20160952 Ver 1_PCN for 17BP.10.R.60 (Anson Bridge 194) 10-07-16_20161007

Corps Submittal Cover Sheet
Please provide the following information:
1. Project Name �Repiacement B�idge No 030194 on SR 1459 o�er Branch of Richardsan
Creek
2. Name of Property Owner/Applicant: NCDUT Division 10 I,a�uis Mitchell P.E.
3. Name of Consultant/Agent: STV Engineers, Inc.
*Agent Authorization needs to be attached.
4. Related/Previous Action ID number(s): N/A
5. Site Address: SR 1459-over Branch of Ric'hazdson Creek north of Burnsville NC
6. Subdivision Name: N/A
7. City: Burnsville NC
8. County: Anson
9. Lat: 35.150168° N Long: -80.278943° W
10. Quadrangle Name: Oakboro NC 1971
11. Waterway: Branch af Richazdsan 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:

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October 5, 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 Projecfs. 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.
�rsaiect DescriptionlPu�'pose and Need
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 October 5, 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.
Back+�round and Methadolos�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 October 5, 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"2 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 located 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 (TaB); see Attachment C- Figure 3. The
� Environmental Laboratory, 1987, "Corps ofEngineers Wetlands Delinea[ion Manual," Technical Report Y-87-1, US Army
Engineer Waterways Experiment Station, Vicksburg, Mississippi.
2 U.S. Army Corps of Engineers. 2012. Regional Supplement to lhe Corps of Engineers Wel[and Delineation Manual: Eastern
Mountains and Piedmont Region, Yersion 2.0., ed. J.F. Berkowitz, J.S. Wakeley, R. W. Lichvar, and C. V. Noble. ERDC/EL TR-
12-9. Vicksburg MS: U.S. Army Engineer Research and Development Center.
3 North Carolina Division of Water Quality. 2010. Methodology for ldentification of Intermittent 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/acement Program October 5, 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.
Streams or Relatrvely Permanent 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 Waters 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 44 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 8 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.
Page 4

NCDOT Division 10 Bridge Upgrade and Rep/acement Program October 5, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
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
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
Page 5

NCDOT Division 10 Bridge Upgrade and Rep/acement Program October 5, 2016
SR 1459 over Branch of Rici►ardson Creek - PCN for NWP #14
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).
Compensatory Miti�aation
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 52 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
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
Page 6

NCDOT Division 10 Bridge Upgrade and Replacement Program October 5, 2016
SR 1459 over Branch of Richardson Creek — PCN for NWP #14
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).
Protected Species
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.
Shortnose sturqean fAcipenser brevirasfrum) — FederallState Endanqered
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.
Biological Conciusion: No Effect
Schweini#z's sunflower (Helianfhus schweinitzir� - FederallState Endanqered
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
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 finro to three cm long.
The lanceolate leaves are opposite on the lower stem and alternate near the flowers. The
Page 7

NCDOT Division f0 Bridge Upgrade and Rep/acement Program October 5, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
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 high 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.
Biolo�ical Conclusion: No Effect
Red-co�ckaded woodqecker (Picvides borealis) - Federal/State Endangered
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.
Bioloqieal Conclusion: No Effect
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NCDOT Division 10 Bridge Upgrade and Replacement Program October 5, 2016
SR 1459 over Branch of Richardson Creek - PCN for NWP #14
Closinq
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,
SN Engineers, Inc.,
Brandon J. Phillips, CHMM
Environmental Science Senior Manager
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
ENVIRONMENTAL OUALITY
PAT MCCRORY
CiOUCl77Ul'
DONALD R. �1AN DER VAART
se�� e�a���
October 5, 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 5,
2016, the impacts are located in CU 03040105 of the Yadkin River basin in the Southem Piedmont (SP) Eco-
Region, and are as follows:
Yadkin Stream Wetlands Buffer (Sq. Ft.)
03040105 Non- Coastal
Sp Cold Cool Warm Riparian � arian Marsh Zone 1 Zone 2
Impacts 0 0 52.0 0 0 0 0 0
(feet/acres)
This mitigation acceptance letter replaces the mitigation acceptance letter issued on October 3, 2016.
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,
�
�
Jame B Stanfill
Credit anagement 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 Revised
S[ate ofNorth Carolina Eovironmental Quality Mi6gation Services
1652 Mail Service Center � 217 W. Jones Street, Suite 3000 � Raleigli, NC 27609-1652
919 707 8976 T

NCDOT Division 10 Bridg� Upgrade and Replacement Program October 30, 2016
SR 1459 over Branch of Richardson Creek — PCN for NWP #14
Attachment A
Pre-Construction �lotification Form

d� `M � ��R
�� q� Office Use Only:
� r Corps action ID no.
I 1 �
� , � , � � < DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the Corps: 0 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):
0 401 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.
1 h. Is the project located within a NC DCM Area of Environmental Concem (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: SR 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: 176P.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 ❑X 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. Agent/Consultant 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 /
ro'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? AgencylConsultant 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 OX 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 OX 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 - Ghoose one Choose one Yes/No -
W2 � Ghoose one Choose one Yes/No -
1/V3 - Choose one Choose one Yes/No -
�/4 - Choose one Ghoose one Yes/No -
W5 - Choose one Choose one YeslNo -
Wg - Choose one Choose one Yes/No -
2g. Total Wetland Impacts:
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impaets (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 44
S2 T Demolition Br. of Richardson Creek PER Corps 15 33
S3 P Stabilization Br. of Richardson Creek PER Corps 15 8
S4 - Choose one - -
S5 - Choose one - -
S6 - Choose one - -
3h. Total stream and tributary impacts 52
3i. Comments:
Stream Impacts are depicted on Attachment C- 5heet 4.
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. Expec#ed pond surtace area (acres):
5j. 5ize 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
B2 • 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 Minim
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. Complete if Usinq a Mitiqation 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. Complete 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:
❑X Yes
52 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 pratected 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? p o�o
2b. Does this ro'ect re uire a Stormwater Mana ement Plan? ❑ Yes � 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 ❑X 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 OX 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
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 ❑X 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 counry 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. 10-05-2016
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization
letter from the a licant is rovided.
Page 10 of 10

