
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided
Page 13 of 13
PCN Form — Version 1 3 December 10, 2008 Version

AGENT AUTHORIZATION FORM
Name: Dennis Lassiter, PE; City of Raleigh Public Utilities Department
Address: PO Box 590, Raleigh, NC 27602
Phone: [phone]
Project Name/Description: Rock Creek Sewer Improvements
Date: March 7, 2016
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
Attention: Tasha Alexander
Field Office: Raleigh Re ug latoiy Field Office
Re: Wetland Related Consulting and Permitting
To Whom It May Concern:
The City of Raleigh hereby designates and authorizes Kimley-Horn and Associates, Inc. to act in my/our
behalf as my/our agent solely for the purpose of processing Jurisdictional Determinations, Section 404
permits/Section 401 Water Quality Certifications applications, and Neuse River Basin Riparian Buffer
Determinations, and to furnish upon request supplemental information in support of applications, etc.
from this day forward until successful completion of the permitting process or revocation by the owner.
In addition, I, the undersigned, a duly authorized owner of record of the easement identified herein, do
authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps) to enter
upon the easement herein described for the purpose of conducting on-site investigations and issuing a
determination associated with Waters of the U.S. subject to Federal jurisdiction under Section 404 of the
Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899.
f
Authorized this the 7 day of r % , ZO
Print Property Owner's Name
Cc: Karen Higgins
NC Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
zl2& -
-
Property Owner's Signature

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0 Wake County 0 2,000 4,000
eec 'a ePie � �, �� 0°'``,:..`. Feet
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North
kCarolina
WAKE
South
Carolina LEE JOHNSTON
Georgia Atlantic Ocean
0 40 80 0 6HAI1
RIETT
momE= Miles mom= Miles
Figure 1: Vicinity Map
Rock Creek Sewer Improvements
Wake County
Raleigh, North Carolina

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Figure 2: USGS Topographic Map
Rock Creek Sewer Improvements
Wake County
Raleigh, North Carolina

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Affected Parcels
Project Study Area
Wake County Parcels (May 2016)
4
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Figure 5: Affected Parcels Table
LABEL
PIN—NUM OWNER
ADDRESS
1
1705880219 STATE EMPLOYEES CREDIT UNION
3808 SIX FORKS RD
PO BOX 26807 RALEIGH NC 27611-6807
2
1705777740 WINDSOR CREST PROPERTIES INC
10014 CHAPEL HILL RD
MORRISVILLE NC 27560-9399
3
1705777611 MCCLAIN FAMILY HOLDINGS LLC
2113 FALLON OAKS CT
RALEIGH NC 27608-1676
4
1705776594 COFFEY, RALPH D III COFFEY, LISA W
3626 ROCK CREEK DR
RALEIGH NC 27609-7127
5
1705776443 SARANT, JAMES N JR SARANT, GINA R
3620 ROCK CREEK DR
RALEIGH NC 27609-7127
61
1705776364 BAIRD, STANFORD D BAIRD, ANNA L
3614 ROCK CREEK DR
RALEIGH NC 27609-7127
7
1705776247 GUIDO, RICHARD L
3610 ROCK CREEK DR
RALEIGH NC 27609-7127
8 '
' 1705775198 PITCHFORD, JANE DEMPSEY
219 COUNTRY CLUB DR
GREENVILLE NC 27834-6218
9
1705775099 UDELL, IAN W UDELL, ERIKA A
3600 ROCK CREEK DR
RALEIGH NC 27609-7127
10
1705776001 HENRY, CATHERINE LORAH HENRY, JONATHAN KEITH
3524 ROCK CREEK DR
RALEIGH NC 27609-7125
11
1705765994 HODGES, DEMPSEY HODGES, AMY
3520 ROCK CREEK DR
RALEIGH NC 27609-7125
12
1705765897 DISBROW, JARRETT THOMAS DISBROW, STEPHANIE CHAPPELL
3516 ROCK CREEK DR
RALEIGH NC 27609-7125
13
1705777292 SIGGINS, PETER SIGGINS, JULIE A
3608 BROWNING PL
RALEIGH NC 27609-7142
14
1705777170 FLOYD, CHRISTOPHER S FLOYD, PAMELA
3612 BROWNING PL
RALEIGH NC 27609-7142
15
1705767997 LIN, ARTHUR H T LIN, YI KUNG L C
3614 BROWNING PL
RALEIGH NC 27609-7142
16
1705766800 TAYLOR, RITCHIE W TAYLOR, ELIZABETH C
3510 ROCK CREEK DR
RALEIGH NC 27609-7125
17
1705765793 ALFORD, JOHN BLAKELY ALFORD, SHERYL AUSTIN
3508 ROCK CREEK DR
RALEIGH NC 27609-7125
•18
1705765647 SHUIRMAN, RYAN M SHUIRMAN, DANIELLE F
3504 ROCK CREEK DR
RALEIGH NC 27609-7125
19
1705764453 WRIGHT, CHARLES E WRIGHT, JENNINGS S
113 DICKINSON LN
BEAUFORT NC 28516-7531
20
1705766662 FORTIER, MARK J FORTIER, JULIA A
3505 TENNYSON PL
RALEIGH NC 27609-7130
21
1705766449 WRAP LLC
3901 BARRETT DR STE 102
RALEIGH NC 27609-6611
22
1705763390 MORGAN, PAUL H MORGAN, NATALYLA LEONIDOVNA
3416 ROCK CREEK DR
RALEIGH NC 27609-7124
23
1705765269 MAY, DAVID A MAY, LISA C
3337 COLERIDGE DR
RALEIGH NC 27609-7203
24
1705763273 SMITH, TODD M WEATHERS, MICHELE M
3412 ROCK CREEK DR
RALEIGH NC 27609-7124
25
1705765169 ODEA, SARAH S ODEA, THOMAS F
3333 COLERIDGE DR
RALEIGH NC 27609-7203
26
1705763161 FAHMY, YUSEF
2 SAREVA PL
ASHEVILLE NC 28804-2238
27
1705765160 RIDDELL, COLIN W RIDDELL, KIMBERLY C
3327 COLERIDGE DR
RALEIGH NC 27609-7203
28 >
1705765070 SELDEN, WILLIAM W SELDEN, LUCELIA W JR
3323 COLERIDGE DR
RALEIGH NC 27609-7203
29
1705753936 TIMBERLAKE, BARBARA 0
3400 ROCK CREEK DR
RALEIGH NC 27609-7124
30
1705755960 JACKSON, GREGORY LJACKSON, LINDSAY D
3319 COLERIDGE DR
RALEIGH NC 27609-7203
31
1705755872 BYRD, DAVID N
3317 COLERIDGE DR
RALEIGH NC 27609-7203
32
1705752875 MULLAN, JAMES B
3320 ROCK CREEK DR
RALEIGH NC 27609-7122
33
1705752729 BRAUN, ERIC M BRAUN, ERIKA L
2707 ROYSTER ST
RALEIGH NC 27608-1529
34
1705751764 FRITTER, MATTHEW C FRITTER, KATHERINE G
3312 ROCK CREEK DR
RALEIGH NC 27609-7122
35
1705751606 WILSON, VICTORIA K KELSEY, W KENT
3304 DELL DR
RALEIGH NC 27609-7118
36
1705754534 MOORE, THOMAS EDWIN MOORE, SARAH H
3622 BELL UE RD
RALEIGH NC 27609-7106
37
17057552081SINGLETON, GARY F
1121 W DREWRY LN
RALEIGH NC 27609-7713
381
1705756314 1 REARDON, DAVID 5
1119 W DREWRY LN
RALEIGH NC 27609-7713

