20160952 Ver 1_401 Application_20161004

Corps Submittal Cover Sheet
Please provide the following information:
1. Project Name: �.eplaceir�c;nt l3rid�� No. (�30194 on SR 1459 over Branch of Richardson
Creek
2. Name of Property Owner/Applicant: NC�]C}T DivisiQn I�, L�uis Mitchell, P.E.
3. Name of Consultant/Agent: STV En 'neers Inc,
*Agent Authorization needs to be attached. �
4. Related/Previous Action ID number(s): N/A
5. Site Address: SR 1459-over Branch of �ichardsan Creek, north of Burnsville, NC
6. Subdivision Name:
7. City: Burnsville, NC
8. County: Anson
9. Lat: 35.150168° N Long: -$0.2i8943" W
10. Quadrangle Name: �J�kbor� �1C t'97I
11. Waterway: Branch of Richardson Creek
12. Watershed: Yadkin-Pee Dee
13. Requested Action:
X Nationwide Permit # 14
� General Permit # �
_ Jurisdictional Determination Request
Pre-Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign Number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/Nature of Activity/Project Purpose:
Site/Waters Name:
Keywords:

I-
�T�(;�-i - �� �
1. �_'f l�-'�7'`�J��
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September 30, 2016
Ms. Crystal Amschler
U.S. Army Corps of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
SUBJECT: Pre-Construction Notification Pursuant to Nationwide Permit #14
NCDOT Division 10 Bridge Upgrade and Replacement No. 030194
SR 1459 over Branch of Richardson Creek, Anson County, North Carolina
State Project No.: 17BP.10.R.60
SN Project No. 2516325
Dear Ms. Amschler;
On behalf of the North Carolina Department of Transportation (NCDOT) — Division 10, STV
Engineers, Inc., (STV) is submitting a Pre-Construction Notification Form (See Attachment A) in
accordance with General Condition No. 31 and pursuant to U.S. Army Corps of Engineers
(USACE) Section 404 Nationwide Permit (NWP) #14 — Linear Transportation Projects. The
NCDOT has retained STV to assist in matters related to wetland permitting services for this
project. Materials supporting our Jurisdictional Determination regarding the approximate location
and extent of jurisdictional waters of the U.S. within the approximate 1.72-acre project study
area (PSA) including a USACE Stream Quality Assessment Worksheet, North Carolina Division
of Water Resources (NCDWR) Stream Identification Form, a Wetland Determination Data Form,
an Approved Jurisdictional Determination (Rapanos) Form, Approximate Waters of the U.S. and
Wetlands Boundary Map, and photographs, are found in Attachment B. Accompanying figures,
permit drawings, list of property owners, and an impact summary are included in Attachment C.
A"No Archaeological Survey Required Form" and "Historic Architecture and Landscapes No
Survey Required Form" are included as Attachment D.
Based on National Agriculture Imagery Program aerial photography for Anson County and
verified by field review, the PSA consists primarily of undeveloped forest, agricultural property,
disturbed (maintained) right-of-way (R/W), and the improved paved roadway.
Pro'ect Des�cri tianlPur ase and �l�eed
STV was retained by the NCDOT to provide engineering and environmental services for the
bridge replacement project on SR 1459 (Blonnie Ross Road). The SR 1459 bridge over Branch
of Richardson Creek PSA is located north of Burnsville in the northwestern portion of Anson
County, west of NC 742; see Attachment C— Figures 1 and 2.

NCDOT Division 10 Bridge Upgrade and Replacement Program September 30, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
The existing bridge consists of a 22' single-span bridge, and the proposed structure is a double
12' X 7' reinforced concrete box culvert (RCBC). The existing R/W is 60' wide. The new double
RCBC will essentially be on the same horizontal alignment as the existing bridge.
This project is part of the NCDOT's Division Managed "Bridge Upgrade and Replacement
Program." This program is intended to replace the State's aging, deficient bridges in an efficient
and cost effective manner. Many of the State's bridges were built in the 1950's and are now
deteriorating faster than funds are available to replace them. It is estimated that for every bridge
replaced, two additional ones become deficient. It is the goal of this program that all bridge
replacements meet state and federal environmental regulations while providing the maximum
benefit to the public.
The existing bridge conditions were most recently evaluated on June 6, 2011 by the NCDOT.
Subsequently, the NCDOT prepared an updated Structural Inventory and Appraisal report for
the SR 1459 Bridge over Branch of Richardson Creek (identified as Bridge No. 030194). This
Structural Inventory and Appraisal report gives the bridge a sufficiency rating of 38 out of 100,
with a status considered "structurally deficient." The NCDOT is planning to replace the existing
SR 1459 Bridge No. 030194 over Branch of Richardson Creek, while funding is available, with
an improved modern structure. During construction, the SR 1459 roadway will be closed to
traffic, and traffic will be detoured off-site.
It is anticipated that this Bridge Upgrade and Replacement Program project qualifies for a NWP
#14. NWP #14 authorizes activities required for the construction, expansion, modification, or
improvement of linear transportation projects in waters of the United States.
�ackgiOLl�ci and Meth�a��ola�v
The scoping meeting for this Bridge Upgrade and Replacement Program project, SR 1459 over
Branch of Richardson Creek Bridge Replacement, was held on July 9, 2013 at the NCDOT
Division 10 offices in Albemarle, NC. Representatives from the NCDOT, STV, and NCDWR
attended. Scoping documents prepared by the NCDOT were reviewed and discussed at that
time. A field review followed the scoping meeting and included a site visit to the proposed SR
1459 over Branch of Richardson Creek Bridge Replacement project site on July 9, 2013. An
agency representative from the NCDWR attended the field meeting to review the jurisdictional
waters of the U.S. at that time. It was agreed by the NCDWR that a NWP #14 would be
appropriate for this bridge replacement project.
Field surveys were conducted within the proposed SR 1459 over Branch of Richardson Creek
Bridge Replacement project study area (PSA) by STV environmental scientists on August 23,
2013. A PSA that was approximately 150 feet wide and 500 feet in length, roughly centered
along the existing bridge, and that extended upstream of SR 1459 for 100 feet and downstream
for approximately 100 feet was field reviewed. Streams and wetlands within the PSA were
assessed and plant communities and their associated wildlife were identified and recorded.
Jurisdictional waters of the U.S. are defined by 33 CFR 328.3(b) and protected by Section 404
of the Clean Water Act (33 U.S.C. 1344), which is administered and enforced in North Carolina
by the USACE, Wilmington District. Potential wetland areas were defined using the USACE
Page 2

NCDOT Division 10 Bridge Upgrade and Rep/acement Program September 30, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
Routine On-Site Determination method as described in the 1987 "Corps of Engineers Wetlands
Delineation Manual."' This technique uses a multi-parameter approach, which requires positive
evidence of hydrophytic vegetation, wetland hydrology, and hydric soils. In addition, the USACE
"Regional Supplement to the Corps of Engineers Wetland Delineation Manual: Eastern Mountains
and Piedmont Region"z was utilized for further procedural and technical guidance. Potential
jurisdictional stream channels were classified according to the most recent North Carolina
Division of Water Resources (NCDWR)3 methodology and USACE guidance. NCDWR Stream
Identification Forms and USACE Stream Quality Assessment Worksheets are included in
Attachment B. The Approved Jurisdictional Determination (Rapanos) Form and representative
photographs of the jurisdictional feature located in the PSA are also included in Attachment B.
Prior to fieldwork, the following references were reviewed to identify possible waters of the U.S.,
including wetland areas:
+ U.S. Geological Service (USGS) 7.5-minute quadrangle maps [Oakboro, NC (1971)]
� U.S. Fish & Wildlife Service (USFWS) National Wetlands Inventory (NWI) Map (Oakboro,
NC)
• U.S. Department of Agriculture (USDA) Soil Conservation Service (SCS), now known as
Natural Resources Conservation Service (NRCS), Soils Series Data Map for Anson County,
NC (2009)
• USDA NRCS Web Soil Survey
The USGS map and Soil Survey each depict a stream within the PSA. The USFWS NWI map
does not depict any potential jurisdictional features within the PSA. Jurisdictional stream
boundaries were delineated and flagged in the field by STV Senior Environmental Scientist
Brandon Phillips, CHMM, with blue and white striped tape at the ordinary high water mark near
the top of the stream bank. The boundaries were surveyed by the NCDOT and mapped using
ArcGIS 10.1 software.
The proposed SR 1459 over Branch of Richardson Creek Bridge Upgrade and Replacement
Program project is Iocated entirely within the Carolina Slate Belt Province of North Carolina,
which is characterized by trellised drainage patterns. Based on topographic mapping, elevations
in the PSA range from approximately 290 feet above National Geodetic Vertical Datum (NGVD)
to 300 feet NGVD (Attachment C- Figure 2). The highest elevation in the PSA is located on SR
1459. The lowest elevation in the PSA is located within Branch of Richardson Creek where it
exits the southeastern portion of the PSA.
According to the NRCS SCS, the project study area contains three soil types: Chewacla silt
loam, 0-2% slopes, frequently flooded (ChA); Shellbluff loam, 0-2% slopes, occasionally
flooded; and, Tarrus gravelly silt loam; 2-8% slopes (Ta6); see Attachment C- Figure 3. The
1 Environmental Laboratory, 1987, "Corps of Engineers Wetlands Delineation Manual, " Technical Report Y-87-1, US Army
Enginccr W�tt�rwnys Expea�imettt 5tata�n, Vi�ksburg, Mississippi.
Z U.S. Army �Cc�r�ss o#° Erigineers. 2i} I 2. Rc�;ronal5tr�ple,rrrent to lhe Corps ofEngineers Wetland Delineation Manual: Eastern
Mountains and Piedmont Region, Version 2.0., ed. J.F. Berkowitz, J.S. Wakeley, R.W. Lichvar, and C.V. Noble. ERDC/EL TR-
12-9. Vickshurg MS: U.S. Army En�;i�tecr Re4ear�h ar�s1 Ds.��:lc���ncnt Center.
3 North Caro�ina Uivision of Water f.�uality. 2[) lti. Me[fro�ldlo�y+.jo1• Irtcn�r"frcurion oflntermitlent and Perennial Streams and their
Origins. Version 4.11. North Carolina Deparhnent of Environment and Natural Resources, Division of Water Quality. Raleigh,
NC.
Page 3