NCDOT Division 10 Bridge Upgrade and Replacement Program October 30, 2016
SR 1459 over Branch of Richardson Creek — PCN for NWP #14
Attachment B
Jurisdictional Determination Materials
-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#
1
I�
DWQ#
RPW Stream A(Branch of Richardson Creek)
STREAM QUALITY AS5ESSMENT WORKSHEET
1. Applicant's Name: NCD�T Division 1 Gi 2. Evaluator's Name: B. Phillins
3. Date of Evaluation: 8/23/13 4. Time of Evaluation: 2:30 nm
5. Name of Stream: Branch of Richardson Creek
7. Approximate Drainage Area: 250 acres
6. River Basin: Yadkin - Pee Dee
8. Stream Order:
' �`. � �
�
�
4; ��
9. Length of Reach Evaluated: 100 ft. 10. Cvunty: Anson
11. Location of reach under evaluation (include nearby roads and landmarks): fratn brid�e �0 100 feet downstream
12. Site Coordinates (if known): 35.150168 N -80.278943 W
13. Proposed Channel Work (if any): culvert
14. Recent Weather Conditions: warm, sunny
15. Site conditions at time of visit: warm, sunnv
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 �aluation point? YES Nt? If yes, estimate the water surf a:
18. Does channel appear on USGS quad map? �E NO 19. Does channel appear on USDA Soil Survey? YES NO
20. Estimated Watershed Land Use: 10 % Residential _% Commercial _% Industrial 2Q % 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 deternuning 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 chazacteristic 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 Branch of Richardson Creek, was determined to have erennial flow within ro'ect 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 Branch of Richardson Creek
# CHARACTERISTICS ECOREGIO NT RANGE SCORE
Coastal Piedmont Mountain
� 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 extensive dischar es = 0; no dischar es = max oints) 0— 5 0— 4 0— 4 3
� 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
'�", � Entrenchment / floodplain access 0— 5 0— 4 0— 2 2
a dee 1 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
extensive de osition= 0; little or no sediment = max oints
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 1 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
� no riffles/ri les ar ools = 0; well-develo ed = max oints
� Habitat complexity
� 1� little or no habitat = 0; fre uent, varied habitats = max oints 0— 6 0— 6 0— 6 4
�1 g Canopy coverage over streambed 0— 5 0— 5 0— 5 3
,x no shadin ve etation = 0• continuous cano = max oints
19 Substrate embeddedness NA* 0— 4 0— 4 2
dee ly embedded = 0; loose structure = max
20 Presence of stream invertebrates 0— 4 0— 5 0— 5 2
� no evidence = 0; common, numerous es = max oints
� 21 Presence of amphibians 0— 4 0— 4 0— 4 2
� no evidence = 0; common, numerous es = max oints
''� Presence of fish
� 22 no evidence = 0; common, numerous es = max oints 0— 4 0— 4 0— 4 2
23 Evidence of wildlife use 0— 6 0— 5 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.

NC DW�
Date: 8/23/2013
RPW Stream A(Branch of Richardson Creek)
Stream Identification Form Version 4.11
Evaluator: Brandon Phillips
Total Points:
Stream is at least intermittent
if > 19 or nerennial if 2 30"
38.75
RP R-.6fl SR 1459
County: Anson County
Stream Determination
Eph emeral I nterm ittei
Latitude: 35.150168
Longitude: -80.278943
Other O�Isboro, NC Quad
e.g. Quad Name:
A. Geomor ho14 Subtotal = 22•� Absent Weak Moderate Strong
1 a Continuity of channel bed and bank 0 1 2 3
2. Sinuosity of channel along thalweg 0 1 2 3
3. In-channel structure: ex. riffle-pool, step-pool, 0 1 ` 2 3
ri le- ool se uence
4. Particle size of stream substrate 0 1 2 3
5. Active/relict floodplain 0 1 2 3
6. Depositional bars or benches 0 1 2 3
7. Recent alluvial deposits 0 1 2 3
8. Headcuts 0 1 2 3
9. Grade control 0 0.5 1 1.5
10. Natural valley 0 0.5 1 1.5
11. Second or greater order channel No = 0 es = 3
B. Hycfralogy �Subtotal = 7.5 )
12. Presence of Baseflow
13. Iron oxidizing bacteria
14. Leaf litter
15. Sediment on plants or debris
16. Organic debris lines or piles
17. Soil-based evidence of high water table?
2
2
0.5
1
3
3
0
1.5
1.5
C. BiolO Subtotal =
18. Fibrous roots in streambed 3 2 1 0
19. Rooted upland plants in streambed 3 2 1 0
20. Macrobenthos (note diversity and abundance) 0 1 2 3
21. Aquatic Mollusks 0 1 2 3
22. Fish 0 0.5 1 1.5
23. Crayfish 0 0.5 1 1.5
24. Amphibians 0 0.5 1 1.5
25. Algae 0 0.5 1 1.5
26. Wetland plants in streambed = Q. � BL = 1.5 Other = 0
`perenni�! etro�me mov �Im ho ir�on�iforl i icinn nThcr mgThnric Coo �'3F nf mani iml.
Notes: re m A Br nch of Rich rd � n Creek w de rmined o b erennial wi hin ro'e limi . ET x fr
and Gambusia s . observed.
Sketch.