North Carolina Division of Water Quality - Stream Identification Form, Version 4.11
Date. 10/20/2015
Project/Site: Rock Creek Sewer
Improvements (S1)
Latitude: 35.828217
Evaluator. R Sullivan/J Hartshorn
(Kimley-Hom)
County Wake County
Longitude. 35.828217
Total Points: 325
Stream Determination (ci
Other
Stream is at least intermittent
Ephemeral Intermittenerennial
e g Quad Name Raleigh West
if a 19 or perennial if z30
1
2
A. Geomorphology Subtotal = 17
Absent
Weak
Moderate Strong
Score
1a. Continuity of channel bed and bank
0
1
2
3
3
2. Sinuosity of channel along thalweg
0
1
2
3
2
3. In -channel structure. ex. riffle -pool, step -pool,
ripple -pool sequence
0
1
2
3
3
4. Particle size of stream substrate
0
1
2
3
3
5. Active/relic floodplain
0
1
2
3
1
6. Depositional bars or benches
0
1
2
3
1
7. Recent alluvial deposits
0
1
2
3
1
8. Headcuts
0
1
2
3
0
9. Grade control
0
0.5
1
1.5
1.5
10. Natural valley
0
0.5
1
1.5
1.5
11. Second or greater order channel
No = 0
Yes = 3
0
artificial ditches are not rated; see discussions in manual
B. Hydrology Subtotal = 9.5
12.
Presence of Baseflow
0
1
2
3
2
13
Iron oxidizing bacteria
0
1
2
3
1
14.
Leaf litter
1 5
1
0.5
0
1.5
15.
Sediment on plants or debris
0
0.5
1
1.5
1
16.
Organic debris lines or piles
0
05
1
1.5
1
17.
Soil -based evidence of high water table'?
No = 0
1.5
Yes = 3
26. Wetland plants in streambed
3
C. Biology Subtotal =
18. Fibrous roots in streambed
3 2
1
0
3
19. Rooted upland plants in streambed
3 2
1
0
3
20. Macrobenthos note diversity and abundance
0 1
2
3
0
21. Aquatic Mollusks
0 1
2
3
0
22. Fish
0 0.5
1
1 5
0
23. Crayfish
0 0.5
1
1.5
0
24 Amphibians
0 0.5
1
1.5
0
25. Algae
0 0.5
1
1.5
0
26. Wetland plants in streambed
FACW = 0.75; OBL = 1 5; Other = 0
0
'perennial streams may also be identified using other methods See p 35 of manual
Notes. Stream S1 is an unnamed perennial channel that drains to Crabtree
Creek. The channel has downcut to bedrock throughout much of the reach
The channel is piped under multiple roads, and a sewer utility easement/pipe
crosses the stream in a couple locations. The stream had moderate flow and is
closely bounded on both sides by residential development.

USACE AID# DWQ # Site # (indicate on attached map)
STREAM QUALITY ASSESSMENT WORKSHEETr
Provide the following information for the stream reach under assessment:
1. Applicant's name: City of Raleigh
2. Evaluator's name: R. Sullivan/J. Hartshorn (Kimley-Horn)
3. Date of evaluation: 10/20/2015
4. Time of evaluation: 2:00 pm
5. Name of stream: Stream S1
6. River basin: Neuse
7. Approximate drainage area: 203 acres
8. Stream order: First Order
9. Length of reach evaluated: 3,000 linear feet
10. County: Wake County
11. Site coordinates (if known): prefer in decimal degrees.
Latitude (ex 34 872312):
35.828217
12. Subdivision name (if any): N/A
Longitude (ex -77 556611): 35.828217
Method location determined (circle): aPS ✓❑I opo Sheetlbrtho (Aerial) Photo/GIS[Dther GISather
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
The reach was evaluated south of Six Forks Rd and west of Rock Creek Drive
14. Proposed channel work (if any): N/A
15. Recent weather conditions: No rain within 3 days prior to the site visit
16. Site conditions at time of visit: Sunny with scant cloud cover and temps ranging from mid-30s to low 70s (F)
17. Identify any special waterway classifications known: Section 10 MTidal Waters Essential Fisheries Habitat
nTrout WatersOutstanding Resource Waters �✓ Nutrient Sensitive Waters Dwater Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? NO If yes, estimate the water surface area:.
19. Does channel appear on USGS quad map? YES 20. Does channel appear on USDA Soil Survey? YES
21. Estimated watershed land use: 50 % Residential 35 % Commercial _% Industrial _% Agricultural
15 % Forested _% Cleared / Logged _% Other (
22. Bankfull width: 15'-301 23. Bank height (from bed to top of bank): 5'-15'
24. Channel slope down center of stream: ✓Flat (0 to 2%) _oGentle (2 to 4%) Dmoderate (4 to 10%) DSteep (>10%)
25. Channel sinuosity: ElStraight Occasional bends DFrequent meander Very sinuous Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
Total Score (from reverse): 38 Comments:
Stream S1 is an unnamed perennial channel that drains to Crabtree Creek. The channel has downcut to bedrock throughout
much of the reach. The channel is piped under multiple roads, and a sewer utility easement/pipe crosses the stream in a
couple locations The stream had moderate flow and is closely bounded on both sides by residential development
Evaluator's Signature �° "� YUJIW-a/m Date 10/20/2015
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please call 919-876-8441 x 26.