NCDOT Division 10 Bridge Upgrade and Rep/acemenf Program September 30, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
Chewacla soil series is included on the NRCS List of Hydric Soils due to inclusions of the
Wehadkee, undrained, soil type.
The proposed PSA is located in the Yadkin-Pee Dee drainage basin, Rocky River Watershed
subbasin 03-04-01-05. The major stream in the project vicinity is Branch of Richardson Creek.
Branch of Richardson Creek is a Class WS-IV water that generally flows in a southeastern
direction to Richardson Creek. Richardson Creek flows to the Rocky River which flows to the
Pee Dee River.
Jurisdictional Waters of the U.S.
The results of the on-site field review conducted by STV environmental scientists indicate that
one jurisdictional relatively permanent water (RPW), RPW Stream A(aka, Branch of Richardson
Creek) is located within the PSA. The figure entitled Approximate Waters of the U.S. and
Wetlands Boundary Map Exhibit (Attachment B) depicts the approximate location of this
jurisdictional feature. No potential jurisdictional wetlands were identified in the PSA.
Representative photographs of the jurisdictional feature that is located within the PSA are
included in Attachment B. The PSA is located in Anson County which is not one of the 25
designated trout counties of NC.
Str�ams_ vr Refa�ivelv Permanenf Waters
RPW Stream A(Branch of Richardson Creek) was concluded to be an RPW with perennial
hydrology. Branch of Richardson Creek, also concluded to be providing important aquatic
function, begins off-site to the northwest and flows southeast across the PSA (Attachment C-
Figure 4). Approximately 272 linear feet (0.09 acre) of Branch of Richardson Creek is located
within the PSA. Branch of Richardson Creek is depicted as a blue line stream on the USGS
topographic quadrangle and is depicted as a stream on the NRCS Soils Series Data Map of
Anson County (Attachment C- Figures 2 and 3, respectively). The Branch of Richardson Creek
flows to Richardson Creek. Richardson Creek flows to the Rocky River which flows to the Pee
Dee River, a traditional navigable water.
More information on the individual stream characteristics of RPW Stream A can be found on the
NCDWR Stream Identification Form and USACE Stream Quality Assessment Worksheet
included in Attachment B.
Impacts to Wa#ers of the U.S.
The project involves the replacement of the existing 22' single span bridge that crosses over
Branch of Richardson Creek on SR 1459 with a double reinforced concrete box culvert (RCBC).
Permanent impacts (designated by the symbol "S' on Attachment C- Sheets 4 and 4A) to
waters of the U.S. would result from the project. Approximately 46 linear feet (0.016 acre) of
Branch of Richardson Creek (RPW Stream A) would be impacted by the placement of the
double RCBC in the stream channel that is currently bridged. Approximately 6 linear feet (0.004
acre) of Branch of Richardson Creek (RPW Stream A) would be impacted by the placement of
riprap along the stream bank within the jurisdictional limits of the stream channel. The existing
bridge abutments have replaced the original streambanks and are considered to be an existing
Page 4

NCDOT Division 10 Bridge Upgrade and Rep/acement Program September 30, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
impact of 38 linear feet. By subtracting the existing stream impacts from the proposed impacts,
a total of 14 linear feet of permanent impacts is anticipated.
Minor temporary impacts (designated by the symbol "TS" on Attachment C- Sheets 4 and 4A)
may occur to a maximum of 33 linear feet (approximately 0.01 acre) of Branch of Richardson
Creek (RPW Stream A) due to the demolition of the existing bridge and the removal of the
existing masonry bridge abutments that may potentially cause incidental debris to fall into the
channel (See Attachment C- Sheets 4 and 4A). Roadway approach work has been minimized
to that which is absolutely necessary within the scope of replacing the bridge and will result in
no additional impacts to waters of the U.S. No major utility relocations would be required as part
of the bridge replacement; no additional impacts would occur as a result of utility relocations.
Hydraulic calculations have been prepared based on the placement of the new double RCBC.
No increase in the upstream flood elevations is anticipated based on these calculations. Based
on the results of the HEC-RAS model for SR 1459 over Branch of Richardson Creek, the
existing bridge can be replaced with a double RCBC without causing a rise to the established
100-year flood elevations and meets the requirements of Federal Highway Administration,
Federal-Aid Policy Guide, 23 CFR 650A, "Location and Hydraulic Design of Encroachments on
Floodplains," and the Memorandum of Agreement between the NCDOT and the North Carolina
Floodplain Mapping Program.
Project activities will be done in compliance with Water Quality Certification No. 3886. All work
in or adjacent to stream waters shall be conducted so that the flowing stream does not come
into contact with the disturbed area. A temporary diversion ditch, bypass pumping apparatus, or
temporary smooth line pipe will be used to convey the stream around the work site during
construction activities. No excavation in flowing stream waters will occur. A special stilling basin
will be used to dewater the stream in the work area. No untreated runoff shall be discharged into
the stream. All necessary measures shall be taken to prevent direct contact between uncured or
curing concrete and waters of the state. Bridge deck drains shall not discharge directly into the
stream. Matting that incorporates plastic mesh and/or plastic twine shall not be used in the
stream or floodplains. No temporary fills or access roads will be used.
Avoidance and Minimization
Due to the nature of the project, avoiding the permanent impacts and minor potential temporary
impacts to Branch of Richardson Creek while achieving project goals is not possible. There is
not a practicable alternative that would achieve the project purpose of replacing the bridge in a
cost effective manner while reducing long term maintenance issues and improving the roadway
approaches without causing permanent and potential minor debris impacts to Branch of
Richardson Creek. Best management practices (BMPs) and appropriate erosion and
sedimentation controls will be installed and maintained during construction activities to allow for
the least adverse effect on the stream channel and associated water quality.
Permanent and potential temporary impacts to Branch of Richardson Creek are unavoidable
due to the requirement to replace the bridge with the double RCBC, the riprap stabilization of a
portion of the stream bank, and the removal of the existing bridge and the existing masonry
abutments. The majority of the riprap for streambank stabilization will be placed in uplands
outside of the stream jurisdictional limits. All work in or adjacent to the stream waters shall be
Page 5

NCDOT Division 10 Bridge Upgrade and Replacemenf Program September 30, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
conducted so that the flowing stream does not come into contact with the disturbed area. All
necessary measures shall be taken to prevent direct contact between uncured or curing
concrete and waters of the U.S. Matting that incorporates plastic mesh and/or plastic twine shall
not be used in the streams or floodplains. No temporary fills or access roads will be used.
Efforts to minimize impacts to this stream included:
• The crossing of Branch of Richardson Creek will essentially remain in the same location
within the existing SR 1459 R/W in order to reduce the need for additional roadway fill
and to avoid additional impacts to Branch of Richardson Creek.
• Fill slopes have been designed to be 1.5:1 as opposed to the standard 4:1.
* The construction of the bridge from either of the stream embankments will eliminate the
need for heavy equipment to enter jurisdictional waters of the U.S. and will allow
demolition of the existing structure and construction of the new bridge with minimal
temporary impacts to the stream channel. The road will be closed during construction,
and an off-site detour will be utilized, to allow work to be performed from the existing
roadway approaches.
Activities on the project site involving impacts to waters of the U.S. will be required to follow the
General Conditions of the USACE Nationwide Permits (Federal Register Vol. 77, No. 34;
updated February 21, 2012), applicable USACE Wilmington District Regional Conditions (March
29, 2012), and applicable NCDWR consistency conditions (March 19, 2012).
Campensa#orv Mi�i+�at�on
As described above, efforts have been made to avoid and minimize impacts to waters of the
U.S. to the maximum extent practicable. The replacement of the existing bridge with a double
RCBC will cause permanent impacts to 14 linear feet (0.02 acre) of RPW Stream A and may
cause potential temporary impacts to 33 linear feet (approximately 0.01 acre) of RPW Stream A
(Branch of Richardson Creek); see Attachment C— Sheets 4 and 4A. To compensate for
permanent stream impacts, the North Carolina Division of Mitigation Services will be used.
Stormwater Mana ement Plan
A bridge replacement project going through the Bridge Upgrade and Replacement Program
process is considered to be a`re-development' procedure and redevelopment procedures do
not require a state stormwater permit. Consequently, Best Management Practices (BMPs) and
runoff controls will be implemented during construction to reduce the stormwater impacts to the
receiving stream due to erosion and unfiltered runoff. Sediment and erosion control will adhere
to "Design in Sensitive Watershed" standards. Temporary construction runoff will be controlled
by using silt fence, silt fence wattle breaks, floating turbidity curtain, temporary rock silt checks,
special stilling basins, rock inlet sediment traps, and temporary matting and grassing.
The proposed double RCBC will be buried approximately 1' below the stream bed and will allow
flow to pass within the natural channel in the low flow barrel. The high flow barrel will be used
when the 2' sill is overtopped during high low events. The proposed roadway will be in normal
crown and will drain through grass shoulders, and roadside special ditches. The proposed
Page 6

NCDOT Division 10 Bridge Upgrade and Rep/acement Program September 30, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
ditches will be stabilized with temporary rock silt checks with polyacrylamide applied, as well as
temporary turF reinforcement matting. Fabric silt fence will be used for small runoff areas where
the flow is in sheet form. Wattle breaks along the proposed temporary silt fence will be used for
small concentrated flows. Floating turbidity curtain will be installed along the stream banks and
will be removed as work progresses. All dewatering activities will be through a permeable fabric
bag.
Cultural Resources
In a document dated September 15, 2016, the NCDOT Archaeologist made a determination of
"No Survey Required" for the Area of Potential Effects (APE) regarding archaeology
(Attachment D— No Archaeological Survey Required Form). In a document dated June 6, 2016,
the NCDOT Architectural Historian made a determination of "Historic Architecture and
Landscapes — No Survey Required" for the Area of Potential Effects (APE) regarding historic
architecture/landscapes (Attachment D— Historic Architecture and Landscapes No Survey
Required Form).
Pratected S�ecies
STV conducted a protected species habitat assessment and review of the PSA on August 23,
2013. Prior to the field reviews, STV reviewed the U.S. Fish and Wildlife Service (USFWS) and
North Carolina Natural Heritage Program (NCNHP) databases, which provided existing data
concerning the potential occurrence of federally and state protected (threatened or endangered)
species in Anson County; the databases were rechecked in September 2016. These databases
indicate that there are three federal and state endangered species that may occur in Anson
County. These protected species and their physical descriptions and habitat requirements are
described below.
Shvrtnpse stur eon AGr' �nser br�virostrum — Federall5tat� �ntian ered
The shortnose sturgeon is an anadromous fish species which spends most of the year in
brackish or salt water and moves into fresh water only to spawn. The shortnose sturgeon is
dark-colored on its dorsal side and light on the ventral side. This species of sturgeon has a wide
mouth pointed downward beneath a short snout and can grow up to three feet long. The sides
of its body contain five rows of sharp, pointed plates. The shortnose sturgeon inhabits the lower
portions of large rivers and coastal rivers along the Atlantic Coast.
Potential habitat does not exist within the reach of perennial section of RPW Stream A, aka,
Branch of Richardson Creek, located.within the project study area due to the shallow conditions
unlike the large river habitat the shortnose sturgeon prefers. There are no records of shortnose
sturgeon being located in the Oakboro, NC USGS quadrangle. Based on the field review, the
available databases, and the limited area of proposed stream disturbance, it is determined that
this project will have `no effect' on shortnose sturgeon.
Biafo icaf Cvnclusi�n: No EfFect
Schweinitz°s sunflnwer ,HEll�fi�'I7llS SChW�lfll�°Z1! - F���ialCS���� Ef1C�aC1 �red
Schweinitz's sunflower is a perennial herbaceous plant limited to the Piedmont counties of North
and South Carolina. The plant grows from one to two meters tall from a cluster of tuberous
Page 7