WETLAND DETERMINATION DATA FORM — Eastern Mountains and Piedmont Region
PCOjzCCJSIC2: BURP SR 1459 over Branch of Richardson Creek CItylCOunly: Burnsville/Anson Sampling l�ate: ��-'3-"
ApplicantlOwner NCDOT Division 10 State: N� Sampling Point:DP#1
Investigator{s}: Brandon Phillips, CHMM Section, Township, Range:
Landform (hillslope, terrace, vtC.}; Terrace Local relief (concave, convex, none}: Convex Slope (%}: —2
Subregi�n (LRR or MLRA}: L�-P Lat 35.ISn168 N Long: -���27R9`�-� �' Datum: NAD 83
Soil Map Unit Name: 51,ellbluFf NVVI classification:
Are climatic f hydrologii, conditions on the site typical for this [ime of year? Yes � No {If no, explain in Remar4<s_}
Are Vegetation , Soil , �r Hydrol�gy significantly disturbed7 11re "Normal Circumstances" present? Yes � No
Are Vegetation , Soil , or Hyclrology� naturally problematic? {If neede�, explain any ansinrers in Remarks.}
SUMMARY OF FINDINGS — Attach site map showing sampling point locations, transects, important features, etc.
H��drophytic V�getation Present? Yes
Hydric Soil Present7 Yes
Wetland Hydrology Present? Yes
Remarks:
No X Is the Sampled Area
�0 X within a Wetland? Yes No X
No X —
DP#1 is represen[ative of au upland area (See Approximate Waters of the U.S. and Wedauds Boundary Map ExhiUit For location of DP#1).
HYDRdLOGY
Wetland Hydrology Indiaators: eG d8 I diC mirtis'rt rrt tw0 ra - ed
Primanr� Indic�tors (minimum �f ong�� r��y�ire �t��� I�I hat ��plv3 _ Surtace Soil Cracks (Cf�}
Surface Water (A1} _ True Aquatic Plants {g14} _ Sparsely Vegetated Concave �urface {B8)
High Water Table (A2} _ Hydrogen Sulfide Odor (C'I} _ Drainage Patterns (B10�
Saturation (A3) _ Oxidized Rhizospheres on Living Roots (C3} _ Moss Trim Lines (g16}
Water Marks {g1) _ Presence of Reduced Iron (C41, _ Dn�-Season WaterTable (C2j
Sediment Deposits [B2) _ Recent Iron Reduction in Tilled Soils (C6) _ Crayfish Burrows (C8j
s Drift deposits (B3) _ Thin Muck Surtace (C7) _ Saturation �'isible on A�rial Imagery (C9�
_ Algal Mat or Crust (B4) _ Other (Explain in Remarks} _ Stunted or Stressed Plants (D1}
Iron Deposits (B5} _ Geomorphic Position (D2)
Inundation Visible on Aerial Imagery (g7') _ Shallcrv,r ,Aquitard (D3j
� VVater-Stained Leaves (89} _ Microtopographic Relief (Ct1)
_ Aquatic Fauna (813) _ FAC-Neutral Test {D5}
Field Observations:
SurfaceWaterPresent? Yes No � Depth (inches):
Water Table Present % Yes No x Depth (inches}:
Saturation Present? Yes Nu X DPpth (inches): Wetland Hydrology Preserh? Yes No X
ineludes ca illa frin e
Describe Recorded D�ta {stream gauge, monitoring +n�ell, aerial photos, previous inspections), if available:
Rem arks:
Wetland Hydrology indicators are not present,
US Army Corps of Engineers Eastern Mountains and Pi�dmont— Version �.0

VEGETATION (Four Strata) — Use scientific names of plants.
Tr� s�r;�um {Plot size: 3o'rna�u, ) 9'a Cover Saecies? Status
� Plu�ane�s occiden�ulra 70 Yes FACW
2. J���lru�.v �u,��n 30 Yes FACU
7.
»� = Total Cover
50% of total cover: 50 20% of total cover: 20
c;eplinolShzub �±tfffiunt {Plot size: lo' radius }
1: J�[glm�s iaigr•a 40 Yes FACU
2, U/mus americana l5 Yes FACW
�. Ce�'cis can<rdena�ia• IS Yes FACU
7
�� = Total Cover
50% of total coder: 35 20% of tvtal cover: l4
Harb Sh�atum (Plot si�e: I.5 meter )
1. L�fii�ni Atrenrts� 70 Yes FACU
2_ S�+rglruni hnleher�.re I S N� FACU
3_ Solamint carolinense 10 No FACU
4_ Con�melina contmainis 5 No FAC
5.
s.
7.
8_
9.
10_
11.
l00 = Total Cove[
50°,U of total cover: 5� 20°/0 of total cover: � 20
WOOCt� VII18 Sd'�tt.IRl (Plot SiZe: 30' radius }
1.
2.
3_
4.
5.
= Total Cover
50% of total cover: 20°10 of total cover:
Remarks: {I nclude photo numbers hera or on a separate sheet }
Hydrophytic vege[a[ion is not present.
Sampling Point. °��
Number �f Dominant Species
That Are OBL, FACW, or FAC: 2 (A}
Total Number of Dominant
Species Across All Strata: 5 {B}
Percent of Dominant Species
That Are OBL, FACW, or FAC:
4D {A1B}
Prevalance Index workshaet:
Total °/o Cover of: Multiplv bv:
OBL species x 1 =
FACW species x 2 =
FAC species x 3 =
FACU species x 4 =
uPL spacies x 5 =
Column Totals: {A} {B)
Prevalence Index = BIP� _
Hydrophytic Vegetation Indicators:
` 1- Rapid Test for Hydrophytic Ve�tation
2 - Dvminance Test is >50%
� 3- Pre�alence Index is _<3.0'
_ 4 - Morphological Adaptations' {Provide supporting
data in Remarks or on a separate sheet}
_ Problematic Hydrophytic Vegetation' (Explain)
'Indicators of hydric soil and wetland hydrology must
be present, unless disturbed vr problemabc.
Definitions ofFourVegetation Strata:
Tree— Woody plants, excluc�ng vines, 3 in. (7.6 cmj or
more in cNameter at breast height (DBH), regardless of
height.
SaplinglSlwub — Woody plants, excluding vines, less
than 3 in. DBH and greater than or equal to 3_28 ft (1
m} tall.
Herb — All herbaceous {non-waody} plants, regardless
of size, and woody plants less than 3.28 ft tall.
Wood}/ vine — RII woody vines greater than 3 28 ft in
heiaht.
Hydrophytic
Vegetati on
Present? Yes No X
US Army Corps of Engineers Eastern Mountains and Piedmont— Version 20