Stream S1
STREAM QUALITY ASSESSMENT WORKSHEET
" These charactenstics are not assessed in coastal streams.
ECOREGION POINT
RANGE
#
CHARACTERISTICS
SCORE
Coastal
Piedmont
Mountain
lno
Presence of flow / persistent pools in stream
0 — 4
0-5
3
flow or saturation = 0; strongflow = maxpoints)0-5
2
Evidence of past human alteration
0-6
0-5
0-5
1
extensive alteration = 0; no alteration = maxpoints)
3
Riparian zone
0-6
0-4
0-5
2
no buffer = 0; contiguous, wide buffer = maxpoints)
4
Evidence of nutrient or chemical discharges
0-5
0-4
0-4
2
extensive discharges = 0; no discharges = maxpoints)
5
Groundwater discharge
0 — 4
0-4
3
no discharge = 0; springs, see s, wetlands etc. = maxpoints)0-3
6
Presence of adjacent floodplain
0-4
0-4
0-2
1
no floodplain = 0; extensive floodplain = maxpoints)
aEntrenchment
/ floodplain access
0— 5
0— 4
0— 2
Q
(deeply entrenched = 0; frequent flooding= max points)
8
Presence of adjacent wetlands
0-6
0-4
0-2
0
no wetlands = 0• large adjacent wetlands = max points)
9
Channel sinuosity
0-5
0-4
0-3
3
extensive channelization = 0 • natural meander = maxpoints)
10
Sediment input
0-5
0-4
0-4
1
extensive deposition-- 0; little or no sediment = maxpoints)
Size & diversity of channel bed substrate
11
NA*
0-4
0-5
3
fine, homogenous = 0; large, diverse sizes = maxpoints)
12
Evidence of channel incision or widening
0-5
0-4
0-5
0
�+
(deeply incised = 0; stable bed & banks = maxpoints)
F*
13
Presenceof major bank failures
0-5
0 — 5
0-5
2
severe erosion = 0; no erosion, stable banks = max oints
90
Root depth and density on banks
14
0-4
0-5
3
H
no visible roots = 0; dense roots throughout = max points)0-3
Impact
Imact by agriculture, livestock, or timber production
0-5
0-4
0-5
2
substantial im act =0• no evidence-- oints
16
Presence of riffle-pool/ripple-pool complexes
0-3
0-5
0-6
4
no riffles/ripples or pools = 0• well-developed = maxpoints)
1
Habitat complexity
0-6
0 — 6
0-6
2
little or no habitat = 0; frequent, varied habitats = max points)
18
Canopy coverage over streambed
no shadingvegetation = 0• continuous canopy= max points)
0— 5
0— 5
0— 5
3
19
Substrate embeddedness
NA*
0-4
0-4
3
(deeply embedded = 0 • loose structure = max
20
Presence of stream invertebrates (see page 4)
0-4
0-5
0-5
no evidence = 0; common, numerous es = maxpoints)0
C7
21
Presence of amphibians
0-4
0-4
0-4
0
O
no evidence = 0; common, numerous types = maxpoints)
0
22
Presence of fish
0-4
0-4
0-4
0
no evidence = 0; common, numerous types = maxpoints)
23
Evidence of wildlife use
0— 6
0— 5
0— 5
0
no evidence = 0; abundant evidence = max points)
Total Points Possible
100
100
100
TOTAL SCORE (also enter on first page) 1
38
" These charactenstics are not assessed in coastal streams.

Vires
EBX Buffer Mitigation Banks
Statement of Availability April 28, 2016
NC Division of Water Resources
Cherri Smith
512 N. Salisbury St.
Archdale Building, 9th floor
Raleigh, NC 27604
Re Project: Rock Creek Sewer Improvements
This document confirms that City of Raleigh (Applicant) for the Rock Creek Sewer Improvements
(Project) has expressed an interest to utilize 1,311 Square Feet of Riparian Buffer Mitigation Credits
from one of the following banks, EBX Neuse Riparian Buffer Umbrella Mitigation Bank, EBX Upper
Neuse Riparian Buffer Umbrella Mitigation Bank, or the EBX-EM Forrest Creek Bank. Specific bank
sites that will be debited will be either Arrington Bridge H, Buffalo Branch, Rudolph, Selma Mill, Cedar
Grove, Ezell, Hatley and/or Forrest Creek, all located in HUC 03020201. As the official Bank Sponsor,
EBX, attests to the fact that mitigation is available for reservation at this time.
These mitigation credits are not considered secured, and consequently are eligible to be used for alternate
purposes by the Bank Sponsor, until payment in full is received from the Applicant resulting in the
issuance of a Mitigation Credit Transfer Certificate by the bank acknowledging that the Applicant has
fully secured credits from the bank and the Banker has accepted full responsibility for the mitigation
obligation requiring the credits/units.
The Banker will issue the Mitigation Credit Transfer Certificate within three (3) days of receipt of the
purchase price. Banker shall provide to Applicant a copy of the Mitigation Credit Transfer Certificate and
a documented copy of the debit of credits from the Bank Official Credit Ledger(s), indicating the permit
number and the resource type secured by the applicant. A copy of the Mitigation Credit Transfer
Certificate, with an updated Official Credit Ledger will also be sent to regulatory agencies showing the
proper documentation.
Please contact me at 919-209-1052 or cconderp_res.us if you have any questions or need additional
information.
Best Regards,
Cara S. Conder
Resource Environmental Solutions, LLC
302 Jefferson Street, Suite 110
Raleigh, NC 27605