NCDOT Division 10 Bridge Upgrade and Rep/acement Program September 30, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
roots. The sunflower consists of a flower with a yellow disk and ray flowers formed on small
heads. The disc is less than 1.5 centimeter (cm) across and the petals are two to three cm long.
The lanceolate leaves are opposite on the lower stem and alternate near the flowers. The
typical habitat for this plant includes roadsides, old pastures, transmission line rights-of-way
(R/Ws), open areas, and edges of upland woods. Periodically maintained R/Ws are typically
considered good potential habitat for the Schweinitz's sunflower. Major characteristics of soils
associated with suitable Schweinitz's sunflower habitat include thin soils, soils on upland
interstream flats or gentle slopes, those which are clayey in texture (and often with substantial
rock fragments), those which have a h.igh shrink-swell capacity, and those which vary over the
course of the year from very wet to very dry. Flowering occurs from August to the first frost of
the year.
No individuals of Schweinitz's sunflower were observed within the project study area and the
area was reviewed within the flowering season. There are no records of Schweinitz's sunflower
being located in the Oakboro, NC USGS quadrangles. The NC Natural Heritage Program
(NCNHP) website was reviewed to determine the locations of the nearest populations of
Schweinitz's sunflower. The NCNHP determined that no populations of Schweinitz's sunflower
were present within several miles of the project study area. The project study area has some of
the proper habitat requirements preferred by this species, but there are no known populations
within the proximity of the project study area, so it is unlikely that Schweinitz's sunflower would
be found within the project study area. Based on the field review during the flowering season,
the available databases, and the limited area of proposed roadside disturbance, it is determined
that this project will have `no effect' on Schweinitz's sunflower.
8ivlagical Cancfusion� �v.EffeGt
Red-c�ckad'ed wood ecker Pr'cc�ides boreali� - FederaUS#ate Endan �r�d
Adult red-cockaded woodpeckers are approximately 18 to 20 cm long with a wingspan of 35 to
38 cm. Adults have a black cap, throat, and stripe on the side of the neck and white cheeks and
underparts. The back is barred with black and white horizontal stripes. Adult males have a small
red spot on each side of the black cap. The bird is native to southern pine forests and typically
nests within open pine stands with trees 80 years or older. Roosting cavities are excavated
within live pines, which are often infected with a fungus which causes what is known as red-
heart disease. Foraging may occur in pine and/or mixed pine/hardwood stands 30 years or older
with trees 10" or larger in diameter at breast height (dbh).
No individuals of red-cockaded woodpecker were observed within the project study area. A
limited number of suitable foraging trees and no nesting trees are present within the PSA. The
NCNHP website was reviewed to determine the locations of the nearest populations of red-
cockaded woodpecker. The NCNHP determined that only historical occurrences of red-
cockaded woodpecker were 'present within Anson County. There are no records of red-
cockaded woodpecker being located in the Oakboro, NC USGS quadrangle. Based on the field
review, the available databases, the limited amount of mature trees suitable for foraging, and
the limited area of proposed disturbance to forested areas, it is determined that this project will
have `no effect' on red-cockaded woodpecker.
8ivlaqic�l Cvnclusiarr: Ncr EffEct
Page 8

NCDOT Division 10 Bridge Upgrade and Replacement Program
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
Closinq
September 30, 2016
Please feel free to contact the undersigned at [phone] should you have any questions or
concerns regarding this PCN pursuant to Nationwide Permit #14.
Sincerely,
STV Engineers, Ir�e
Brandon J. Phillips, CHMM
Environmental Science Senior Manager
Michael A. fagnoc+�Q, �IVS
Senior Scientist '�
Attachment A- Pre-Construction Notification Form
Attachment B- Jurisdictional Determination Materials
Attachment C - Figures
Attachment D- No Archaeological Survey Required Form and Historic Architecture and
Landscapes No Survey Required Form
cc: Garland Haywood - NCDOT
Larry Thompson - NCDOT
Sonia Carrillo - NCDWR (5 copies and $240 fee)
Page 9

Mitigation Services
ENVIRONMEM7ALOUALITY
PA1' MCCRORY
coi�en,w�
DONALD R. VAN DER VAART
S'ecrntm r
October 3, 2016
Mr. Larry Thompson
NCDOT Division 10
North Carolina Department of Transportation
716 West Main Street
Albemarle, North Carolina 28001
Dear Mr. Thompson:
Subject: EEP Mitigation Acceptance Letter:
Division 10 Project, Replace Bridge 194 on SR 1459 (Bonnie Ross Road) over Richardson Creek,
Anson County; WBS Element 17BP.10.R.60
The purpose of this letter is to notify you that the Division of Mitigation Services (DMS) will provide the
compensatory stream mitigation for the subject project. Based on the information received from you on October 3,
2016, the impacts are located in CU 03040105 of the Yadlcin River basin in the Southern Piedmont (SP) Eco-
Region, and are as follows:
Yadkin Stream Wetlands Buffer (Sq. Ft.)
03040105 Non- Coastal
Sp Cold Cool Warm Riparian �p�an Marsh Zone 1 Zone 2
Impacts 0 0 14.0 0 0 0 0 0
(feet/acres)
This impact and associated mitigation need were under projected by the NCDOT in the 2016 impact data.
DMS will commit to implement sufficient compensatory stream mitigation credits to offset the impacts associated
with this project as determined by the regulatory agencies using the delivery timeline listed in Section F.3.c.iii of the
In-Lieu Fee Instrument dated July 28, 2010. If the above referenced impact amounts are revised, then this
mitigation acceptance letter will no longer be valid and a new mitigation acceptance letter will be required from
DMS.
8420.
If you have any questions or need additional information, please contact Ms. Beth Harmon at 919-707-
Sincerely,
�
James B, tanfill
Credit agement Supervisor
cc: Ms. Crystal Amschler, USACE - Asheville Regulatory Field Office
Ms. Donna Hood, NCDWR
Ms. Linda Fitzpatrick, NCDOT - PDEA
File: SR 1459 - Bridge 194 - Division 10
State ofNorth Carolina � Environmental Qua]iTy � Mitigation Services
1652 Mail Service Center � 217 W. Jones Street, Suite 3000 I Raleigh, NC 27609-1652
919 707 8976 T

NCDOT Division 10 Brrdg� Upgrade and Rep/acement Program Sepfember 30, 2016
SR 1459 over Branch of Richardson Creek — PCN for NWP #14
Attachment A
Pre-Construction Notification Form

C7� W +a P�=ni
��,� p� Office Use Only:
*� � Corps action ID no.
I 1 � �
� , � , � p �' DWQ project no.
___ Form Version 1.4 January 2009
Pre-Construction Notification (PCN) 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 (NWP) number: 14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ❑ Yes � No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
m 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 For the record only for Corps Permit:
because written approval is not required? 401 Certification:
❑ Yes � No ❑ 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 � Yes ❑ No
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.
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: SR 1459 over Branch of Richardson Creek
2b. County: Anson
2c. Nearest municipality / town: Burnsville
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state project no: 17BP.10.R.60
3. Owner Information
3a. Name(s) on Recorded Deed�
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent OX Other, specify:
4b. Name: Louis Mitchell, P.E.
4c. Business name NCDOT Division 10
(if applicable):
4d. Street address: 716 West Main Street
4e. City, state, zip: Albemarle, NC 28001
4f. Telephone no.: 704 983-4400
4g. Fax no.: 704 982-3146
4h. Email address; [e-mail]
5. AgenUConsultant Information (if applicable)
5a. Name: Brandon Phillips, CHMM
5b. Business name STV Engineers, Inc.
(if applicable):
5c. Street address: 900 West Trade Street, Suite 715
5d. City, state, zip: Charlotte, NC 28202-1144
5e. Telephone no.: [phone]
5f. Fax no.: [phone]
5g. Email address: [e-mail]
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): WBS 17BP.10.R.60
1 b. Site coordinates (in decimal degrees): Latitude: 35.150168 Longitude: -80.278943
1 c. Property size: 1.72 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Branch of Richardson Creek
2b. Water Quality Classification of nearest receiving water: WS-IV
2c. River basin� Yadkin-Pee Dee
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:
Existing conditions include SR 1459 (Blonnie Ross Road) and Bridge No. 030194, undeveloped forest, agricultural property and disturbed/maintained
right-of-way.
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: 272
3d. Explain the purpose of the proposed project:
To replace Bridge No. 030194 with an improved, modern structure.
3e. Describe the overall project in detail, including the type of equipment to be used:
Bridge replacement using heavy construction equipment. Refer to Project Description in cover letter for details on the proposed development.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the � Yes X❑ No ❑ Unknown
Corps or State been requested or obtained for this property /
pro'ect includin all rior hases in the ast? Comments:
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: STv Engineers, Inc.
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 ❑X 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 X❑ No
6b. If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ❑X 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 impact Type of wetland Forested Type of jurisdiction Area of
number Corps (404,10) or impact
Permanent (P) or DWQ (401, other) (acres)
Tem ora T
W1 - Choose one Choose one Yes/No -
W2 - Choose one Choose one Yes/No -
W3 - Choose one Choose one Yes/No -
�/4 - Choose one Choose one Yes/No -
W5 - Choose one Choose one Yes/No -
W6 - Choose one Choose one Yes/No -
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.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial (PER) or Type of Average Impact
number intermittent (INT)? jurisdiction stream length
Permanent (P) or width (linear
Temporary (T) (feet) feet)
S1 P Culvert Br. of Richardson Creek PER Corps 15 8
S2 T Demolition Br. of Richardson Creek PER Corps 15 33
S3 P Stabilization Br. of Richardson Creek PER Corps 15 6
S4 - Choose one - -
S5 - Choose one • -
S6 - Choose one - -
3h. Total stream and tributary impacts 14
3i. Comments:
Stream Impacts are depicted on Attachment C- Sheet 4; permanent impacts associated with culvert placement do not include the approximate 38
linear feet of the existing bridge abutment which is in direct contact with the creek.
Page 4 of 10
PCN Form — Version 1.4 January 2009

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 individuall list all o en water im acts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number (if applicable) Type of impact Waterbody Area of impact (acres)
Permanent (P) or type
Tem ora T
01 - Choose one Choose
02 - Choose one Choose
03 - Choose one Choose
04 - Choose one Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If ond or lake construction ro osed, then com lete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID number Proposed use or Wetland Impacts (acres) Stream Impacts (feet) Upland
purpose of pond (acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 Choose one
p2 Choose one
5f. Total:
5g. Comments: No pond or lake construction impacts are proposed.
5h. Is a dam high hazard permit required? � Yes � No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. 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 chart below. If yes, then individually list all buffer impacts
below. If an im acts re uire miti ation, then ou MUST fill out Section D of this form.
6a. Project is in which protected basin? ❑ Neuse � Tar-Pamlico � Catawba � Randleman ❑ Other:
6b. 6c. 6d. 6e. 6f. 6g.
Buffer Impact Reason for impact Stream name Buffer Zone 1 Zone 2
number — mitigation impact impact
Permanent (P) or required? (square (square
Tem orar T feet feet
61 - Yes/No
62 - Yes/No
B3 - Yes/No
B4 - Yes/No
B5 • Yes/No
66 - Yes/No
6h. Total Buffer Impacts: o 0
6i. Comments:
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The majority of the riprap for stream bank stabilization will be placed in the uplands outside of the jurisdictional limits of the stream channel with only a minimal amount of
riprap placed within the stream channel. Best management practices (BMPs) and appropriate erosion and sedimentation controls will be installed and maintained during
construction activities. Potential temporary impacts to Branch of Richardson Creek are unavoidable due to the requirement to remove the existing bridge and the existing
masonry abutments. The horizontal alignment will be maintained. See cover letter for additional details on avoidance and minimization.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Construction of the double reinforced concrete box culvert will take place from roadway approaches which will minimize stream impact.
2. Com ensato Miti ation for Im acts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for X� 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):
2c. If yes, which mitigation option will be used for this
project?
3. Comnlete if Usina a Mitiaation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
3c. Comments:
❑ DWQ ❑X Corps
❑ Mitigation bank
❑X Payment to in-lieu fee program
❑ Permittee Responsible Mitigation
Type: Choose one
Type: Choose one
Type: Choose one
4. Com�lete if Making a Payment to In-lieu Fee Pri
4a. Approval letter from in-lieu fee program is attached.
4b. Stream mitigation requested:
4c. If using stream mitigation, stream temperature:
4d. Buffer mitigation requested (DWQ only):
4e. Riparian wetland mitigation requested:
4f. Non-riparian wetland mitigation requested:
4g. Coastal (tidal) wetland mitigation requested:
4h. Comments:
0 Yes
14 linear feet
warm
square feet
acres
acres
acres
5. Complete if Using a Permittee Responsible Mitigation Plan
Quantity:
Quantity:
Quantity:
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
The NCDMS In-Lieu Fee Program will be used for compensatory mitigation.
Page 6 of 10
PCN Form — Version 1.4 January 2009