SOIL Sampling Point:Dr#1
Profile Description: (Describe to the depth needed to documentthe indicator or conflrm the absence of indicatdrs.j
Q��Ut Matrix Retiox Fe�tures
fir{chas) Col�r tmoist °� C��lor (�n,q�y�) 90 Tvp� L�c TaSc[ure RPmark.s
13-$ 10 YR 3/2 100 Sandy Fill materials
8-2Q 10 YR 4/4 100 Ssndy OI$Y
'T �: C=Goncentr�tion D=De�letion, P,h'1=RHclured P.,���trix, Br1S=Masked Sand Urains ZL�c�tion: PL=Pore Liniri , M=M�trix.
Hydric Soil Indicators: Indicators for Problematic Hydric Soils ;
Histc,sol {A1;� _ Dark Si�ifi�ce tU7) _ 2 cm ti9uck (A'I Oj (MLRA 147)
Histic EF�ipe!��n �A2) _ Pol�rvalue gelovv SurfacE� (;�} (MLRA 9d7, 148) _ Coast Prairie Reclor: {.A16}
Bl��ck Histi�_ (A3j _ Thin Gark S�_irfa�? (S�j (MLRA 147, 148} (MLRA 147, 148j
Hy�r�gen S�alfi�Y (A�j _ Loamy GlPyed P�latri�; (F2j _ Piedmc,nt Floor�pl�in �oils {F 19}
Stratifie� L�yers (;HSj _ Deplet��i h�atr�:: {F3} {MLRA 136,1d7)
_ 2 �m A�uc4<(A1u� (LRR I� _ F�dax G�,rk 3urtace (F6) _ Very Shallc�w D�rkSurf�c.e �,TF12}
_ DAplet�d Belo�nr D�rk Surf��ce tA11) _ De�.�let�d d�,rk SuYfe�ce (F7) _ Clther {Explain in Remarks�
_ Thick Dark Surface (A.'12j _ Redox De�,re�si�ns (F&j
San�l�,� Muck�,� MinFral (S1) (LRR N, _ Iron-1�langan�sa Iv9asses (F12j (LRR N,
MLRA 147, 148) MLRA 136)
_:�an�iy Gl�y�� Matrix (S�} _ Umbric'�urf�rP (F1�) (MLRA 136, 122) 31n�icators �thydropf�iytie ��eyetation and
_ Sanr_l� FedGx. (�.5j _ Piedmont Flood�}lai�-i �,oils f,F19} (MLRA 148) +r�iptlan� hy��rolog�! m���,t be pres�nt,
.7CI�I�1pBlI ��II�Cf�IX, f,7E� R�d ParNr�t Material fF21) (MLRA 127, 147) unl�:s:3 di�turbecl or pr��blernatic.
Restrictive Layer (if observed):
Ty�e:
C?�pth (inches): Hydric 5oil Present? Yes No %�
RPmarl<s:
Hydric Soil Indicators aze not present.
U`� Army 4vorps ��f Engineers Eastern M�uritains �nd Fiedrnont—Version 20

ATTACHMENT A
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD): october 7, 2016
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
NCDOT - Division 10 (Larry Thompson)
716 W. Main Street, Albemarle, NC 28001
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
Anson County - SR 1459 (Blonnie Ross Road) over UT to Richardson Creek
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT
SITES)
State: NC County/parish/borough: Anson Clty: Burnsville
Center coordinates of site (lat/long in degree decimal format):
Lat. 35.150168 °N; LOng. -80.278943 °W,
Universal Transverse Mercator: ��
Name of nearest waterbody: uT to R��nardsor, creek
Identify (estimate) amount of waters in the review area:
Non-wetland waters:
�50 linear feet: width (ft) and/or acres.
Cowardin Class: R��er�ne
Stl'@al'Yl FIOW: Perennial
Wetlands: N�A acres.
Cowardin Class: NiA
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal: NiA
Non-Tidal: NiA
1

E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
� Office (Desk) Determination. Date:
� Field Determination. Date(s):
SUPPORTING DATA. Data reviewed for preliminary JD
(check all that apply - checked items should be included in case file and,
where checked and requested, appropriately reference sources below):
� Maps, plans, plots or plat submitted by or on behalf of the
applicant/consultant:
❑✓ Data sheets prepared/submitted by or on behalf of the
appl�nt/consultant.
Office concurs with data sheets/delineation report.
� Office does not concur with data sheets/delineation report.
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
❑ U.S. Geological Survey Hydrologic Atlas:
� USGS NHD data
� USGS 8 and 12 digit HUC maps
❑✓ U.S. Geological Survey map(s). Cite scale & quad name:
❑✓ USDA Natural Resources Conservation Service Soil Survey.
Citation:
❑ National wetlands inventory map(s). Cite name:
❑ State/Local wetland inventory map(s):
❑ FEMA/FIRM maps:
� 100-year Floodplain Elevation is:
(National Geodectic Vertical Datum of 1929)
❑ Photographs: ❑ Aerial (Name & Date): or
� Other (Name & Date):
� Previous determination(s). File no. and date of response letter:
� Other information (please specify):
�

1. The Corps of Engineers believes that there may be jurisdictional waters of the
United States on the subject site, and the permit applicant or other affected party
who requested this preliminary JD is hereby advised of his or her option to
request and obtain an approved jurisdictional determination (JD) for that site.
Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the option to obtain an approved JD in
this instance and at this time.
2. In any circumstance where a permit applicant obtains an individual permit, or
a Nationwide General Permit (NWP) or other general permit verification requiring
"pre-construction notification" (PCN), or requests verification for a non-reporting
NWP or other general permit, and the permit applicant has not requested an
approved JD for the activity, the permit applicant is hereby made aware of the
following: (1) the permit applicant has elected to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional waters; (2) that the applicant has the option to request an approved
JD before accepting the terms and conditions of the permit authorization, and
that basing a permit authorization on an approved JD could possibly result in less
compensatory mitigation being required or different special conditions; (3) that
the applicant has the right to request an individual permit rather than accepting
the terms and conditions of the NWP or other general permit authorization; (4)
that the applicant can accept a permit authorization and thereby agree to comply
with all the terms and conditions of that permit, including whatever mitigation
requirements the Corps has determined to be necessary; (5) that undertaking
any activity in reliance upon the subject permit authorization without requesting
an approved JD constitutes the applicant's acceptance of the use of the
preliminary JD, but that either form of JD will be processed as soon as is
practicable; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a preliminary JD constitutes agreement that all
wetlands and other water bodies on the site affected in any way by that activity
are jurisdictional waters of the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative appeal or in any Federal court; and (7) whether
the applicant elects to use either an approved JD or a preliminary JD, that JD
will be processed as soon as is practicable. Further, an approved JD, a proffered
individual permit (and all terms and conditions contained therein), or individual
permit denial can be administratively appealed pursuant to 33 C.F.R. Part 331,
and that in any administrative appeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary
to make an official determination whether CWA jurisdiction exists over a site, or
to provide an official delineation of jurisdictional waters on the site, the Corps will
provide an approved JD to accomplish that result, as soon as is practicable.