Jurisdictional Determination Request
bS'Arn-4 &bras
of Engineers,
W Immg 6o Dlet.d
This form is intended for use by anyone requesting a jurisdictional determination (JD) from the
U.S. Army Corps of Engineers, Wilmington District (Corps). Please include all supporting
information, as described within each category, with your request. You may submit your request
to the appropriate Corps Field Office (or project manager, if known) via mail, electronic mail, or
facsimile. A current list of county assignments by Field Office and project manager can be
found on-line at: http://www.saw.usace.army.mil/Missions/Regulato!yPermitPro_r�px , by
telephoning: 910-251-4633, or by contacting any of the field offices listed below:
ASHEVILLE REGULATORY FIELD OFFICE
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number [phone]
Fax Number [phone]
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
General Number [phone]
Fax Number [phone]
WASHINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number [phone]
Fax Number [phone]
WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number 910-251-4633
Fax Number [phone]
Version: December 2013 Page 1

Jurisdictional Determination Request
INSTRUCTIONS
All requestors must complete Parts A, B, C, D, E and F.
NOTE TO CONSULTANTS AND AGENCIES. If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part G.
NOTE ON PART D — PROPERTY OWNER AUTHORIZATION: Please be aware that all JD
requests must include the current property owner authorization for the Corps to proceed with the
determination, which may include inspection of the property when necessary This form must be
signed by the current property owner to be considered a complete request.
NOTE ON PART D - NCDOT REQUESTS: Property owner authorization/notification for JD
requests associated with North Carolina Department of Transportation (NCDOT) projects will be
conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS: A Corps approved or preliminary JD 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 also request a certified wetland determination from the local office of the Natural
Resources Conservation Service, prior to starting work
Version: December 2013 Page 2

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address:
City, State:
County:
Directions:
N/A (Linear Utility Easement)
Raleigh, North Carolina (NC)
Wake
See Figure 1 Vicinity Map
Parcel Index Number(s) (PIN)
B. REQUESTOR INFORMATION
Name:
Mailing Address.
Telephone Number:
Electronic Mail Addressl
N/A (Linear Utility Easement)
Ross Sullivan, Kimley-Horn
421 Fayetteville Street, Suite 600, Raleigh, NC 27601
919-677-2104
ross sullivan@kimley-hom com
Select one:
❑ I am the current property owner.
❑✓ I am an Authorized Agent or Environmental Consultant
❑ Interested Buyer or Under Contract to Purchase
❑ Other, please explain.
C. PROPERTY OWNER INFORMATION
Name: Dennis Lassiter
Mailing Address: City of Raleigh Public Utilities Department
P.O. Box 590; Raleigh, NC 27602
Telephone Number. 919-996-3477
Electronic Mail Address 3: [e-mail]
❑ Proof of Ownership Attached (e.g. a copy of Deed, County GIS/Parcel/Tax Record data)
1 If available
z Must attach completed Agent Authorization Form
3 If available
Version: December 2013 Page 3

Jurisdictional Determination Request
D. PROPERTY OWNER CERTIFICATION
I, the undersigned, a duly authorized owner of record of the property/properties identified herein,
do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps)
to enter upon the property herein described for the purpose of conducting on-site investigations
and issuing a determination associated with Waters of the U.S. subject to Federal jurisdiction
under Section 404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of
1899.
Property Owner (please print) Date
Property Owner Signature
E. JURISDICTIONAL DETERMINATION TYPE
Select One:
❑✓ I am requesting that the Corps provide a preliminary JD for the property identified herein.
This request does include a delineation.
❑ I am requesting that the Corps provide a preliminary JD for the property identified herein.
This request does NOT include a delineation
❑ I am requesting that the Corps investigate the property/project area for the presence or
absence of WoUS5 and provide an approved JD for the property identified herein This
request does NOT include a request for a verified delineation
❑ I am requesting that the Corps delineate the boundaries of all WoUS on a property/project
area and provide an approved JD (this may or may not include a survey plat)
I am requesting that the Corps evaluate and approve a delineation of WoUS (conducted
by others) on a property/project area and provide an approved JD (may or may not
include a survey plat).
4 For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E
5 Waters of the United States
Version: December 2013 Page 4

Jurisdictional Determination Request
F. ALL REQUESTS
❑✓ Map of Property or Project Area (attached). This Map must clearly depict the boundaries
of the area of evaluation
❑✓ Size of Property or Project Area 2_8
acres
III verify that the property (or project) boundaries have recently been surveyed and marked
by a licensed land surveyor OR are otherwise clearly marked or distinguishable.
G. JD REQUESTS FROM CONSULTANTS OR AGENCIES
(1) Preliminary JD Requests:
17Completed and signed Preliminary Jurisdictional Determination Form6.
Project Coordinates. 35.827972
Latitude -78.637258 Longitude
Maps (no larger than 11x17) with Project Boundary Overlay:
❑✓ Large and small scale maps that depict, at minimum: streets, intersections, towns
✓❑ Aerial Photography of the project area
❑✓ USGS Topographic Map
❑✓ Soil Survey Map
F] Other Maps, as appropriate (e g National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
6 See Appendix A of this Form. From Regulatory Guidance Letter No. 08-02, dated June 26, 2008
Version: December 2013 Page 5