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 X 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: o
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).
6h. Comments:
Page 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified � Yes ❑X No
within one of the NC Ri arian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
� Yes ❑ No
2. Stormwater Mana ement Plan
2a. What is the overall percent imperviousness of this project? 0%
2b. Does this pro'ect re uire a Stormwater Mana ement Plan? ❑ Yes ❑X No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
The Bridge Upgrade and Replacement Program process is considered a're-developmenY procedure and does not require a state stormwater permit.
BMP's and runoff controls will be implemented during construction to reduce the stormwater impacts to the receiving stream due to erosion and runoff.
Sediment and erosion control will adhere to "Design for Sensitive Watershed" standards. �
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which local overnmenYs 'urisdiction is this ro'ect?
❑ 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 Pro ram 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 � Yes ❑ No
attached?
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 8 of 10
PCN Form — Version 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the 0 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 0 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 ❑X No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ❑Yes ❑X 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 ❑X 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.
Project involves the replacement of an existing structure.
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.
N/A
�
Page 9 of 10
PCN Form — Version 1.4 January 2009

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 0 No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act Yes X No
impacts? � �
5c. If yes, indicate the USFWS Field Office you have contacted. -
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Anson County is not a listed county with Designated Critical Habitat. Endangered species information was obtained in September, 2016 from the
NCNHP and USFWS Ipac website.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes ❑X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NOAA EFH Webpage
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 ❑X 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?
Please see NCDOT'No Survey Required Forms', Attachment D.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ❑X Yes ❑ No
8b. If yes, explain how project meets FEMA requirements:
Hydraulic calculations have been prepared based on the placement of the double reinforced concrete box culvert. No increase in the upstream flood
elevations is anticipated based on these calculations. Based on the results of the HEC-RAS model for SR 1459 over Branch of Richardson Creek, the
existing bridge can be replaced without causing a rise to the established 100-year flood elevations and meets the requirements of Federal Highway
Administration, Federal-Aid Policy Guide, 23 CFR 650A, "Location and Hydraulic Design of Encroachments on Floodplains, and the NCDOT MOA.
8c. What source(s) did you use to make the floodplain determination?
FEMA FIRM maps on-line
Louis Mitchell, PE. 09-30-2016
Applicant/AgenYs Printed Name Applicant/Agent's Signature Date
(AgenYs signature is valid only if an authorization
letter from the a licant is rovided.
Page 10 of 10

NCDOT Division 10 Bridge Upgrade and Rep/acement Program September 30, 2016
SR 1459 over Branch of Richardson Creek — PCN for NWP #14
Attachment B
Jurisdictional Determination �II'iaterials
-USACE Stream Quality Assessment Worksheet
-NCDWR Stream Identification Form
- Wetland Determination Data Form
-Approved Jurisdictional Determination (Rapanos) Form
-Approximate Waters of the U.S. and Wetlands Boundary Map Exhibit
-Photographs

OFFICE USE ONLY: USACE AID#
�
DWQ#,
RPW Stream A(Branch of Richardson Creek)
STREAM QUALITY ASSESSMENT WORKSHEET
1. Applicant's Name: NCDpT Division 10 2. Evaluator's Name: B. Phi�li
3. Date of Evaluation: 8/23/13 4. Time of Evaluation: 230 nm
5. Name of Stream: Branch of Richardson Creek 6. River Basin; Yadk.in - Pee Dee
7. Approximate Drainage Area: 250 acres 8. Stream Order: 2nd
�
���� '' �
�
9. Length of Reach Evaluated: 100 ft. 10. County: Anson
11. Location of reach under evaluation (include nearby roads and landmarks): from brid�e to 1 p� feet ci_v_wn�tream
12. Site Coordinates (if known): 35.150168 N -80.278943 W
13. Proposed Channel Work (if any): culvert
14. Recent Weather Conditions: warn� sunny
15. Site conditions at time of visit: warm. suru�v
16. Identify any special waterway classifications known: _Section 10 Tidal Waters �Essential Fisheries Habitat
_Trout Waters _Outstanding Resource Waters , Nutrient Sensitive Waters �Water Supply Watershed IV (I-IV)
17. Is there a pond or lake located upstream of tl valuatian point? YES NO If yes, estimate the water surf area:
18. Does channel appear on USGS quad map? Y�E NO 19. Does channel appear on USDA Soil Survey? YES NO
20. Estimated Watershed Land Use: 10 % Residential _% Commercial �% Industrial 24 % Agricultural
70 % Forested _% Cleared / Logged _% Other { '
21. Bankfull Width: 15 ft 22. Bank Height (from bed to top of bank): 3 ft
23. Channel slope down center of stream: ,Flat (0 to 2%) X Gentle (2 to 4%) ,Moderate (4 to 10%) _Steep (>10%)
24. Channel Sinuosity: _Straight X Occasional Bends _Frequent 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): 54 Comments: Perennial RPW
RPW Stream A aka Bran�h of R.ichardson Creek, was determiined to bave perennial flaw within praject limits.
Evaluator's Signature � t � Date � �/ 3
This channel evaluation form is in nde to be �u d only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers in order 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 OS/03. To Comment, please ca11919-876-8441 x 26.

STREAM QUALITY ASSESSMENT WORKSHEET
RPW Stream A Br�rtch of Richardson Cree�
ECOREGIO NT RANGE
# CHARACTERISTICS Coastal p�ednlnnt Mountain SCORE
1 Presence of flow / persistent pools in stream 0— 5 — 0— 5 2
no flow or saturation = 0; stron flow = max oints)
2 Evidence of past human alteration 0— 6 0— 5 0— 5 4
(extensive alteration = 0; no alteration = max oints)
3 Riparian zone 0— 6 0— 4 0— 5 3
no buffer = 0; conti uous, wide buffer = max oints
Evidence of nutrient or chemical discharges
4 0-5 0-4 0-4 3
(extensive dischar es = 0; no dischar es = max oints
� 5 Groundwater discharge 0— 3 0— 4 0— 4 2
no dischar e= 0; s rin s, see s, wetlands, etc. = max oints
� Presence of adjacent floodplain
�
6 no flood lain = 0; extensive flood lain = max oints) 0— 4 0— 4 0— 2 3
,'y�" � Entrenchment / floodplain access 0— 5 0— 4 0— 2 2
Q+ (dee lv entrenched = 0; fre uent floodin = max oints)
g Presence of adjacent wetlands 0— 6 0— 4 0— 2 0
(no wetlands = 0; lar e ad�acent wetlands = max oints
9 Channel sinuosity 0— 5 0— 4 0— 3 2
extensive channelization = 0; natural meander = max oints
10 . Sediment input 0— 5 0— 4 0— 4 1
extensrve de osition= 0: little or no sediment = max omts)
11 Size & diversity of channel bed substrate NA* 0— 4 0— 5 2
fine, homo enous = 0; lar e, diverse sizes = max oints)
12 Evidence of channel incision or widening 0— 5 0— 4 0— 5 2
� (dee lv incised = 0; stable bed & banks = max oints)
Presence of ma or bank failures
� 13 � 0-5 0-5 0-5 3
�� (severe erosion = 0; no erosion, stable banks = max oints
�14 Root depth and density on banks 0— 3 0— 4 0— 5 2
E„� no visible roots = 0; dense roots throu hout = max oints)
� Impact by agriculture or livestock production
15 substantial im act =0; no evidence = max oints 0— 5 0— 4 0— 5 3
16 Presence of riffle-pool/ripple-pool complexes . 0— 3 0— 5 0— 6 2
F no nffles/ri les or ools = 0; well-develo ed = max omts
� Habitat complexity
� l7 0-6 0-6 0-6 4
� (little or no habitat = 0; fre uent, varied habitats = max oints
�Canopy coverage over streambed
1 g no shadin ve etation = 0; continuous cano = max oints 0— 5 0— 5 0— 5 3
x 19 Substrate embeddedness NA* 0— 4 0— 4 2
(dee 1 embedded = O; loose structure = max)
20 Presence of stream invertebrates 0— 4 0— 5 0— 5 2
� no evidence = 0; common, numerous es = max omts)
� 21 Presence of amphibians 0— 4 0— 4 0— 4 2
� no evidence = 0; common, numerous t es = max oints)
''� Presence of tish
0 22 (no evidence = 0; common, numerous es = max oints) 0— 4 0— 4 0— 4 2
� Evidence of wildlife use
23 0-6 0—S 0-5 3
(no evidence = 0; abundant evidence = max oints
Total Points Possible 100 100 100
TOTAL SCORE (also enter on first page) 54
* These characteristics are not assessed in coastal streams.

