20161262 Ver 1_401 Application_20161216

McGill
A S S O C I A T E S
December 14, 2016
William Elliot
US Army Corps of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
Dear Mr. Elliot:
- 1 6 1 2 6 2
r (' 2 2 2016
JL
6E -Q -WATER RSSOURCgS
401 &B FF RP M N
RE: Chandy Street Stormwater Drainage
Improvements
Town of Boone
Watauga County, North Carolina
Please find enclosed a PCN application for a Nationwide Permit on the Chandy
Street Stormwater Drainage Improvements Project in Watauga County, North Carolina.
The PCN application is requesting approval on a NWP #3 for temporary fill impacts to an
unnamed tributary to Hodges Creek. Included with the PCN application is a Rapanos
form and project supporting figures. A courtesy copy of the application is being provided
to North Carolina Department of Environmental Quality — Division of Water Resources.
Please let me know if you have any questions or comments.
Sincerely,
Y
SOCIATES, P.A.
/'�'
Program Services Manager- Environmental
Enclosures
cc: Eric Gustaveson, Town of Boone
Byron Hamstead, USFWS
Andrea Leslie, NCWRC
Keith Webb, PE, McGill Associates
NCDEQ, DWR — Main Office
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Preliminary ORM Data Entry Fields for New Actions
6- BEGIN DATE [Received Date]:
Prepare file folder F-1 Assign Action ID Number in ORM FI
1. Project Name [PCN Form A2a]: Chandy Street Stormwater Drainage Improvements
2. Work Type: Private E] Institutional 0 Government F71 Commercial
3. Project Description / Purpose [PCN Form 113d and 133e]:
The project will replace an existing failed culvert to upgrade an existing sewerline, as well as
ensure the protection of private property and an existing adjacent municipal sewer line.
4. Property Owner /Applicant [PCN Form A3 or A4]:
Loretta Bumgarner /Town of Boone
S. Agent/ Consultant
6. Related Action ID Number(s) [PCN Form 65b]:
McGill Associates, P.A. / John C. Vilas
7. Project Location - Coordinates, Street Address, and/or Location Description [PCN Form 131b]:
36.2041 N. -81.66792 W. / 143 Chandy St. Boone, NC 28607
8. Project Location - Tax Parcel ID [PCN Form 131a]: 2900935797000
9• [PCN Form A2b]: Watauga
10. [PCN Form A2c]: Boone
11. [PCN Form 62a]: Hodges Creek
12. Watershed / 8 -Digit Hydrologic Unit Code [PCN Form 132c]: New / 05050001
Authorization: Section 10 El Section 404 7 Section 10 & 404
Regulatory Action Type:
Standard Permit Pre -Application Request
✓ Nationwide Permit # 3 Unauthorized Activity
Regional General Permit # Compliance
Jurisdictional Determination Request F_� No Permit Required
Revised 20150602

O�OF W A TF9OG
h r
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre -Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
® Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
❑ 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
® Yes ❑ No
For the record only for Corps Permit:
❑ Yes ® No
1f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation❑Yes
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
® No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2. Project Information
2a. Name of project:
Chandy Street Stormwater Drainage Improvements
2b. Cou0ty:
Watauga
2c. Nearest municipality / town:
Boone
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: Loretta C. Bumgamer
3b. Deed Book and Page No.
Book: 238, Page: 536
"22
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
143 Chandy Street DE -WAT R E
3e. City, state, zip:
Boone, NC 28607 RMITTIN
3f. Telephone no.:
[phone]
3g. Fax no.:
3h. Email address:
Chandy Street Stormwater Drainage Improvements
PCN Application
December 2016
Page 1 of 13

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ® Other, specify: Town of Boone Public Works
4b. Name:
Eric Gustaveson, Public Works Interim Director
4c. Business name
(if applicable):
4d. Street address:
321 East King Street
4e. City, state, zip:
Boone, NC 28607
4f. Telephone no.:
[phone]
4g. Fax no.:
4h. Email address:
[e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name:
John C. Vilas
5b. Business name
(if applicable):
McGill Associates, P.A.
5c. Street address:
468 New Market Blvd. Ste B
5d. City, state, zip:
Boone, NC 28607
5e. Telephone no.:
[phone]
5f. Fax no.:
[phone]
5g. Email address:
[e-mail]
Chandy Street Stormwater Drainage Improvements December 2016
PCN Application Page 2 of 13

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
2900935797000
1 b. Site coordinates (in decimal degrees):
Latitude: 36.2041 Longitude: - 81.6792
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size:
0.32-acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to proposed project:
Hodges Creek
2b. Water Quality Classification of nearest receiving water:
C; Tr:+
2c. River basin: map is available at
htto://h2o.enr.state.nc.us/admin/maps/
New
Chandy Street Stormwater Drainage Improvements December 2016
PCN Application Page 3 of 13