Jurisdictional Determination Request
Delineation Information (when applicable):
Wetlands:
❑ Wetland Data SheetS8
Tributaries:
❑✓ USACE Assessment Forms
❑ Upland Data Sheets Other Assessment Forms
(when appropriate)
❑ Landscape Photos, if taken
❑✓ Field Sketch overlain on legible Map that includes:
■ All aquatic resources (for sites with multiple resources, label and identify)
■ Locations of wetland data points and/or tributary assessment reaches
■ Locations of photo stations
■ Approximate acreage/linear footage of aquatic resources
(2) Approved JDs including Verification of a Delineation:
❑ Project Coordinates:
Latitude
Longitude
Maps (no larger than 11x17) with Project Boundary Overlay:
❑ Large and small scale maps that depict, at minimum: streets, intersections, towns
❑ Aerial Photography of the project area
❑ USGS Topographic Map
❑ Soil Survey Map
❑ Other Maps, as appropriate (e.g. National Wetland Inventory Map, Proposed Site Plan,
previous delineation maps)
1987 Manual Regional Supplements and Data forms can be found at:
http•//www.usace.armv.mil/Missions/CivilWorks/ReeulatoryProsramandPermits/reg supp.aspx
Wetland and Stream Assessment Methodologies can be found at:
http://Portal.ncdenr.org/c/document library/get file?uuid=76f3c58b-dab8-4960-ba43-45b7faf06f4c&groupld=38364 and,
http://www.saw.usace.army.mil/Portals/59/docs/regulatory/publicnotices/2013/NCSAM Draft User Manual 130318 pdf
8 Delineation information must include, at minimum, one wetland data sheet for each wetland/community type.
Version: December 2013 Page 6

Jurisdictional Determination Request
Delineation Information (when applicable)
Wetlands:
❑ Wetland Data Sheets9
Tributaries:
❑ USACE Assessment Forms
❑ Upland Data Sheets ❑ Other Assessment Forms
(when appropriate)
❑ Landscape Photos, if taken
❑ Field Sketch overlain on legible Map that includes:
• All aquatic resources (for sites with multiple resources, label and identify)
• Locations of wetland data points and/or tributary assessment reaches
• Locations of photo stations
• Approximate acreage/linear footage of aquatic resources
Supporting Jurisdictional Information (for Approved JDs only)
❑ Approved Jurisdictional Determination Form(s) (also known as "Rapanos
Form(s)")
❑ Map(s) depicting the potential (or lack of potential) hydrologic connection(s),
adjacency, etc to navigable waters
9 Delineation information must include, at minimum, one wetland data sheet for each wetland/community type.
Version: December 2013 Page 7
,,, _-_._

Jurisdictional Determination Request
I. REQUESTS FOR CORPS APPROVAL OF SURVEY PLAT
Prior to final production of a Plat, the Wilmington District recommends that the Land
Surveyor electronically submit a draft of a Survey Plat to the Corps project manager for
review.
Due to storage limitations of our administrative records, the Corps requires that all hard-
copy submittals include at least one original Plat (to scale) that is no larger than 11"x 1 T'
(the use of match lines for larger tracts acceptable). Additional copies of a plat, including
those larger than 11"x1T', may also be submitted for Corps signature as needed. The
Corps also accepts electronic submittals of plats, such as those transmitted as a Portable
Document Format (PDF) file. Upon verification, the Corps can electronically sign these
plats and return them via e-mail to the requestor.
(1) PLATS SUBMITTED FOR APPROVAL
❑ Must be sealed and signed by a licensed professional land surveyor
❑ Must be to scale (all maps must include both a graphic scale and a verbal scale)
❑ Must be legible
❑ Must include a North Arrow, Scale(s), Title, Property Information
❑ Must include a legible WoUS Delineation Table of distances and bearings/metes
and bounds/GPS coordinates of all surveyed delineation points
❑ Must clearly depict surveyed property or project boundaries
Must clearly identify the known surveyed point(s) used as reference (e.g. property
corner, USGS monument)
nWhen wetlands are depicted:
• Must include acreage (or square footage) of wetland polygons
• Must identify each wetland polygon using an alphanumeric system
Version: December 2013 Page 8

Jurisdictional Determination Request
❑ When tributaries are depicted:
• Must include either a surveyed, approximate centerline of tributary with
approximate width of tributary OR surveyed Ordinary High Water Marks
(OHWM) of tributary
• Must identify each tributary using an alphanumeric system
• Must include linear footage of tributaries and calculated area (using approximate
widths or surveyed OHWM)
• Must include name of tnbutary (based on the most recent USGS topographic
map) or, when no USGS name exists, identify as "unnamed tributary"
all depicted WoUS (wetland polygons and tributary lines) must intersect or tie -to
surveyed project/property boundaries
Must include the location of wetland data points and/or tributary assessment
reaches
F] Must include, label accordingly, and depict acreage of all waters not currently
subject to the requirements of the CWA (e.g. "isolated wetlands", "non -
jurisdictional waters"). NOTE: An approved JD must be conducted in order to
make an official Corps determination that a particular waterbody or wetland is not
jurisdictional.
F] Must include and survey all existing conveyances (pipes, culverts, etc.) that
transport WoUS
Version: December 2013 Page 9

Jurisdictional Determination Request
(2) CERTIFICATION LANGUAGE
❑ When the entire actual Jurisdictional Boundary is depicted:
include the following Corps Certification language:
"This certifies that this copy of this plat accurately depicts the boundary of the jurisdiction
of Section 404 of the Clean Water Act as determined by the undersigned on this date.
Unless there is a change in the law or our published regulations, the determination of
Section 404 jurisdiction may be relied upon for a period not to exceed five (5) years from
this date. The undersigned completed this determination utilizing the appropriate Regional
Supplement to the 1987 U.S. Army Corps of Engineers Wetlands Delineation Manual."
Regulatory Official:
Title:
Date:
USACE Action ID No.:
❑ When uplands may be present within a depicted Jurisdictional Boundary
include the following Corps Certification language:
"This certifies that this copy of this plat identifies all areas of waters of the United States
regulated pursuant to Section 404 of the Clean Water Act as determined by the
undersigned on this date. Unless there is change in the law or our published regulations,
this determination of Section 404 jurisdiction may be relied upon for a period not to exceed
five years from this date. The undersigned completed this determination utilizing the
appropriate Regional Supplement to the 1987 U.S. Army Corps of Engineers Wetlands
Delineation Manual."
Regulatory Official:
Title:
Date:
USA CE Action ID No.:
Version: December 2013 Page 10