This preliminary JD finds that there "may be"waters of the United States on the
subject project site, and identifies all aquatic features on the site that could be
affected by the proposed activity, based on the following information:
IMPORTANT NOTE: The information recorded on this form has not
necessarilv been verified bv the Corps and should not be relied upon for
later jurisdictional determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
�
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)

SAMPLE
Estimated
Site Cowardin amount of Class of
number Latitude Longitude Class aquatic aquatic
resource in resource
review area
1 0.1 acre Non-section 10
— non-wetland
2 100 linear feet Non-section10
— wetland
3 15 square feet Non-section 10
— wetland
4 0.01 acre Non-section 10
— non-wetland

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 Forn► 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 (laUlong in degree decimal format): Lat. 35.150168° j�, 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 (TNW) lnto which the aquatic resource flows: Pee Dee River
P�Iame of watershui pr FiydraallogiG Unit Cndc: (HL1C}: Q3(kltl i 05
j� Checic it' i7�a��ldiagr���n r�f'revi�u� r�rc� ar�cil�r pratcntial juris�lictional are�s isfare available upon reyuc:st.
� Checic if �ttier sitcs {c.g., aLf`site rniti�ati�n �;ites, dispnsal s�tes, etc... } are assUciated witl� ti�is action and are recorded on a
different JD form.
D. E�E.VC�W P�:RF�E�.ME[] FC�R SIT� EWAL[IATION (CHECK ALL THAT APPL�:
� CJ�Tficc (De.�sk) Determinatian. �ate: [)�if22113.
� 1=ield L7ct�ninati�r�. Dale(s}: Q$1231i3
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JIJRISDICTION.
There Are np "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]
❑ Waters subj�;ct 4c� the ei�b and flow af the tirle.
� Waters are presently uscd, or have I�e�n uscd 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. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply): 1
❑ T'NWs, including territorial seas
� Wetlands adjacent to TNWs
� Relatively permanent watersZ (RPWs) that flow directly ar indirectly into TNWs
[] Non-RPWs that flow directly or indirectly into TNWs
❑ Wetlands directly abutting RPWs that flow directly or indirectly into T'NWs
[� 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: .�stabliahcd by OHWM.
Elevation of established OHWM (if known): .
2. Nvn-re�ulatecl watersJ�vetiands (check if applicable):3
[] PotcntiJiEy jurisdictior��i 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 appropriate sections in Section III below.
2 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 Supporting documentation is presented in Section III.F.

SECTION III: CWA 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 TNV1� AND ITS ADJACENT WETLANDS (IF AN�:
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 identified 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 LIsY
Drainage area: Pick List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relatinnsi�ip with TNW:
❑ Tributary flows directly into TNW.
❑ Tributary flows through Pick List h-ibutaries before entering TNW.
Project waters are PickList river miles from TNW.
Project waters are PiCk Lis� river miles from RPW.
Project waters are FtckList aerial (straight) miles from TNW.
Project waters are PIck List 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 erosional 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 TNW.

(b) Gencral Trihutarv CFraracteris€ics fcheck alt that applv3�
Tributary is: ❑ Natural
❑ Artificial (man-made). Explain:
❑ Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: Pick List.
Primary h-ibutary substrate composition (check all that apply):
❑ Silts ❑ Sands ❑ 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: Piek List
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for: Pick List
Estimate average number of flow events in review area/year: Piek List
Describe flow regime: .
Other information on duration and volume: .
Surface flow is: Piek Ltst. Characteristics:
Subsurface flow: Plek Llst. Explain findings:
❑ Rye (or otherj test performed: .
Tributary has (check all that apply):
❑ Bed and banks
❑ OHWM6 (check all indicaiors that apply):
❑ elear, natural line intpressed on the bank ❑
❑ changes in the character of soil ❑
❑ shelving �
❑ vegetation matted down, bent, or absent ❑
❑ leaf litter disturbed or washed away ❑
❑ sediment deposition ❑
❑ water staining �
❑ other (list):
❑ Discontinuous OHWM.� Explain: ,
the presence of litter and debris
destruction of terrestrial 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):
❑ Higl; Tide I.ine inrIicated $y; [� Mean �tigh Water Mar% indicatec� by:
❑ ail or scum tine aiong shore obj�cts ❑ survey to avaiiaEaCe datum;
❑ fne shell or debris deposits (f+oreshore) ❑ physieal markings;
❑ physical rnarkingslcharacteristics ❑ vegetation 3iReslchang�s 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 natuial 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.
'Ibid.

(iv) Biolagica[ Characteristics. Chranttel suppurts (check all that apply):
❑ Ripari�n corridor. Chart�cteristics (type, average width): .
❑ Wctland Fnnge. Charactcristics: .
❑ Habitat for:
❑ Fc:derally l,isted species. Explain findings: .
❑ Fishlspawn areas. Ex�lain findings: .
❑ 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) Gencrai Wetland CharacCeris;ics:
Properties:
Wetland size: acres
Wetland type. Explain: .
Wetland quality. Explain: .
Project wetlands cross or serve as state boundaries. Explain:
(b) Gene � Flaw Rclatianship with Non-TNW:
F[aw is: Pick L%t. �xplain: ,
Surface flow is: Pi€I[ L�St
Characteristics:
Subsurface flow: Plsk L�it. Explain findings:
❑ Dye (or other) test performed: .
(c) Wetland _Adjacency �etermin3tion wit17 Non-TNW:
❑ Directly abutting
❑ Not directly abutting
❑ Discretc: wetCand hydrolQgic eanneetion. Explain: non jurisdictional stormwater conveyance.
❑ Ecological connection. Exp[ain: .
❑ Separatc�i hy 6ertnlbamer. Explain; .
(d) Proximity (Re[atiansiyip} to `f`NW
Project wetlands are PICk Llst river miles from TNW.
Project waters are Pick L3st aerial (straight) miles from TNW.
Flow is from: �'[Ck LEst.
Estimate approximate location of wetland as within the P[ek Lf9t floodplain.
(ii) Chemica( 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) Siologic�l Char9cteristics. Wetland supports (check all that apply):
❑ Riprxrian buffer. Char�cteristics (type, �verage width): .
�❑ Vegetativn ty�aelpercent co�er. Explain: ,
Habitat far:
❑ F�ferally Lisked species. Explair� findings: .
❑ Fishlspttwn �reas. Exp€ain iantiings: .
❑ Other cnwirt�nmentalEy-sensative species. Explain findings:
❑ Ayuaticlwildli% divcrsity. Explain findings: .
3. Characteristics of all wetlands adjacent to the tributary (if eny)
All wetland(s) being considered in the cumulative analysis: �'[Ck List
Approximately ( ) acres in total are being considered in the cumulative analysis.