RPW Stream A(Branch of Richardson Creek)
NC DWQ Stream identification Form Version 4.11
Date: 8/23/2013 Project/S't�.���� R-fi4 SR 1459 Latitude: 35.150168
r r7 tRi h n r k
Evaluator: Brandon Phillips County: Anson County Longitude: -80.278943
Total Points: Stream Determinatibn {circle one Other Oakbaro, NC Quad
Stream is at least intermittent 38.75 E�hemeral Intermitten �renreiaf e.g. Quad Name:
if Z 19 or perennial if>_ 30"
A. Geomor hol� (5ubtotal = 22•� } Absent
1a Continuity of channel bed and bank 0
2. Sinuosity of channel along thalweg 0
3. In-channel structure: ex. riffle-pool, step-pool, 0
rip I�e-pool sequence
4. Particle size of stream substrate 0
5. Active/relict floodplain 0
6. Depositional bars or benches 0
7. Recent alluvial deposits 0
_ .�_�_ : �
8. Headcuts 0 �
9. Grade control 0
___ «__. _._ _ _...._. _..
10. Natural valley 0
11. Second or greater order channel No = 0
.. _. . _ _ - -----
'� artificial ditches are not rated; see discussions in manual
B. HydraPa�Y �subtotai = 7.5 �_
-_.... - �.. . . . . ...._
12. Presence of Baseflow 0 i
13. Iron oxidizing bacteria 0
14. Leaf litter 1.5
15. Sediment on plants or debris 0 i
16. Organic debris lines or piles 0
17. Soil-based evidence of high water table? No = 0
C. Biolc� (Subtotal -
18. Fibrous roots in streambed 3
19. Rooted upland plants in streambed 3 �
20. Macrobenthos (note diversity and abundance) 0
21. Aquatic Mollusks 0
22. Fish 0
23. Crayfish 0
24. Amphibians 0
-_.. _.. ___ _ _ -_--
25. Algae 0 �
26. Wetland plants in streambed �
'perenn��l etroamc m�v alen hc iricn4iFcri i imnn n4hor mc4hn.ic Cco n 4S nf m�ni ml
Notes:
Sketch.
Weak
1
1
1
1
1
1
1
0.5
0.5
1
0.5
0.5
Moderate
2
�
�
_ _..�
2
2
�
2
1
1
3
3
3
3
3
3
3
1.5
2 3
2 3
0.5 0
1 1.5
� 1.5
1
1
2
2
1
1
1
= 1.5 Other = 0

WETLAND DETERMINATION DATA FORM— Eastern Mountains and Piedmont Region
PrOJzCt1SICe: BURP SR 1459 over Branch of Richardson Creek CIIy1C0Ullty Burn�ville/Anson Samplinc� C�ate ��-�3-13
ApplicantlOwner: NCDOTDivision io State: N� S�mplingPoint:DP#i
Investigator(s): Brandon Phillips, CHMM Section, Township, Ran��:
Landform (liillslope, terrace, etc }: Terrace Loc:�l relief (conc�ve, convex, none}: Convex Slope (°/o}: —2
Subregion (LRR or MLRA}: L�-P Lat: 35.15016R N Long: -R��Z��9`�-� �' Datum: NAD 83
Soil Map Unit Name: Shellbluff NWI classification
Are climatic 1 hydrologic conditions on the site typical for this time of year? Yes X No (If no, explain in Remarl<s )
Are Vegetation , Soil , �r Hydrology significantly disturbed? Are "N�rmal Cireumstances" present? Yes X No
,�re Veget�tion , Soil , or Hydrology naturally problematic? {If needed, explain any answers in Remarks )
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
Hydrophytic Vec�etation Present? Yes
Hydric Soil Present? Y�s
VVetland Hydrology Present? Yes
Remarks:
No X � Is the Sampled Area
No X 'i within a Wetland? Yes No X
No X �
DP#1 is representa[ive of an upland area (See Approximate Waters of [he U.S. and Wedands Boundary Map Exhibit For location of DP#1).
HYDROLOGY
Wetland Hydrology Indicators: SeF�c,r�d:1N Indi�_.;�ar� (mu7imum ��i �w� rac�uir�e.i�
Primarv Indicators �minimum of one is required, check all that a,pplyl _ Surface Soil Craclts (B6}
Surface Water (A1) _ True Aquatic Plants (g14} _ Sp�rsely V'eget�ted Concave Surface {g8}
_ High Water Table (A2} _ Hydr�gen Sulfide Odor (C1) _ Drainage Patterns (B10}
Saturation {A3} _ Oxic�ized Rhizospheres on Livin� Roots (C3} _ Moss Trim Lines (�16}
Water Marks (B1j _ Presen�e of �educed Iron (C4) _ Dry-Seasc�n UVaterTable (C�}
Sediment Deposits {Bi) _ Recent Iron Reduction in Tilled Soils (C6) _ Crayfish Curr�ws (C�)
Drift Deposits {g3) _ Thin Muck Surtace {C7) _ Saturation Visible �n A�rial Imag�ry {C9j
Alg�l Mat or Crust (g4} _ Other (Explain in Remarks} ,_ Stunted or Stressed Plants (L�1}
Iron Deposits {B5} _ Geom�rphic Position (D2)
Inundation Visible on Aerial Imagery {87} _ Shallow Aquitard (D3)
Water-Stained Leaves (B9} � Microtopogr�phic RPlief (Ct1)
_ Aquatic Fauna (B13} _ FAC-Neutral Test (D5}
Field Observations:
SurfaceWaterPresenY? Yes No X Depth (inches):
'�later Table Pres�nt^ Yes No X Depth [inches):
Saturation Present? Yes No X Depth [inches}: Wetland Hydrology Preserit? Yes No �
(includes capillarV frinqe}
Describe Rec�rded Data (stream gauge, monitoring well, aarial photos, previ�us inspections), if �vailable:
Wedand Hydrology Tndicators are not present.
US Army Corps of Engineers Eastern Mountains and Piedmont—Versi�n � 0

VEGETATION (Four Strata) — Use scientific names of plants. Sampling Point: °�'
Al�s+�3u[c Dumin:�7[ Inciicatr�r ' DominanceTestworksheet:
Tr�e SEr�tiorn (Plot size 30' radius ) `� rover :ai���es? Status :�umber of Dominant Species
� Plufuitus occidenmlis 70 Yes FACW ; That Are OBL, FACW, or FAC: 2 (A} '
� 2 ,Ili,�,l!lli.s' 177,(1'f! 30 Yes FACU : '
� i Total Number of Dominant
`� � Species Across All Strata: 5 {B) i
i�
Percent of Dominant Species
�� � That Are 08L, FACW, or FAC: 40 {A/8)
�E �
� � Prevalence Index worksheet:
� �� = Total Cover
� Total °/o Cover of: Multiplv bv: �
50°/0 of total cover: 50 20% of total cover: 20 08L species x 1= _ '
Saulm�l5ht'ub Stratum (Plot size: Ul' r:,eliu.w } ' FACW species x 2=
� 1 ✓«Rlans nigra 4p Yes FACU � FAC species X 3— �
� 2 Ulmus arnericana l5 Yes FACW ' FACU species X 4—
I3 Cercis canadensis 15 Yes FACU UPL species X 5=
4 i Column Totals: (A} (B}
� i Prevalence Index = B!A =
� 6. '
� � }iydrophytic Vegetation Indicators:
i 7. '
�_ 1- Rapid Test for Hydrophytic Ve�tation �
�8.
2- Dominance Test is >50qo
' 9 3- Prevalence I ndex is <_3 0' i
� '1� = Total Caver ,
i _ 4- Morphological Adap[ations {Provide supporting !
50% of total cover: 35 20% of total couer: 14 data in Remarks or on a separate sheet} �
Herb Straturn (PIOt SIZe: 1.5 meter � � i
1 Gofium nerenne 70 Yes FACU — Problematic Hydrophytic Vegetation' {Explain}
2 Sorgl�um hnlepense IS N� FACiJ �
;'Indicators of hydric soil and wetland hydrology must
3 Solanum carolinense i0 No FACU � be present, unless disturbed or problematic
4. Commelrnaconanunis 5 No FAC I.— �';..-- —`----- .--------.—..,_�
� Definttions of Four Vegetation Strata:
5.
i
' 6 , Tree-Woody plants, exduc�ngvines, 3 in (7 6 cm) or .
' more in diameter at breast height (DBH), regardless of '
7 I height. i
8
SaplinglShrub-Woo� plants, excludingvines, less
9 than 3 in DBH and greater [han or equal to 3 28 ft (1
; ��j m} tall ,
11 Herb - All herbaceous (non-woody} plants, regardless
if�[y = Total �we�, of size, and woody plants less than 3 28 ft tall
! 50% of total cover: 5� 2Q°/� vf total c�rvar 20
Wo�ody vine - All woody vines greater than 3 28 ft in �I
VV�aciy Vine Stratunm {Plot size: 30'radius ) hei ht
,� -
I� — _ i
� 3 -- ---- - --------
4
Hydrophytic
�. Vegetatian
= Total Cover Present? Yes No X
; 50% of total cover: 20°/o of total cover: '
' Remarks: (Include photo numbers here or on a separate sheet )
I
p Hydrophytic vegetation is not present. !
US Army Corps of Engineers Eastern Mountains and Piedmont - Version 2 0

SOIL
Sampling Point:Dr�l
__ . _ --- —......-- � . _.._._
Profile Description: (Describe to the depth needed to document the indicator or confirm the absence of indicators.}
�-���m.���� _._ .._--_..__��atrix Re�iox Featurzs
rin�:����.�;i Color trnoist} _ ;ro r��lor (moi�,tl °ro �' Lor2 a<�yi+i,�.� � F�ernarks_
0-8 10 YR 3/2 100 Sandy Fill materials
8�i0 10 YR 4/4 100
'T��pe: ��=Conr_entration
Hydric Soil Indicators:
_ Histos�71 (F1j
_ Histic E�i�eraon +A2)
_ Blacl:: Histic (A3)
_ H�,J�ro�en Sulfid�. (H�1,1
_ �tratifiEd Lay?rs fHSj
_ 2 �=m P��ur_� (A1U� (LRR M
_ C�eplet�d Bel�wr C���rk Surt��ce (f111,1
_ Thic4�: C���rk. Surf�ce (1�92}
v '�an�_ly� P�,1uc4c,� Min�ral ( �1} (LRR N,
MLRA 147, 148)
_ `�an�iy Glet�zd Matri� {���4)
_ Sandy �edox. f�;}
.7CIIfJ�JF'CI NI�t(IY•. 1�.7rJ]
Restrictive Layer (if observed}:
TyF �e:
C��pCh jlncf-�esi _...�_ �...
Ramarks: ---- -----
Sandy clay
;diar_ed h���tri�, ha1�=Masl::eJ Sari�J �rain� ZL�c�tion: FL=P�re Linir��, M=Prl�trii.
Indicators for Problematic Hydric Soils'
_ C�ark S�_nft�ce jS7j _ 2 crn ti�ucl<. {A10j (MLRA 147)
_ F'��I�>>value BFI��+n� Surface (:.�,�j {MLRA 147, 148) _�'o�st F'rairiF Recio;:: {.A16}
_ Thin Dark Si_�rfara (Sg;, (MLRA 147, 148) (MLRA 147, 148)
_ Lo�my ��le�ed P��dtrix {F2) _ Pie�m�nt Flo�dpl�in Soils {F19J
_ GG�let�ci I+rlatrix: (F3�} {MLRA 736, 147)
_��dox D�rk. Si_��f�ce {FF} _ Very Shall�7vd CJarl< �urf��:e fTF'12j
� De�_�IGt?cl Gark Surf��ce (F7j _ Other {E:cpl��in in Rem��rks)
_ R�dox D��,r�,si�ns {F8)
_ Iron-M�naanese Iv9a�ses I,F1�) (LRR N,
M LRA 136)
_ Urnbrir c;urfare (F13) (MLRA 136, 122) 3lndicatars uf h�fdrophytic: �vPgFtati�n anr�
_ Pi�dmont Flr.�c,r�E,ldin 'c,c�ils fF'1 a) (MLRA 148) v�ietl��n� hy�rolo�ay mia�t b� present,
! Re� Par�nt Materi�l (F2'1) {MLRA 127, 147) unlPs�� disturGe�_1 or pr�,blernatic
Hydric Soil Indicators aze not present.
� Hydric 5oil Present? Yes No X
U� Arm�+ �'�rps crt Enr�ineers E�etern N1our�tain" �n� F'ie��77ont—l�er.sion 2 0

APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION: NCDOT Div 10 BURP - SR 1459 over Branch of Richardson
Creek
State:NC County/parish/borough: Anson City: Burnsville
Center coordinates of site (ladlong in degree decimal format): Lat. 35.150168° �, Long. -80.278943° �.
Universal Transverse Mercator: N 3889934.5 E 565677.56
Name of nearest waterbody: Branch of Richardson Creek
Name of nearest Traditional Navigable Water (T'NW) lnto which the aquatic resource flows: Pee Dee River
?�3sne of �iratershed �r l�yclr��3ra�;ic Unit C�odc {��1t.fC): i1344i71 l75
� Check if ir�a�ldi�gram �f re.view arca andlor potez�tsai jurisclictional areas is/arc availablu upnn re�uest.
� Che�k if otiter sites (e.�,, affsitc niiti�yatian sitcs, dispasal sitGs, etc...� are a,wsociated wiFh tt�is aeti�n and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPL1�:
� 43Ffiee {Desk} �e(crminati�nn. I)ate: 08/22/13.
� Fic:ld DecemiinatiUn. Dtttc(s): []�l23/13
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Are �tp "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the
review area. [Required]
0 Waters subject to the ebb and flow of the tide.
� Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce.
Explain: .
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There Are "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [RequiredJ
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): 1
TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent watersZ (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
❑ Wetlands directly abutting RPWs that flow directly or indirectly into "TNWs
[,� Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
❑ Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
❑ Impoundments of jurisdictional waters
[� Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non-wetland waters: RPW Stream A(Branch of Richardson Creek) = 2721inear feet: 15 width (ft) and/or 0.09 acres.
Wetlands: acres.
c. Limits (boundaries) of jurisdiction based on:'Established fay [?HWM.
Elevation of established OHWM (if known): .
2. Non-reguixted waterslwet{ands (check if applicable):3
0 Pt�tcntiallyjur'ssdiclionai waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain: .
' Boxes checked below shall be supported by completing the appmpriate sections in Section III below.
Z For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months).
3 SuppoRing documentarion is presented in Section III.F.

S�:CTI��I [F1: �WA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete
Section III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.1.; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacenY':
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNVV) AND ITS ADJACENT WETLANDS (IF AN17:
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps
determine whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non-navigable tributaries of TNWs where the tributaries are "relatively permanent
waters" (RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3
months). A wetland that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round
(perennial) flow, skip to Section III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and
EPA regions will include in the record any available information that documents the existence of a significant nexus between a
relatively permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even
though a significant nexus finding is not required as a matter of law.
If the waterbody° is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must
consider the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, fpr
analytical purposes, the tributary and all of its adjacent wetlands is used whether the review area identitied in the JD request is
the tributary, or its adjacent wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section III.B.1 for
the tributary, Section III.B.2 for any onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite
and offsite. The determination whether a significant nexus exists is determined in Section III.0 below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: Pick List
Drainage area: Pick Lisf
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Ciel�ationship �vi(I� "I'NW'�:_
❑ Tributary flows diruz:i9y Inft� Ti*iW.
❑ Tributary flows thrnu�h Pick I,ist tributaries before entering TNW.
Project waters are PickList river miles from TNW.
Project waters are PicJc Lis� river miles from RP W.
Project waters are PlckList aerial (straight) miles from TNW.
Project waters are PickList aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNWS:
Tributary stream order, if known:
^ Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and emsional features generally and in the arid
West.
5 Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TN W.

(b) G�:e3craf Trihutary Char�ctc�•istics (check a�l [l�at a!:
Tributary is: [] Natural
❑ Artrtic�al {r77an-mad�}. Expl�in:
❑ ManiF}ulatcd (man-alt[:rcd). Fxplain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick List.
Primary tributary substrate comp��sit3on (check all that apply):
❑ Silts ❑ Sr�nds ❑ Concrete
❑ Cobbles ❑ Gravel ❑ Muck
[� Bedrock ❑ Vegetation. Type/% cover:
❑ Other. Explain: .
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain: .
Tributary geometry: Ptck List
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for: Pick Z,iat
Estimate average number of flow events in review area/year: Plck List
Describe flow regime: .
Other information on duration and volume: .
Surface flow is: Plck List. Characteristics:
SubsurFaee flow: �ek List. Ex�l�sin findings:
❑ Dye (or c�iher} test perfar�ned: .
Tributary has (check all that apply):
❑ Bed and banks
❑ OHWM�' (check all indi�atc3rs that ap�71y):
❑ clear, natural line impressed oi� Flz�: i�ank
❑ changes in the character of soil
❑ shelving
❑ vegetation matted down, bent, or absent
❑ I�:af tittez• distur�i�d nr washed away
❑ tie�isnenl depositic.fn
❑ water staining
❑ other (list):
❑ Discontinuous OHWM.� Explain:
■
■
■
■
■
■
■
the presence of litter and debris
deshuction of terresh-ial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
abrupt change in plant community
If factors other than the OHWM were used to determine lateral extent of CWA jurisdiction (check all that apply):
❑ High Tide Line indicated by: 0 Mean High Water Mark iildicated by:
❑ ail crr �c;un� liner.ii<�ng s�t��rc: s�bjccts ❑ survey t� av3ilable datur��;
❑ tinc shc�l o�- cic�ri� d��nsits (ttxreshore) ❑ physical markin�k;
❑ physicai anfirkin�slc�iaracE�ristics ❑ vegetation lin�slchanges in vegetation types.
❑ tidal gauges
❑ other (list):
(iii) Chemical Characteristics:
Characterize h-ibutary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.).
Explain: .
Identify specific pollutants, if known: .
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
711�i�.

(iv) Biological Characteristics. Channel supports (check all that apply):
❑ Riparian eurridor. �l�ar��ct�ristics (type, average width): .
❑ W�clarid Iringe. Ch�r�ctciistics: .
❑ Habitat for:
❑ Fer�er311y Ls�ted sps�;ies. Ex�lain findings: .
❑ Fisfrlspawn areas. Cx��laii7 lieiciings: .
❑ Other environmentally-sensitive species. Explain findings:
❑ Aquatic/wildlife diversity. Explain findings: .
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) Gencrsal Wctian�i Cl�aracTca'istics:
Properties:
Wetland size: acres
Wetland type. Explain: .
Wetland quality. Explain: .
Project wetlands cross or serve as state boundaries. Explain:
(b) Ger�eral E��uiw I��lationshi rvi�h Non-"i"NW:
E"Ic�w is: Pick List. Explain: .
Surface flow is: Pick I..,�st
Characteristics:
Subsurta4c Ilo�v: Fisk �,��t. I�x��Eai:� findings:
❑ I)ye (c�r ��thcro°) ttMt ��crtomte�i: .
(c) Wetl�ncl �1.di�tcency i]ets:nnin�Eic�n wtCh Ncxn-`fNW:
❑ L7irectfy al�uttin�
❑ Not directly abutting
❑ Discrete wetland hydrologic connection. Explain: non-jurisdictional stormwater conveyance.
❑ Ecological connection. Explain: .
❑ Separated by berm/barrier. Explain: .
(d) P�•oxiinily (,f{�Iriti<�sls�i}� tci'i N1�'
Project wetlands are Pick List river miles from TNW.
Project waters are Pick Lis# aerial (straight) miles from TNW.
Flow is from: Pi�k Lis#.
Estimate approximate location of wetland as within the PiCic LiBt floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain: .
Identify specific pollutants, if known: .
(iii) Biological Characteristics. Wetland supports (check all that apply):
❑ Riparian buffer. Characteristics (type, average width): .
❑ Vegetation type/percent cover. Explain: .
❑ Habital for:
❑ Federally Listed species. Explain findings: .
❑ Fish/spawn areas. Explain findings: .
❑ Other environmentally-sensitive species. Explain findings:
❑ Aquatic/wildlife diversity. Explain findings: .
3. Charactcristits of ail wetlands adjacent to the tributary (if any}
All wGcla�ul(s) hci�g considcrcri in the cumudative analysis: Pick List
Approximately ( ) acres in total are being considered in the cumulative analysis.

For each wetland, specify the following:
Dires:dy s�6uts`? (Y/�f) Si•r.e (ir� a4res} C?ircctly ahuts�Y1N) Siie (in act°�:si
Summarize overall biological, chemical and physical functions being performed: .
C. SIGNIFICANT NEXUS DETERMINATION
A signific$nt nexus analysis will assess the flow characteristics and functions of the tributary itself $nd the functions performed
by any wetlands adjacent to the tributary to determine if they signiticantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combinatioo with all of its adjacent
wetlands, has more than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW.
Considerations when evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow
of water in the tributary and its proximity to a TNW, and the functions performed by the tributary and all its adjacent
wetlands. It is not appropriate to determine significant nexus based solely on any specitic threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNV�. Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of signiticant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and
discussed in the Instructional Guidebook. Factors to consider include, for example:
• Does the h-ibutary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a T'NW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support funetions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downsh-eam foodwebs?
• Does the Mbutary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or
biological integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented
below:
1. Signifcant nexus tindings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D: .
2. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D: .
3. Significant nexus tindings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain findings of
presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to
Section III.D: .
D. DETERMINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL
THAT APPL1�:
1. TN Ws and Ad jaee�tt Weflands. Cfie�:k all that apply and provide size estimates in review area:
Q 7'i�f Ws_ Iincar f��t widtli (ft), Or, acrc�s.
[f Wetl�i�c�s at�jacent tU �"t�Ws: acres.
2. !t�'Ws thaf flnw directiy or indireedy into "7'�"Ws.
� Tributaries o#' `I'I�i Wr whcr� tr�l�ut.sries ty�ricaIiy flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: RPW Stream A(Branch of Richardson Creek) has an OHWM, well-defined bed and banks, fish and
some sediment deposition. RPW Stream A is depicted as a blue line on the USGS topographic quadrangle and as a stream on
the NRCS Soil Series Map. RPW Stream A(Branch of Richardson Creek) flows to Richardson Creek (RPW) which flows to
the Rs�cky River {R�'W) �ti�hioh ilc�ws tv tYle t'ce Qce l2iver {'I'N W).
Q Tributa3�ies of TNW �vl�ere [ribttl;trics l�ave oantii�uc�us Ilc�w "4e�scmally" (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that h-ibutary flows
seasonally: .