Jurisdictional Determination Request
(3) GPS SURVEYS
For Surveys prepared using a Global Positioning System (GPS), the Survey must include
all of the above, as well as:
❑ be at sub -meter accuracy at each survey point
include an accuracy verification:
One or more known points (property corner, monument) shall be located with the
GPS and cross-referenced with the existing traditional property survey (metes and
bounds).
❑ include a brief description of the GPS equipment utilized.
Version: December 2013 Page 11

ATTACHMENT A
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD):
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
Kimley-Hom, ATTN Ross Sullivan on behalf of the City of Raleigh Public Utilities Department
421 Fayetteville Street, Suite 600, Raleigh, NC 27601
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT
SITES)
State: NC County/parish/borough: Wake City: Raleigh
Center coordinates of site (lat/long in degree decimal format):
Lat. 35827972 ON; Long. -78.637258 °W.
Universal Transverse Mercator: 17
Name of nearest waterbody: Crabtree creek
Identify (estimate) amount of waters in the review area:
Non -wetland waters:
1,177 linear feet: 20 width (ft) and/or N/A acres.
Cowardin Class: Rivenne
Stream flow: Perennial
Wetlands: NSA acres.
Cowardin Class: N/A
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal: N/A
Non -Tidal: NSA
1

E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
❑ Office (Desk) Determination. Date:
❑ Field Determination. Date(s):
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: Kimley-Horn
❑ Data sheets prepared/submitted by or on behalf of the
applic 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: Raleigh West, 1:24,000
❑✓ USDA Natural Resources Conservation Service Soil Survey.
Citation: Wake County (1970)
❑ 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: ❑✓ Aerial (Name & Date): NC oneMap Latest orthoimagery or
❑ Other (Name & Date):
❑ Previous determination(s). File no. and date of response letter:
❑ Other information (please specify):
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.
3

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
necessarily been verified by the Corps and should not be relied upon for
later jurisdictional determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
II
�# Apri15, 2016
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)

Estimated
Site
Cowardin
amount of
Class of
number
Latitude
Longitude
Class
aquatic
aquatic
resource in
resource
review area
S1
35.828188
-78.637308
Riverine
1,177 linear
non -section
feet
10 — non -tidal

AGENT AUTHORIZATION FORM
Name: Dennis Lassiter, PE; City of Raleigh Public Utilities Department
Address: PO Box 590, Raleigh, NC 27602
Phone: [phone]
Project Name/Description: Rock Creek Sewer Improvements
Date: March 7, 2016
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
Attention: Tasha Alexander
Field Office: Raleigh Regulatory Field Office
Re: Wetland Related Consulting and Permitting
To Whom It May Concern:
The City of Raleigh hereby designates and authorizes Kimley-Horn and Associates, Inc. to act in my/our
behalf as my/our agent solely for the purpose of processing Jurisdictional Determinations, Section 404
permits/Section 401 Water Quality Certifications applications, and Neuse River Basin Riparian Buffer
Determinations, and to furnish upon request supplemental information in support of applications, etc.
from this day forward until successful completion of the permitting process or revocation by the owner.
In addition, 1, the undersigned, a duly authorized owner of record of the easement identified herein, do
authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps) to enter
upon the easement herein described for the purpose of conducting on-site investigations and issuing a
determination associated with Waters of the U.S. subject to Federal jurisdiction under Section 404 of the
Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899.
f
Authorized this the � day of
Print Property Owner's Name
Cc: Karen Higgins
NC Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
�pd. Z��a -
Property Owner's Signature

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0 Wake County B rdst
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Georgia Atlantic Ocean
0 40 80 0 6HA1 ETT
mmmil:= Miles mmm= Miles
' Figure 1: Vicinity Map
Rock Creek Sewer Improvements
Wake County
Raleigh, North Carolina

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Figure 2: USGS Topographic Map
Rock Creek Sewer Improvements
Wake County
Raleigh, North Carolina