For each wetland, specify the following:
Direclly abuts7 fYM] 5izc (in acres] Dircctiv abuts? (YIN? Siae (1n acresl
Summarize overall biological, chemical and physical functions being performed: .
C. SIGMFICANT NEXUS DETERMINATION
A signiticant nexus analysis will $ssess the flow characteristics and functions of the tributary itself and the functions performed
by any wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity
of a TNW. For each of the following situations, a significant nexus exists if the tributary, in combination 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 signifcant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNV1�. Similarly, the fact an adjacent wetland lies within or
outside of a floodplain is not solely determinative of significant 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 tributary, in combination with its adjacent wedands (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 TNW?
• Does the h-ibutary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and
other species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the Mbutary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream foodwebs?
• Does the tributary, 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. Significant nexus findings 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. Signiticant nexus tindings 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. Signiticant nexus findings 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 APPL17:
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
❑ TNWs: linear fect width (ft), Or, acres.
❑ Wet3ands adjacent tt� TNWs: acres.
2. RPWs that 11ow d[rec#ly or indirectly into TIYWs.
� Tributaries of TA[Ws where tri6utaries tyFaically 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 Rocky River (RPW) wisich i�ows to the Pc�; Dee Rivcr (TNW}.
� Tributaries of TNW wher� tril�utaries have cont'snuous flnw "seasqnally" (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: .

Pro�ide estimates fnrjurisd►ctional waters in the r�rriew area (check all that apply):
� Tributary waters. RPW 5tream A is Z72 linear feet I5 width (ft).
❑ Ot3�er ��an�wetland water�: acres.
Identify type(s) of waters: .
3. hlan-RPWse that flow directly or indirectly into TNWs.
❑ Watcrbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
T'NW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
❑ Trihutary waters: linear fe�t width (ft).
❑ 4ther non-wetiand waters: acres.
Identify type(s) of waters: .
4. Wetlands directty abuCting aa RPW that Raw directly nr indIrecily in#o TNWs.
❑ Wcilaads dirc..ctly abut I2PW snd titus are jurisdictional as adjaccnt wetlands.
[� Wetlands riirectty abuttit�g an RPW where iributarics rypically �low year-round. Provide data and rationale
indicating that tributary is perennial in Section III.D.2, above. Provide rationale indicating that wetland is
directly abutting an RPW: .
❑ Wetlands directly abutting an RPW where tributaries 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. Wetlands adjacent to but nnt directly abutting an RPW that flaw directly or indirectly into TNWs.
❑ Wetlands that do oot dir�ctly abut an RPW, but when considerzd in cam6ination with the tributary to which they are adjacent
and with similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this
conclusion is provided at Section III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to rion-RPWs that flow directly or indirectly ioto TNWs.
❑ Wetlands adjaoent to sueh waters, and have when considcrcd in cainbination 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 general ru[c, the impoundment of a jurisdictinnal trihutary remains ju�isdictianal.
�Demonstrate that impaundnient was cre�tted from "wat�rs a#'the U.S.," or
Demo�strate that water meets the criteria for one of the categories �res�nied abo�e (1-6), or
❑ Derno�strate �hat water is isolatcd with a nexus to commerce (see E 6elaw},
ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCii WATERS (CFIECK ALL THAT APPLY):1°
❑ which ttre or cou�d 6e used by interstate or foreign travelers far recreational or other purposes.
❑ from which �sh c�r shellfish are or cnuld he taken a�d sold in interstate or foreign commerce.
❑ which Are or could be used for industrial purposa�s by industries in interstate commerce.
❑ lnterstate iscslated waters. Explain: .
aSee Footnote # 3.
9 To complete the annly5is rc%r to the kcy in Sectian fII.D.6 of the Instructional Guidebook.
1D Prior tu asserting or' declining CWA jurisdictian bssed solely on this cs[c�;pry, Corps Districts will elevate Ihe action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiclion Fo!lowing Rapanos.

❑ Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide cstimates For jurisdictavnal waters in the re�iew area (check all that apply):
❑ Tributary waters: li»ear feei widtf� {ft}.
❑ Other rtvn-wctland waters: acrus.
Ide�tify type(s} of waters: .
❑ Wetla�ds: aeres.
F. NON-JU[tISDICTIONAL WATERS, INCLIlDING WE"i'LAriIaS (CFIECK ALL THAi APPLY):
❑ If pvtential wetlands were assessed within the review asn�a, th�e are�►s did not meet the criteria in the 1987 Corps of Engineers
W�tland Qalineatiu�n Manual and/orappropriaEe Rcgional SupplemcnFs.
❑ Re�iew area included isoiated watcrs wich no substantial nexus to interstate (or fareign) commerce.
❑ Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solelv on the
"Migratary Bird Etu[e" [MBR).
❑ Weters do not meet the "Significant Nexus" standard, where such a finding is required far jurisdiction. Explain: .
❑ �dther: (explain, if nnt co�e,�reci abv�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
judginent (chcck all that apply}.
�] Non-wetlartd waters (i.e., rivers, streams): line�r feet width (ft).
❑ Lakeslpancis: acres.
❑ Uther nan-wetfand wnters: acres. List type nf aquatic resource: .
❑ Wctlands: aares.
Provide acreage estimates for non-jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is requiread f�r jurisdic#ion (chec:[c al! that applyJ:
❑ Noa-wetland waEers (i.e., rit+ers, sri'cams): 1ine�ar feet, width (ft).
❑ Lakesl�rands: acres.
❑ Uther non-wetland waters: acees. List type of �qaatic resource: .
❑ Wet[ands: acres.
SECTIUN IY: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked
ans� reques[ed, �ppropriately referen�e sources below):
� Maps, pians, plots rar plat submitted by or on behalf of the applicant/consultant: Attachment B- Approximate Waters of the U.S.
and WetlaittEs Bnunriary Map Exhibit.
� Data shc;ets pccparedfsubmitted by or on behalFof the appiieandconsultant.
❑ C3ffice concurs with data sheetsldelinention report.
❑ Office dacs not cnncur with daks shc;etslc�elineation repvrt.
0 Data sheets prepared by the Corps: .
� Corps na�igabl� watcrs' sFudy: .
❑ U.S. Get�logic.�►1 Survey Hydroiogic Atlas; .
❑ USGS NHD data.
❑ 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): .
Q FEMA/FIRM maps: .
❑ 100-year Flpodplain Eieva[ian is: (National Geodectic Vertical Datum of 1929)
� Photographs: � Aerit�l (Name & Date):NAIP, FLnson County 2010.
or � Other (Name & Date): Photos (08/23/13).
❑ Previous determination(s). File no. and date of response letter: .
❑ 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 Rep/acement Program September 30, 2016
SR 1459 over Branch of Richardson Creek — PCN for NWP #14
'�.�--.�.'�{ � � . -��' .�-:� �T ,-
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Photograph 1— A view of the SR 1459 bridge over Branch of Richardson Creek, looking to the
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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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NCDOT Division 10 8ridge Upgrade and Replacement Program October 30, 2016
SR 1459 over Branch of Richardson Creek — PCN for NWP #14
Attachment C
Figures