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:
The project site is a sewerline and drainaae easement corridor located on the eastern perimeter of Loretta
Bumgamer's property at 143 Chandy Street The corridor contains an existing 6" PVC sewerline and approximately
135 -linear feet of UT -Hodges Creek including a 50' section of 30" CMP The ape of the culvert is not known: the
culvert was installed around the same time as the adjacent sewerline and is believed to have been installed to allow
for separation from the stream channel and cover over the sewerline
The culvert has exceeded its designed lifespan and has failed: the bottom is fully corroded and sink holes have
formed on the ground surface above the culvertThe property owner has raised concerns about the sink holes and
potential future drainage and sewerline problems in the area The Town of Boone is responsible for maintaining the
sewerline and the culvert. The replacement culvert diameter will be upsized from 30 -inches to 48 inches in order to
meet a 50 -year storm design standard. The replacement culvert will be used for the oriainal intended purpose PVC
sewer line adjacent to the culvert will be replaced with Ductile Iron Pipe (DIP) durina the culvert replacement
Area surrounding the Proiect Site is primarily single-family residential
3b. List the total estimated acreage of all existing wetlands on the property:
None
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
Streams have not been delineated beyond the scope of the project site The project site encompasses aRproximately 50
linear feet of intermittent stream. an unnamed tributarytoHodges Creek, that flows through a culvert. There is
approximately 75 linear feet of open channel above the existing culvert and 10 linear feet below the culvert to the
property line.
3d. Explain the purpose of the proposed project:
The project will replace and upgrade an existing failed culvert with a new one to ensure the protection of private
property, and an existing municipal sewer line will be upgraded from PVC to DIP in the area adjacent to the culvert
Chandy Street Stormwater Drainage Improvements December 2016
PCN Application Page 4 of 13

3e. Describe the overall project in detail, including the type of equipment to be used:
The followina actions will be completed:
(1) Removal of the failed 50'x 30" CMP culvert.
(2) Installation of a new 50' x 48" HDPE within the existina culvert footprint matchina the previous alignment and
slope. The slope of the replacement culvert will be 9.8% and because of risk for headcuttinp the culvert will not be
countersunk. Culvert replacement work will be completed in the dry: a stream diversion measure will be employed Fill
from the temporary flow diversion measure will result in approximately 10 -If of temporary stream impacts (S-1)
(3) Replace existing 6" PVC sewer pipe with 6" DIP• no enlargement of the sanitary sewer will take place
Project work will be completed outside of the trout spawnina moratorium of October 15 throuah April 15 The project
will not result in chances of existina flow patterns All temporary fill resultina from the flow diversion measure will be
removed from the stream channel followina work. Disturbed stream banks will be returned to the original arade and
stabilized using biodegradable erosion control blankets and temporary erosion control seed mix Project work will be
completed primarily by backhoe.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the Corps or
State been requested or obtained for this property / project (including
all prior phases) in the past?
Comments: JD Forms completed by McGill Associates are attached.
❑ Yes ® No ❑ Unknown
4b. If the Corps made the jurisdictional determination, what type of
determination was made?
❑ Preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for this
project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ® No
6b. If yes, explain.
Chandy Street Stormwater Drainage Improvements December 2016
PCN Application Page 5 of 13

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ® Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non-404, other)
(acres)
Temporary T
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
PER or
(Corps - 404, 10
stream
length
Permanent P or
()
intermittent
DWQ — non-404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 []POT
Fill
UT-Hodges Creek
❑ PER
® INT
® Corps
❑ DWQ
5
10
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
10
3i. Comments: 10-If of temporary stream impacts for flow diversion measure.
Chandy Street Stormwater Drainage Improvements December 2016
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4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
Open water
impact number —
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody type
4e.
Area of impact (acres)
01 ❑P❑T
02 ❑P❑T
03 ❑P❑T
04 ❑P❑T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
Pond ID
number
5b.
Proposed use or purpose
of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
Size ofpond watershed (acres):
F5k.
Method of construction:
Chandy Street Stormwater Drainage Improvements December 2016
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6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar -Pamlico ❑ Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number—
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
required?
131 ❑P❑T
❑Yes
❑ No
B2 ❑P
❑Yes
❑ No
B3 ❑P
El Yes
❑ No
6h. Total buffer Impacts
6i. Comments:
Chandy Street Stormwater Drainage Improvements December 2016
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D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
New replacement culvert will be set in the footprint of the existing culvert minimizing disturbance Existina stream
profile will not be altered. Work will be avoided during high flow or rain events: the contractor will monitor weather
forecasts for 48 hour rain -free window before beginning work.
b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
No sediment and erosion control measures in stream channel. A stream diversion measure will be used to ensure
work in jurisdictional waters can be comDleted in the dry. All temporary fill will be removed from the stream channel
following work: disturbed stream banks will be returned to their original grade and streambanks will be stabilized with
erosion control blankets and temporary erosion control seed mix
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
❑ Yes ® No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
El Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
Chandy Street Stormwater Drainage Improvements December 2016
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4h. Comments:
S. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? If yes, you will have to fill out this entire form — Dlease
contact the State for more information.
❑ Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Chandy Street Stormwater Drainage Improvements December 2016
PCN Application Page 10 of 13