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0 350 700
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Figure 5: Affected Parcels Table
LABEL
PIN—NUM OWNER
ADDRESS
1
1705880219 STATE EMPLOYEES CREDIT UNION
3808 SIX FORKS RD
PO BOX 26807 RALEIGH NC 27611-6807
2
1705777740 WINDSOR CREST PROPERTIES INC
10014 CHAPEL HILL RD
MORRISVILLE NC 27560-9399
3
1705777611 MCCLAIN FAMILY HOLDINGS LLC
2113 FALLON OAKS CT
RALEIGH NC 27608-1676
4
1705776594 COFFEY, RALPH D III COFFEY, LISA W
3626 ROCK CREEK DR
RALEIGH NC 27609-7127
5
1705776443 SARANT, JAMES N JR SARANT, GINA R
3620 ROCK CREEK DR
RALEIGH NC 27609-7127
61
1705776364 BAIRD, STANFORD D BAIRD, ANNA L
3614 ROCK CREEK DR
RALEIGH NC 27609-7127
7
1705776247 GUIDO, RICHARD L
3610 ROCK CREEK DR
RALEIGH NC 27609-7127
8
1705775198 PITCHFORD, JANE DEMPSEY
219 COUNTRY CLUB DR
GREENVILLE NC 27834-6218
9
1705775099 UDELL, IAN W UDELL, ERIKA A
3600 ROCK CREEK DR
RALEIGH NC 27609-7127
10
1705776001 HENRY, CATHERINE LORAH HENRY, JONATHAN KEITH
3524 ROCK CREEK DR
RALEIGH NC 27609-7125
11
1705765994 HODGES, DEMPSEY HODGES, AMY
3520 ROCK CREEK DR
RALEIGH NC 27609-7125
12
1705765897 DISBROW, JARRE17THOMAS DISBROW, STEPHANIE CHAPPELL
3516 ROCK CREEK DR
RALEIGH NC 27609-7125
13
1705777292 SIGGINS, PETER SIGGINS, JULIE A
3608 BROWNING PL
RALEIGH NC 27609-7142
14
1705777170 FLOYD, CHRISTOPHER S FLOYD, PAMELA T
3612 BROWNING PL
RALEIGH NC 27609-7142
15
1705767997 LIN, ARTHUR H T LIN, YI KUNG L C
3614 BROWNING PL
RALEIGH NC 27609-7142
16
1705766800 TAYLOR, RITCHIE W TAYLOR, ELIZABETH C
3510 ROCK CREEK DR
RALEIGH NC 27609-7125
17
1705765793 ALFORD, JOHN BLAKELY ALFORD, SHERYL AUSTIN
3508 ROCK CREEK DR
RALEIGH NC 27609-7125
18
1705765647 SHUIRMAN, RYAN M SHUIRMAN, DANIELLE F
3504 ROCK CREEK DR
RALEIGH NC 27609-7125
19
1705764453 WRIGHT, CHARLES E WRIGHT, JENNINGS S
113 DICKINSON LN
BEAUFORT NC 28516-7531
20
1705766662 FORTIER, MARK FORTIER, JULIA A
3505 TENNYSON PL
RALEIGH NC 27609-7130
21
1705766449 WRAP LLC
3901 BARRETT DR STE 102
RALEIGH NC 27609-6611
22
1705763390 MORGAN, PAUL H MORGAN, NATALYLA LEONIDOVNA
3416 ROCK CREEK DR
RALEIGH NC 27609-7124
23
1705765269 MAY, DAVID A MAY, LISA C
3337 COLERIDGE DR
RALEIGH NC 27609-7203
24
1705763273 SMITH, TODD M WEATHERS, MICHELE M
3412 ROCK CREEK DR
RALEIGH NC 27609-7124
25
1705765169 ODEA, SARAH S ODEA, THOMAS F
3333 COLERIDGE DR
RALEIGH NC 27609-7203
26
1705763161 FAHMY, YUSEF
2 SAREVA PL
ASHEVILLE NC 28804-2238
27
1705765160 RIDDELL, COLIN W RIDDELL, KIMBERLY C
3327 COLERIDGE DR
RALEIGH NC 27609-7203
28
1705765070 SELDEN, WILLIAM W SELDEN, LUCELIA W JR
3323 COLERIDGE DR
RALEIGH NC 27609-7203
29
1705753936 TIMBERLAKE, BARBARA 0
3400 ROCK CREEK DR
RALEIGH NC 27609-7124
30
1705755960 JACKSON, GREGORY LJACKSON, LINDSAY D
3319 COLERIDGE DR
RALEIGH NC 27609-7203
31
1705755872 BYRD, DAVID N
3317 COLERIDGE DR
RALEIGH NC 27609-7203
32
1705752875 MULLAN, JAMES B
3320 ROCK CREEK DR
RALEIGH NC 27609-7122
33
1705752729 BRAUN, ERIC M BRAUN, ERIKA L
2707 ROYSTER ST
RALEIGH NC 27608-1529
34
1705751764 FRITTER, MATTHEW C FRITTER, KATHERINE G
3312 ROCK CREEK DR
RALEIGH NC 27609-7122
35
1705751606 WILSON, VICTORIA K KELSEY, W KENT
3304 DELL DR
RALEIGH NC 27609-7118
36
1705754534 MOORE, THOMAS EDWIN MOORE, SARAH H
3622 BELLEVUE RD
RALEIGH NC 27609-7106
37
1705755208 SINGLETON, GARY F
121 W DREWRY LN
RALEIGH NC 27609-7713
38
1705756314 REARDON, DAVID S
119 W DREWRY LN
RALEIGH NC 27609-7713

North Carolina Division of Water Quality - Stream Identification Form, Version 4.11
Date- 10/20/2015
Project/Site: Rock Creek Sewer
Improvements (S1)
Latitude. 35 828217
Evaluator R Sullivan/J Hartshorn
(Kimley-Hom)
County: Wake County
Longitude. 35.828217
Total Points: 32.5
Stream Determination (ci
Other
Stream is at least intermittent
Ephemeral Intermittenerennial
e g Quad Name Raleigh West
if a 19 or perennial if z 30
0
1
A. Geomorphology Subtotal = 17
Absent
Weak
Moderate
Strong
Score
1a Continuity of channel bed and bank
0
1
2
3
3
2. Sinuosity of channel along thalweg
0
1
2
3
2
3. in -Channel structure* ex riffle -pool, step -pool,
ripple -pool sequence
0
1
2
3
3
4. Particle size of stream substrate
0
1
2
3
3
5. Active/relic floodplain
0
1
2
3
1
6. Depositional bars or benches
0
1
2
3
1
7. Recent alluvial deposits
0
1
2
3
1
8. Headcuts
0
1
2
3
0
9. Grade control
0
0.5
1
1.5
1.5
10. Natural valley
0
0.5
1
1.5
1.5
11. Second or greater order channel
No = 0
Yes = 3
0
artificial ditches are not rated, see discussions in manual
B. Hydrology Subtotal = 9.5
12
Presence of Baseflow
0
1
2
3
2
13.
Iron oxidizing bacteria
0
1
2
3
1
14.
Leaf litter
1.5
1
0.5
0
1.5
15.
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0
0.5
1
1 5
1
16.
Organic debris lines or piles
0
0.5
1
1.5
1
17.
Soil -based evidence of high water table?
No = 0
1.5
Yes = 3
26 Wetland plants in streambed
3
C. Biology Subtotal = 6
18. Fibrous roots in streambed
3 2
1
0
3
19. Rooted upland plants in streambed
3 2
1
0
3
20. Macrobenthos note diversity and abundance)
0 1
2
3
0
21. Aquatic Mollusks
0 1
2
3
0
22. Fish
0 0.5
1
1.5
0
23 Crayfish
0 0.5
1
1.5
0
24. Amphibians
0 0.5
1
1.5
0
25 Algae
0 0.5
1
1.5
0
26 Wetland plants in streambed
FACW = 0.75; OBL = 1.5, Other = 0
0
'perennial streams may also be identified using other methods See p 35 of manual
Notes: Stream S1 is an unnamed Derennlal channel that drains to Crabtree
Creek. The channel has downcut to bedrock throughout much of the reach
The channel is piped under multiple roads, and a sewer utility easement/pipe
crosses the stream in a couple locations The stream had moderate flow and is
closely bounded on both sides by residential development.