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See Sheet 1-A For Index of Sheets
See Sheet 1-B For Stondo�d 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
20 10 0 20 40
PLANS
20 l0 0 20 40
PROFILE (HORIZONTAL)
4 2 0 4 8
PROFILE (VERTICAL)
DESIGN DATA
ADT 2008 = 70
ADT 2025 = 140
DHV = N/A
D = N/A
T = b%
V = 45 MPH
FUNC. CLASSIFICATION:
LOCAL
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A�so� CO U1�TY
LOCATI011L• BRIDGE #194 OVER BRANCH OF RICHARDS0111 CREEK
0111 SR 1459 (BL01V111IE ROSS RD.)
TYPE OF WORK GRADIIVG, PAVING, DRAZ11tAGE, f�' STRUCTURE
STREAM IMPACTS
SITE 1
SEE
FIGURE �
SITE 1
BEGIN CULVERT
-L- STA. 11+88.01
-L-
PROJECT LE11iGTH
i /;
LENGTH OF ROADWAY PROJECT WBS 17BP.IO.R.60 = 0.050 MILES
LENGTH OF STRUCTURE PROJECT WBS I7BP.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
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PLANS PREPARED FOR THE NCDOT BY:
� S'1'V/ Ralph Whitehead Associates, Inc.
900 West Trode St., Ste. 715
Charlotte, NC 28202
NC License Number F-0991
2012 STANDARD SPECLF[CATIONS
HYD�
ENGIIVEER
RIGHT OF WAY DATE: NIKKI T. HONEYCUTT, PE ROADwAY
DECEMBER 2, 2014 PRo�Ecz ENcrxsEa DESIGN
ENGINEER
LETTLNG DATE: MAAMOON K. ABDELAZIZ
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LEGEND STREAM PERMIT IMPACT
AREA (AC) LENGTH (FT)
� DENOTES IMPACTS IN -
SURFACE WATER PERMANENT 0.02 52 S I TE 1
SW IMPACTS
�DENOTES TEMPORARY TEMPORARY �
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BL-/
-L- STA �t20.00 P/ _ //+05A0 .
EL = 30373' EL = 2995Y
vc = na
K=37
'�'- DS = 30 MPH�
�� �PROPOSED GRADE
BEGIN CULVERT
-L- STA 11+88J4
( J3S� �
BL-2
� ` ` -"--- Pl =l1+70A0 LT
$ � � �-1.3S2j'------- ___ __ El- 294A0
� s' � r� � � 13,g2y --___ ___ _ �- �i
p N -
iT n p u ��_ $� � � 13A3%'---
iw �� $� �
� W •
� W � � � � �
=NOTE:THE DESIGN SPEED SHOWN FOR VERTICAL CURVES -"' i� �� ��'
lS UP TO 20 MPH LESS TNAN THE OVERALL DESIGN a W ii �i
SPEED PER SUB-REGIONAL TIER DESIGN GUIDEUNES. � W
10+00 10+50 11 +00 11 +50 12+00
EXIST BRIOGE
TO BE REMOVED
END CULVERT
-L- STA l2t/5.83
P/ _ /2-:E5.(l0
E� = 2se.sr
VC = 90'
K=52
DS = 35 MPH�
� LOW POINT
-L- STA /2+39.35
EL = 299A5'
� PROPOSED DOUBLE l2'X7' RCBC
Pl =12+05.W LT
F/ = 99.?1�
'—I-�-� � . _�
12+50 13+00
END PROJEGT WBS I7BP.�R.60
�- STA /3+/OAO
EL = 29953'
BL-3
lNG GROUND
13+50
CULVERT HYDRAUUC DATA
DESAGN D/SCHARG£ � 650 CFS
DFS/GN FREQUENLI' = 25 YRS
�src�v mr ecevArroa - 29a2 Fr
ease ascHarce - aoo cFs
BASE fRE01/EA�Y = /QD YRS
BASE NW ELEVATbN � 29A48 Ff
OVERf�PHY�'a O/SC/��ARG£ = J�QD CFS
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 52 S I TE 1
SW IMPACTS
�DENOTES TEMPORARY TEMPORARY
IMPACTS IN SURFACE WATER SW IMPACTS 0.01 33
SEE
� � FIGURE
`� ` SITE 1
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315
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305
300
295
290
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BL-/
-L- STA �t20.00 P/ _ //+05A0 .
EL = 30373' EL = 2995Y
vc = na
K=37
'�'- DS = 30 MPH�
�� �PROPOSED GRADE
BEGIN CULVERT
-L- STA 11+88J4
( J3S� �
BL-2
� ` ` -"--- Pl =l1+70A0 LT
$ � � �-1.3S2j'------- ___ __ El- 294A0
� s' � r� � � 13,g2y --___ ___ _ �- �i
p N —
iT n p u ��_ $� � � 13A3%'---
iw �� $� �
� W •
� W � � � � �
=NOTE:THE DESIGN SPEED SHOWN FOR VERTICAL CURVES -"' i� �� ��'
lS UP TO 20 MPH LESS TNAN THE OVERALL DESIGN a W ii �i
SPEED PER SUB-REGIONAL TIER DESIGN GUIDEUNES. � W
10+00 10+50 11 +00 11 +50 12+00
EXIST BRIOGE
TO BE REMOVED
END CULVERT
-L- STA l2t/5.83
P/ _ /2-:E5.(l0
E� = 2se.sr
VC = 90'
K=52
DS = 35 MPH�
� LOW POINT
-L- STA /2+39.35
EL = 299A5'
� PROPOSED DOUBLE l2'X7' RCBC
Pl =12+05.W LT
F/ = 99.?1�
'—I—�—� � . _�
12+50 13+00
END PROJEGT WBS I7BP.�R.60
�- STA /3+/OAO
EL = 29953'
BL-3
lNG GROUND
13+50
CULVERT HYDRAUUC DATA
DESAGN D/SCHARG£ � 650 CFS
DFS/GN FREQUENLI' = 25 YRS
�src�v mr ecevArroa - 29a2 Fr
ease ascHarce - aoo cFs
BASE fRE01/EA�Y = /QD YRS
BASE NW ELEVATbN � 29A48 Ff
OVERf�PHY�'a O/SC/��ARG£ = J�QD CFS
OVERr�PU1� FREQUENCV= )50 YRS
aEirroPai� Ecevar�av = � Fr
315
310
305
300
295
290