i'rcr�idC c.�sti�nat�r fnrjUriss3ictianal �v�sters in thc: rcvicw an:a {chcck all that apply):
� Tri{�uEary w�ters:: RPW Stream A is l72 lin�ar f�ct 15 wit[th (ft).
❑ [7lher i�cm-wetiand wAts:rs: acres.
Identify type(s) of waters: .
iYon-RPWse that flow direef�y or indirectly into �I� Ws.
f] Water�ody lhat is not 1 Tt+1W or an RPW, but tl�ws �iirectly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provid� r.�;tintiates f�r jurisdic;tianal w�tters within the review area (check all that apply):
❑ `I`ri��utary watcrs: linc:ar fecl width (ft).
❑ CJthe:r non-wctiaizcl wat�rs: acres.
Identify type(s) of waters: .
4. Wetlands c9irectty abuttia� an FtPN' ;hat flow directiv ar indirectly inta 7`N Ws.
(] Wctlancls ciirsrctfy al�ut ttFW ��7d tlius ase jurisclir:tinna$ as :��j��;er�t wctia�ds,
❑ WeN�ar7cls directly af�uttin� F3n R[' W wh�re lributaries typis:ally 4lt��v ye�r-r��und. Provide data and rationale
indicating that h-ibutary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW: .
❑ Wetlands directly abutting an RPW where Mbutaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW: .
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
5. Wetlnnd� ad�acent to i�ut nat directly abutting an RPW thst f�ow dir�ctly ar ir�directly into T�IWs.
❑ W�tla�cis that do nc�t dirct;tly abut hn RP W, but when cc���si�ier�ci in cnrTit�in�tian wifh the triL�utary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a T'NW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
Wetlands adja�ent to non«RPWs that flow direetEy pr indirectly into T1V1�'�.
❑ Wetluncls adjacent to s�cii waters, and have wh�;n cnn�idered in combi�iatian with the tributary to which they are adjacent and
with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this
conclusion is provided at Section III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
Impoundments of jurisdictional waters 9
As a�cneral ru��, tEl� sm�nunc�meni c�F a jurisslictic�nai tributary rcmainw,Eur't�;clicti�na�.
(� [J�:mr�r�strafe; t�at ic�j�o��ndment w�s c�x;�4iccI #i-om'`waters Qft}z� 1J.5.„" ��r
❑ Demanstrlte lhal watcr 3ne:cts the criit;ri�a fcrr nne of the categ«ries �resc��taci abt��Fe (1-6), or
❑ I3emnnstrakc that �vater is isc}lat�•d wi4l� a ncxus lt� ccr�nzncrce {se.c: � l�clo�u}.
E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
StJC["� �'V.aTERS (CE��!;CK Ai.l� �'HA7' A��'PLY}:�n
❑ e�°l�ich �re ar cvul�i Lse usecl i�y interstais: nr fasc:i�n tr�4�elers fi�r recreational or other purposes.
❑ fi•ram which tish �a• sh�ilfi�h .erc nr cfluid i�e takcn €tra�) scri�l it� interstate or foreign commerce.
[,� w��ic.l� �r�e c�r eEsulr� #�c: usec� Ff7r industrial ,�ur}�ases i�y inciustries in interstate commerce.
❑ [nterst�tc: iscrlate�l tivatcrs. Cx�l�tin: .
BSee Footnote # 3.
9 To complete the analysis refer to the key in Section III.D.6 of the [nstructional Guidebook.
�0 Prior to asserting or declining CWA jurisdiction based solely on this categary, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the pracess described in the Corps/EPA Memorandum Regarding CWA Act Jurlsriicfi�tn Fo!/owing Rapanos.

❑ Other factors. Explain:
Identify water body and summarize rationale supporting determination:
f'rc��ide estias3ate:s tirr juris�i�ctir�naf waters in the review area (check all that apply):
❑ TrihuFary wats:rs: liRcar ts;et width (f't).
❑ Oths:r r�t�n-w�tla�r�d w�tcn: acres.
Idcntily typ�{�} of waters: .
❑ Wetlands� acres.
F, i�i)iV-JUR[SDICT3C?EYAL WATEI22�;, I1VCE.U�ING WET1.A�1)S (Cl�ECK Af.I. THAT AP['L1�:
❑ lf �nle�itial sac:tlan�ls were asse:sseri witlli� th�: review area, t�lcse ��rehs did not mcet tl�e criteritt in the 1987 Corps of Engineers
Wutlanc! Delineatityn Manual �sncir'nr,tP�r�apriatc Eteg'scrnal 5u�piernents.
� Revicw area includ�d isc7!<y[ud �3�a�si�s �vith no suhstantial nex�s to int�:rstate (or foreign) commerce.
❑ Prior to the 7an 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solelv on the
'`aVtigntc�ry $i�•d f{ulc' (MF3R).
❑ Waters ticr n�Ji mac:i tl�c "5igiuficant �iexus" standard, where such a finding is required for jurisdiction. Explain: .
❑ {7tlzc�•: (explain, ii�n�t cov�rc� a6n�e): .
Provide acreage estimates for non jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR
factors (i.e., presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional
jud�mc«t {chcc:k siI t��at �n�lY):
❑ i'S[an-wc;tlssiz�i watcrs (i.c., rivers, strcams}: �inear f��t width (ft).
[j Laiccs,!pernds: acres_
[] Ot�ier n�ar�-�vclEand ��atc:rs: t�cres. List ty}�e of ayuatic res�urce: .
❑ Wtil�a�c�s: acre::.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finclin� is reyuircd fc�rjuri�ci'r�tinn (check atl f�r�t �ip�lyj:
❑ N<�r�-werland vuatcrs {i.ea, rivers, streams]: lia��dr feet, width (fi).
❑ L�ske�l��nn�ls; acrr;s.
� Q�the;r �a�n-��etland w•atc;rs: acres. I.ist type t�f'�tquati� resource: .
❑ W�:tlands: acres.
SF:C'ilUI4 IV: �ATA SOURCFS.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
and reyuestt�, a��rnpriately refc�renc�. sources below):
� Ma�s, �tans, �3I�ts crr piat sut7milted by or o� behalf of the applicandconsultant: Attachment B- Approximate Waters of the U.S.
��nci Wetlan�i� E3c�undary Map �.xhihit-
� Dala sheets g�rt;pu�cc�ls�sh��iitt�ci 6y s�r on l7t'h�lf c'#`the appxicant/consultant.
[] {)Fficc cancurs wilii ciata sheet�.�'cieiincatix�st repnr[.
❑ at�fic:c dcaes nof eaitcur +viEh r�ata she�t:;ldclintati[an re�csrt.
❑[7�rta s�iaets pr�par�cl hy thu C.urps: .
❑ Ct�r�y nauigabic �4�aters' :�tudy: .
[� iJ.S. C;�UEogica3 SucVcy Hycii•uio�ic Atla:+: .
[� f.FStiS �+I Hi] daka.
❑ USGS 8 and 12 digit HUC maps.
� U.S. Geological Survey map(s). Cite scale & quad name:1:24000, Oakboro, NC (1971).
� USDA Natural Resources Conservation Service Soil Survey. Citation: NRCS Soil Series Data for Anson County (2009).
(� National wetlands inventory map(s). Cite name: Oakboro, NC.
❑ State/Local wetland inventory map(s): .
❑ FEMA/FIRM maps: .
0 100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
(� Photographs: � Aerial (Name & Date):NAIP, Anson County 2010.
or � Other (Name & Date): Photos (08/23/13).
❑ Previous determination(s). File no. and date of response letter: .
0 Applicable/supporting case law: .
[] Applicable/supporting scientific literature: .
� Other information (please specify): .

B. ADDITIONAL COMMENTS TO SUPPORT JD: The limits of jurisdictional waters of the U.S., Stream A(Branch of Richardson
Creek) were delineated by STV and surveyed by the NCDOT (Attachment B- Approximate Waters of the U.S. and Wetlands Boundary Map
Exhibit). Stream A was determined to be a relatively permanent water (RPW) with perennial flow based on an OHWM, well-defined bed
and banks, fish and some sediment deposition and is also depicted on the USGS and Soils Survey as a stream (blue line) feature. RPW
Stream A(Branch of Richardson Creek) flows to Richardson Creek (RPW) which flows to the Rocky River (RPW), which flows to the Pee
Dee River (TNW).

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NCDOT Division 10 Bridge Upgrade and Replacement Program September 30, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
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Photograph 1- A view of the SR 1459 bridge over Branch of Richardson Creek, looking to the
northeast.
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Photograph 2- A view of RPW Stream A(Branch of Richardson Creek) at the SR 1459 bridge,
looking upstream to the north.

NCDOT Division 10 Bridge Upgrade and Replacement Program September 30, 2016
SR 1459 over Branch of Richardson Creek — PCN for NWP #14
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Photograph 3— A view of RPW Stream A(Branch of Richardson Creek) at the SR 1459 bridge,
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Photograph 4— A view of RPW Stream A(Branch of Richardson Creek) flowing under the SR
1459 bridge.

NCDOT Division 10 8ridc�� Upgrade and Rep/acement Program September 30, 2016
SR 1459 over Branch of Richardson Creek — PCN for NWP #14
Attachment C
Figures

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See Sheet 1-8 For Stondard Symbology Sheet
BEGIN PROJECT WBS 17BP.IO.R.60
-L- STA.10 + 20.00
CLEARING ON THIS PROJECT SHALL BE PERFORMED
TO THE LIMITS ESTABLISHED BY METHOD II.
GRAPHIC SCALES DESIGN DATA
20 l0 0 20 4o ADT 2008 = 70
ADT 2025 = 140
PLANS DHV = N/A
20 l0 0 20 40 D= N/A
T = 6 °/a
PROFILE (HORIZONTAL) V = 45 MPH
4 2 0 4 8
FUNC. CLASSIFICATION:
PROFILE (VERTICAL) LOCAL
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A1�S01� CO U1�TY
LOCATION: BRIDGE #l94 OVER BRANCH OF RICHARDSON CREEK
ON SR 1459 (BLONNIE ROSS RD.)
TYPE OF WORK GRADI11lG, PAVI11lG, DRAI11lAGE, � STRUCTURE
STREAM IMPACTS
SITE 1
SEE
FIGURE—
SITE 1
BEGIN CULVERT
-L- STA. 71 + 88.01
-L-
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PROJECT LENGTH
LENGTH OF ROADWAY PROJECT WBS 17BP.IO.R.60 = 0.050 MILES
LEIVGTH OF STRUCTURE PROJECT WBS I7BA.IO.R.60 = 0.005 MILES
TOTAL LENGTH OF PROJECT WBS 17BP.IO.R.60 = 0.055 MILES
NCDOT CONTACT: GARLAND HAYWOOD, PE
Division Bridge Manager
�T6 STAT6 PROl8C1' R6Y6R6NC8 NQ
��� 17BP.10.R.60
STATB PRd.NO. P.A.VROI.N0.
17BP.10.R.60
17BP.10.R.60
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END PROJECT WBS 17BP.IO.R.60
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PLANS PREPARED FOR THE NCDOT BY:
� S'I'V / Ralph Whitehead Assoeiates, Inc.
900 West Trade St., Ste. 715
Charlotte, NC 28202
NC License Number F-0991
20/2 STANDARD SPEC7F7CATIONS
FIYDRA ULICS
ENGINEER
RIGHT OF WAY DATE: NIKKI T. HONEYCUTT, PE ROADwAY
DECEMBER 2, 2014 rRo�Ecz ExcrxEEn DESIGN
ENGINEER
LETTING DATE: MAAMOON K. ABDELAZIZ
MAY 20� �LO�S PROJECT DESIGNER
P.E.
Permit Drawing
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LEGEND STREAM PERMIT IMPACT
AREA (AC) LENGTH (FT)
� DENOTES IMPACTS IN -
SURFACE WATER PERMANENT 0.02 14 S I TE 1
SW IMPACTS
�DENOTES TEMPORARY TEMPORARY �
IMPACTS IN SURFACE WATER SW IMPACTS 0.01 33 �
SEE
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JENNIFER L WHITLEY
DB 485 PG 296
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BEGIN CULVERT
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EXIST BRIOGE
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END CULVERT
-L- STA l2t/5.83
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VC = 90'
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END PROJEGT WBS I7BP.�R.60
�- STA /3+/OAO
EL = 29953'
BL-3
lNG GROUND
13+50
CULVERT HYDRAUUC DATA
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ease ascHarce - aoo cFs
BASE fRE01/EA�Y = /QD YRS
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OVERr�PU1� FREQUENCV= )50 YRS
aEirroPai� Ecevar�av = � Fr
315
310
305
300
295
290