USACE AID# DWQ # Site # (indicate on attached map)
MSTREAM QUALITY ASSESSMENT WORKSHEET,�s ;
Provide the following information for the stream reach under assessment:
1. Applicant's name: City of Raleigh 2. Evaluator's name: R. Sullivan/J. Hartshorn (Kimley-Horn)
3. Date of evaluation: 10/20/2015 4. Time of evaluation: 2:00 pm
5. Name of stream: Stream S1 6. River basin: Neuse
7. Approximate drainage area: 203 acres 8. Stream order: First Order
9. Length of reach evaluated: 3,000 linear feet
11. Site coordinates (if known): prefer in decimal degrees.
Latitude (ex. 34.872312): 35.828217
10. County: Wake County
12. Subdivision name (if any): N/A
Longitude (ex -77 556611):
35.828217
Method location determined (circle)- [D3PS ✓Yopo Sheet ✓1Jrtho (Aenal) Photo/GIS[3)ther GISather
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
The reach was evaluated south of Six Forks Rd and west of Rock Creek Drive
14. Proposed channel work (if any): N/A
15. Recent weather conditions: No rain within 3 days prior to the site visit
16. Site conditions at time ofvisit: Sunny with scant cloud cover and temps ranging from mid-30s to low 70s (F)
17. Identify any special waterway classifications known: FISection 10 MTidal Waters Essential Fisheries Habitat
nTrout Waters 00utstanding Resource Waters F✓ Nutrient Sensitive Waters Dwater Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? NO If yes, estimate the water surface area:
19. Does channel appear on USGS quad map? YES 20. Does channel appear on USDA Soil Survey? YES
21. Estimated watershed land use: 50 % Residential
15 % Forested
22. Bankfull width: -15'-30'
24. Channel slope down center of stream: Flat (0 to 2%)
25. Channel sinuosity: ELStraight Occasional bends
35 % Commercial _% Industrial _% Agricultural
_% Cleared / Logged _% Other ( )
23. Bank height (from bed to top of bank): 5'-15'
J71Gentle (2 to 4%) E[Moderate (4 to 10%) CLSteep (>10%)
Frequent meander Overy sinuous Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
Total Score (from reverse): 38 Comments:
Stream S1 is an unnamed perennial channel that drains to Crabtree Creek. The channel has downcut to bedrock throughout
much of the reach. The channel is piped under multiple roads and a sewer utility easement/pipg crosses the stream in a
couple locations The stream had moderate flow and is closely bounded on both sides by residential development
Evaluator's Signature Rom, ` u,&,` `a n Date 10/20/2015
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please call 919-876-8441 x 26.

Stream S1
STREAM QUALITY ASSESSMENT WORKSHEET
* These characteristics are not assessed in coastal streams.
ECOREGION POINT
RANGE __
#
CHARACTERISTICS
SCORE
Coastal
Piedmont
Mountain
1no
Presence of flow / persistent pools in stream
0 — 4
0-5
3
flow or saturation = 0; strop flow = maxpoints)0-5
2
Evidence of past human alteration
0-6
0-5
0-5
1
extensive alteration = 0 • no alteration = maxpoints)
3
Riparian zone
0-6
0-4
0-5
2
no buffer = 0; contiguous, wide buffer = maxpoints)
4
Evidence of nutrient or chemical discharges
0-5
0-4
0-4
2
extensive discharges = 0; no discharges = max points
5
Groundwater discharge
0 — 4
0-4
3
no discharge = 0; springs, see s, wetlands etc. = maxpoints)0-3
6
Presence of adjacent floodplain
0— 4
0— 4
0— 2
1
no floodplain = 0• extensive floodplain = max points)
Entrenchment / floodplain access
0— 5
0— 4
0— 2
0
(deeply entrenched = 0; frequent flooding= max points)
8
Presence of adjacent wetlands
0-6
0-4
0-2
0
no wetlands = 0; large adjacent wetlands = max points)
9
Channel sinuosity
0 — 4
0-3
3
extensive channelization = 0• natural meander = maxpoints)0-5
10
Sediment input
0-5
0-4
0-4
1
extensive deposition= 0• little or no sediment = maxpoints)
11
Size & diversity of channel bed substrate
NA*
0-4
0-5
3
fine, homogenous = 0; large, diverse sizes = maxpoints)
12
Evidence of channel incision or widening
0-5
0-4
0-5
>�
(deeply incised = 0; stable bed & banks = maxpoints)
13
Presence of major bank failures
0 — 5
0-5
2
a
severe erosion = 0; no erosion, stable banks = maxpoints)0-5
Root depth and density on banks
14
no visible roots = 0; dense roots throughout = max points)0-3
0-4
0-5
3
Impact by agriculture, livestock, or timber production
15
substantial impact =0• no evidence = max points)
0-5
0-4
0-5
2
16
Presence of riffle-pool/ripple-pool complexes
0-3
0-5
0-6
4
no riffles/ripples or pools = 0• well-developed = maxpoints)
17
Habitat complexity
0-6
0-6
0-6
2
little or no habitat = 0; frequent, varied habitats = maxpoints)
18
Canopy coverage over streambed
x
no sbadinvegetation = 0; continuous canopy= max points)
0— 5
0— 5
0— 5
3
19
Substrate embeddedness
NA*
0-4
0-4
3
(deeply embedded = 0• loose structure = max
20
Presence of stream invertebrates (see page 4)
0-4
0-5
0-5
no evidence = 0; common, numerous types = maxpoints)
(�
21
Presence of amphibians
0-4
0-4
0-4
0
O
no evidence = 0; common, numerous types = maxpoints)
22
Presence of fish
0 — 4
0-4
0
no evidence = 0; common, numerous es = maxpoints)0-4
23
Evidence of wildlife use
0-6
0-5
0-5
0
no evidence = 0; abundant evidence = maxpoints)
Total Points Possible
100
100
100
TOTAL SCORE (also enter on first page)
38
* These characteristics are not assessed in coastal streams.

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