LEGEND �
��
�
�DENOTES IMPACTS IN �,�1, �Q
SURFACE wATER I y�
� MEPACTS INESURFACE WATER �P'� �� DAVIDOTUCKER �Q���O ��
/ DB 802 PG 186
+
STREAM PERMIT IMPACT TEMPORA IMPACTS
AREA (AC) LENGTH (FT) IN SURF CE WATER
PERMANENT 0.02 52 + �
SW IMPACTS
TEMPORARY 0.01 33 / N
SW IMPACTS
x-X
� X�ERMANENT IMPACTS ��
IN SURFACE WATER
� X X ^ /
�
�
—w
SR /459
PERMANENT IMPACTS
IN SURFACE WATER
_--c
► -_� _ _` C � �
� - - - - - = � �
ROBERTO ROSS '
DB 931 PG 3
iR1 . r\ .
" �\ � /
- ____ �
�S ��
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OF q�y��N �REEK
, �15—
--
Permit Draw�g
Sheet of
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■ ■ ■ ■ ■
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IN SURFACE WATER ;,
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EMILY R THOMAS
SANDRA A THOMAS
,� DB 353 PG 194
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PERMANENT IMPACTS
IN SURFACE WATER
-F ------F
---
CURTIS KOWHITLEY
JENNIFER L WHITLEY
DB 485 PG 296
� � ��> ����r
DIVISION OF HIGHWAYS
ANSON COUNTY
PROJECT: 17BP.10.R.60
BRIDGE it19�d OVER
BRANCH OF RICHARDSON CREEg
ON SR 1�059
(BLONNIE ROSS ROAD>
SHEET 1 OF 1 10.d 5/ 2016

WETLAND PERMIT IMPACT SUMMARY
WETLANDIMPACTS SURFACE WATERIMPACTS
Hand Existing Existing
Permanent Temp. Excavation Mechanized Clearing Permanent Temp. Channel Channel Natural
Site Station Structure Fillln Fillln in Clearing in SW SW Impacts Impacts Stream
No. (From/To) Size / Type Wetlands Wetlands Wetlands in Wetlands Wetlands impacts impacts Permanent Temp. Design
(ac) (ac) (ac) (ac) (ac) (ac) (ac) (ft) (ft) (ft)
1 -L- 12+77 to 13+07 2- 12' X 7' RCBC 0.02 0.01 52 33
Culvert
TOTALS: 0.02 0.01 52 33

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

Project Tracking No.:
16-06-0001
�'��'��,� NO ARCHAEOLOGICAL SURVEY REQUIRED �FORM �_�s��'�
�'�as �q , This form only pertains to ARCHAEOLOGICAL RESOURCES far this project. It is not •� '�'- `�m�
,�; !F �+ G?' , �� . ° r
•,�.,�i�l valid for Historic Architecture and Landscapes. You must consult sepazately with the ,. �-- �
�., ���% Historic Architecture and Landscapes Group. �� ��%
PROJECT INFORMATION
Project No: STR. #030194 County: Anson
WBS No: 17BP.10.R.60 Document: PCE
F.A. No: na Funding: � State ❑ Federal
Federal Permit Required? � Yes ❑ No Permit Type: NWP 14
Project Description: 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 azea 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 files archived 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:/l�;is.ncdcr.govlttpawe� reveals that recorded
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:l/websoilsurvey.nres.usda.�pp/WebSoilSurvey.as�) 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 ARCHAEOLOCYSUR VEY REQU/RED " form far the Amended Minor Transporta[ion Projects as Qualified in Ihe 20/5 Progrnmmatrc Agreement.
1 Of 3

Project Tracking No.:
16-06-0001
Brief Explanation of why the available information provides a reliable basis for reasonably predic�ing
that there are no unidentified 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
pretty remote.
SUPPORT DOCUMENTATION
See attached: � Map(s) ❑ Previous Survey Info
� Other: soil map
FINDING BY NCDOT ARCHAEOLOGIST
NOE ARC.FI�4EQLaGY SrlR �EY RE�,] UIRED
�
NCDOT ARCHAEOLOGIST
❑ Photos ❑Correspondence
September 15, 2016
Date
"No ARCffAE'OLOGYSURVEYREQU/RED"form for rhe Amended Minor Transporfafion Projects as Qualified in the 1015 ProgrammaticAgreement.
2 of 3

Projecl T�•acking No. (/nler•iial Use�
16-06-0001
HISTORIC ARCHICTECTURE AND LANDSCAPES
NO SURVEY REQUIRED 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
Project No: ' County: Anson
WBSNo.: 17BP.10.R.60 Document PCE-Data Sheet
T e:
Fed. Aid No: N/A Funding: State Federal
Fe�leral Yes No Permit NW 14
Permit s: T e s:
Pro►ect Descriution: Replace Bridge No. 030194 on Blonnie Boss Road.
SUMMARY OF HISTORIC ARCHICTECTURE AND LANDSCAPES REVIEW
Descr�nl�an of review rrctiviiles, results, and cnnclusions:
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 are no National
Register listed or eligible properties and no survey is required. If design plans change, additional
review will be required.
Wiev the nvrcflable iirfnrmrriian prov%l+�s n rellabte bnsis �'or rerrsonablv prerlicli�e,� that tirere
are no unirlentified si�n�ficrr►rt /tistoric rrrcliltecturaf or l�rndscape resources in tlre nroiect
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 �nd no survey is required.
Map(s)
�
SUPPORT DOCUMENTATION
❑Previous Survey Info. ❑Photos ❑Correspondence ❑Design Plans
FINDING BY NCDOT ARCHITECTURAL HISTORIAN
and I,an�iscapes -- NO SURVEY REQUIRED
NCDOT Architectural Historian
Date
Hisroric Arclvi�ecnire mxl Landscnpes NO SURVIdY RIsQUIItli17 jorm jor Minor �ra�sporm�ion Prajec�s ns (�1dJ�1ed in fhe 2007 P�•ogranmalic AgreenienL
Page 1 of 3