LEGEND STREAM PERMIT IMPACT
AREA (AC) LENGTH (FT)
� DENOTES IMPACTS IN -
SURFACE WATER PERMANENT 0.02 14 S I TE 1
SW IMPACTS
�DENOTES TEMPORARY TEMPORARY
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SEE
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305
300
295
290
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SPEED PER SUB-REGIONAL TIER DESIGN GUIDEUNES. � W
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TO BE REMOVED
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BL-3
lNG GROUND
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CULVERT HYDRAUUC DATA
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315
310
305
300
295
290

LEGEND
P�7�T1 DENOTES IAiPACTS IN
IL;�'L1a SURFACE WATER
pENflTfS TEI�P�RART
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IMf'ACTS IN Sl1RFACf WATER �P� / DAVID TUCKER
J DB 802 PG 186
ff
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r�n��a�� i�n�acrs
AREA (AC) LENGTH (FT) � IN SUftF E WATER
PERMANENT 0.02 I4 '� �
SM IMPACTS
TEMPORARY 0.01 33 M
SW IMPACTS
� �(�-11� RF� WATER �T5 ��
� x X- FROM S7ABILI�ATIOH � ,i
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BtONN1E R055 ROAG
SR l459
4' PERMANENT IMPACTS
IN SURFACE WATER
FROM NEW CULVERT
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CURTIS O HITLEY
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N����
DIVISION OF HIGHWAYS
ANSON COUNTY
PROJECT: 17BP10.R.60
� BRIDGE i�19� OVER
BRANCH OF RICHARDSON CREEg
ON SR 1�59
(BLONNIE ROSS ROAD)
SHEET 1 OF 1 9/ 30 / 2016

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NCDOT Division 10 Bridge Upgrade and Replacement Program September 30, 2016
SR 1459 over Branch of Richardson Creek — PCN for NWP #14
Attachment D
No Archaeological Survey Required Form and Historic Architecture
and Landscapes No Survey Required Form

Project Tracking No.:
16-06-0001
��•��, NO ARCHAEOLOGICAL SURVEY REQUIRED �FORM �1�-St3t��,
1��� �"`ygy �', This form only pertains to ARCHAEOLOGICAL RESOURCES for this project. It is not ' 31f �``�`�nu'�1
"tij, iYuPsf�:iR. � i�j t-- I n I�
; �,�.� ��; valid for Historic Architecture and Landscapes. You must consult separately with the .�,�,} ��
�� Historic Architecture and Landscapes Group. `����'�`j���
�' �°`� . ....
PROJECT INFORMATION
Project No:
WBS No:
STR. #030194
17BP10.R.60
County:
Document:
Anson
PCE
F.A. No: na Funding: � State ❑ Federal
Federal Permit Required? � Yes ❑ No Permit Type: NWP 14
ProjectDescription: NCDOT Division 10 intends to replace Bridge No. 194 on SR 1459, Blonnie Roass
Road, over an unnamed tributary of Richardson Creek near the Union County line. The proposed
replacement structure will be a reinforced concrete box culvert in the same location as the original
structure. The length of the proposed project is listed at 260 feet (nearly 79.25 meters). Right-of-way
(ROW) at the crossing is currently listed at 50 feet, but the proposed project may require ROW to expand
out to 85 feet (approximately 25.9 meters). For the purposes of the archaeological review, the area of
potential effects (APE) will encompass an area of nearly .51 acre (almost .21 hectare).
SUMMARY OF CULTURAL RESOURCES REVIEW
Brief description of review activities, results of review, and conclusions:
A review of the site maps and fles azchived at the North Carolina Office of State Archaeology was
conducted on June 6, 2016, NCDOT archaeologist, Brian Overton. No previously identified
archaeological sites are recorded within the proposed APE, nor are any archaeological sites recorded
within .5 mile of the proposed APE. An examination of the data presented on the North Carolina State
Historic Preservation Office HPOWEB GIS Service (http:Ilgis.ncdcr.goWfhpow�:€�l] reveals that recarded
historic properties are located within the same radius, including a no-longer-extant historic house
(AN0175) and the William Parker House (AN0176). One cemetery has been recorded approximately .3-
mile (nearly .5 kilometer) south-southeast of the bridge. It should be noted, however, that no historic
properties are recorded in the vicinity of the APE.
An examination of soils in Anson County presented on the National Resources Conservation Service Web
Soil Survey (http:llwehsoi�sur�ey.nres.�sda.gavfapplWebSpilSurvev.asqx) indicates that the following
soil types fall within the delineated APE: Shellbluff loam, 0 to 2 percent slopes, occasionally flooded
(ShA); and Tarrus gravelly silt loam, 2 to 8 percent slopes (TaB).
No further archaeological investigations are required for the project within the area established as the
current APE. Should the project change to include a larger footprint than covered by the current APE,
further consultation will be necessary. In the unlikely event that archaeological remains are encountered
during the bridge replacement, work should cease in that area and the NCDOT Archaeology Group
should be notified immediately.
"No ARCHAEOLOGYSUR VEYREQUIRED "form for the Amended Minor Transpor[ation R�ojects as Qua(ified in the 2015 Programmaric Agreement.
1 of 3

Project Tracking No.:
16-06-0001
Bri�f Earplanation of why the avni1a61e information provides a reliable basis for reasonably predicting
that there are no unidenhfied historic properties in the APE:
The bridge replacement project, as it is currently proposed, represents a fairly small footprint of earth-
disturbing activity with very little suggested outside areas that have previously been significantly
disturbed. The likelihood that archaeological deposits that might represent an important contribution to
our understanding of history or prehistory in the region could be impacted by this project appears to be
preriy remote.
SUPPORT DOCUMENTATION
See attached: � Map(s) ❑ Previous Survey Info
� Other: soil map
FINDING BY NCDOT ARCHAEOLOGIST
NC] ARC'�1.4EULDGY ��iR �`Ei' RL'�Ulh'E13
� ,
NCDOT ARCHAEOLOGIST
❑ Photos ❑Correspondence
September 15, 2016
Date
"No ARCHAEOLOCYSURVEYRE'QUIRED "form for the Amended Minor Transportation Projects as Qualified in the 1015 Programma�ic Agreement.
2 of 3

Project No:
WBS No. :
Fed. Airl No:
Federal
Projecl Trackiwg No. (/���e�•nal Use�
16-06-0001
HISTORIC ARCHICTECTURE AND LANDSCAPES
NO SURVEY REQUIRI+.D FORM
This form only pertains to Historic Architecture and Landscapes for this project. It
is not valid for Archaeological Resources. You must consult separately with the
Archaeology Group.
PROJECT INFORMATION
County: Anson
17BP.10.R.60 Document PCE-Data Sheet
_ Type:
� N/A Fun�ling: State Federal
Yes No Permit N W 14
Prr�iecd ,aesrri�leo►t: Replace Bridge No. 030194 on Blonnie Boss E�nad.
SUMMARY OF HISTORIC ARCHICTECTURE AND LANDSCAPES REVIEW
13�scri�iio�rr crf revic�i+u nctivities,.r�sreE�'s, re�er! co►aclusions:
Review of HPO quad maps, HPO GIS information, historic designations roster, and indexes was
undertaken on June 6, 2016, Based on this review, there are no existing NR, SL, LD, DE, or SS
properties in the Area of Potential Effects, which is 260' from each end of the bridge and 40'
from the centerline each way. There are no structures within the APE based on aerial and street
view imagery. Modern chicken houses sit to the northeast of the APE. There ace no National
Register listed or eligible properties and no survey is required. If design plans change, additional
review will be required.
Wlr flie rrvrrilrr6lc� i►r or�t�rrrtir�n �a•rrvi�!c•s a relrrrhf� 6rrsr`s `or rerrsUy�ri61 �rerliete�e tfrrrt ther�
rrre rrr� eririrle�►afiir��l si�jti�c�r��t fersturic rrr•cfiii�ctr�rr�l �r lrrnrLse�rue reserrrre�s ►IT lile yrui�ct
area:
HPO quad maps and GIS information recording NR, SL, LD, DE, and SS properties for the
Anson County survey, Anson County GIS/Tax information, and Google Maps are considered
valid For the purposes of determining the likelihood of historic resources being present. There
are no National Register listed or eligible properties within the APE and no survey is required,
III
SUPPORT DOCUMENTATION
❑Previous Survey Info. ❑Photos ❑C�irres4�at�dLt�cc ❑Design Plans
FINDING BY NCDOT ARCHITECTURAL HISTORIAN
and [.�in415ct�pcs -- NO SURVEY REQUIR�'D
NCDOT Architectural Historian
Date
Hisloric Archilech�re mid /.nndscapes NO SURVliY R&Q(//N/iD form for Mina• "('rnnsparinlrnn I'rojecls ns Qualrfied in Ihe 1007 Pragranunalic Agree�nenl.
Page 1 of 3

DMS ILF Mitigation Request Statement of Compliance with §143-214.11 & 143-214.20
link iv G.S. 9�13-2'�4.11
Prior to accessing the Division of Mitigation Services (DMS), all applicants must demonstrate compliance
with G.S. § 143-214.11 and 143-214.20. All requests MUST include this form signed and dated by the
permit applicant or an authorized agent. Please refer to DENR's Implementation Policy for more details.
Compliance Statement:
I have read and understand G.S. § 143-214.11 and 214.20 and have, to the best of my
knowledge, complied with the requirements. I understand that participation in the DMS is
voluntary and subject to approval by permitting agencies.
Please check all that apply:
� Applicant is a Federal or State Government Entity or a unit of local government
meeting the requirements set forth in G.S. 143-214.11 and is not required to
purchase credits from a mitigation bank.
� There are no listed mitigation banks with the credit type I r�eed located in the
hydrologic unit where this impact will take place �iink tv ow� r�sr�
0 Mitigation bank(s) in the hydrologic unit where the impacts will occur have been
contacted and credits are not currently available.
� The DWR or the Corps of Engineers did not approve of the use of a mitigation
bank for the required compensatory mitigation for this project.
� This is a renewal request and the permit application is under review. Bank
credits were not available at the time the applica#ion was submitted.
Enter date permit application was submitted for review:
Note: It is the applicant's responsibility to document any inquiries made to private mitigation
banks regarding credit availability.
I have read and understand the DMS refund olicies attacher�
inifia/ here
Larry B. Thompson
Signature of Applicant or Agent Printed Name
September 30, 2016
Date
17BP.10.R.60 (Anson County Bridge 194) SR 1459 over Branch of Richardson Creek
Project Name Location