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified
El Yes No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
El Yes El No
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
No change in site imperviousness.
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: No stormwater rules using a NWP #3
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
Watauga County
❑ Phase II
3b. Which of the following locally -implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
® Other: None
3c. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
4. DWQ Stormwater Program Review
❑ Coastal counties
4a. Which of the following state -implemented stormwater management programs apply
❑ HOW
❑ ORW
(check all that apply):
❑ Session Law 2006-246
® Other: None
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ® No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Chandy Street Stormwater Drainage Improvements December 2016
PCN Application Page 11 of 13

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la. Does the project involve an expenditure of public (federal/state/local) funds or the
® Yes ❑ No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes ❑ No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application?
❑ Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
Single and complete proiect with no change from the oriainal or intended use: no extension of services.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
No sewaae disposal associated with this project.
Chandy Street Stormwater Drainage Improvements December 2016
PCN Application Page 12 of 13

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
habitat?
®Yes ❑ No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
❑Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
El Raleigh
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
https:/Mrww.fws.-goy/raleiah/species/cntylisttwatauaa.htm Areas within the vicinity of the Prosect Site contain potential
habitat for the Northern Lona -eared Bat fMvotis seAtentr/ona/isl However the proposed project does not involve the
firm of trees or disturbina potential NLEB habitat Supporting habitat and species occurrences were not observed
on the Proiect Site for the followina federally listed species: Boa turtle Carolina northern flvina squirrel Vrainia bla
eared bat. Spruce -fir moss spider. Blue Ridae goldenrod Heller's blazina star, Roan mountain bluet and Spreading
avens The North Carolina Natural Heritage Proaram species occurrence database was aueried for the Project Site
no records for rare species important natural communities natural areas or conservation/managed areas within the
proposed prosect boundary.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
httpJ/ccma nos nose oov/products/bioaeoaraphv/ -efht
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
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
http•//ais ncdcr aov/hpoweb/ Project site is approximately 5,200-f
eet from the nearest National Resister historic site
Jones House. HPO Site ID: WT0008 Project will have no effect" to this National Register historic site
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
❑ Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? http://fris.nc.aoy/fristHome.aspx?ST=NC
John C. Vilas
Agent's Printed Name
z�Z7 Cid
Agent's Signature
(Agent's signature is Aid only If an authorization letter from the applicant
isprovided.)
12/14//2016
Date
Chandy Street Stormwater Drainage Improvements December 2016
PCN Application Page 13 of 13

.� McGill
A C S 0( I A l L S
AGENT AUTHORIZATION FORM
PROJECT NAME:
PROJECT COUNTY:
PROPERTY PIN:
PROPERTY OWNER:
PROPERTY OWNER TELEPHONE:
Chandv Street Stormwater Drainage Improvements
Watauga
2900935797000
Loretta Bumoarner
(828,) 264-5147
PROPERTY OWNER REPRESENTATIVE: Eric Gustaveson Public Works Interim Director — Town
of Boone
The undersigned, registered property owner(s) of the above noted property, do hereby authorize
John C. Vilas of McGill Associates P.A.
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's/Representative's Address (if different than property above):
321 East King Street
Boone, NC 28607
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature:
Date: 111
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I INCH = 600 FEET
143 CHANDY STREET
LOCATION MAP
PROJECT #
CULVERT REPLACEMENT
eMcGM
AUGUST 5, 2016
16.00174
WATAUGA COUNTY,
A S S 0 C I A T E S
ENVIRONMENTAL - FINANCE
NORTH CAROLINA
468 NEA nhkKET BLVD. SM B BOONE, NC 28407 PH. (829) 3861920

T . ..
,�• • • • has
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0 ,
�., � • ::. ;. J,, .. •Gas •
• ,•cs- a •. -� ••
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'afield '• '" • I `V"�
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Inkle e .,
�. BM -4
\ �L
GRAPHIC SCALE �f
-600 0 300 600 /`��,\ USGS
BOONE QUADRANGLE
NORTH CAROLINA WATAUGA CO.
-
I INCH = 600 FE 7.r MINUTE
ET I SERIES (TOPOGRAPHIC) 21 C SW
143 CHANDY STREET-
USGS TOPO MAP
PROJECT #
CULVERT REPLACEMENT
1
AUGUST 5, 2016
16.00174
WATAUGA COUNTY,
NORTH CAROLINA
AS S 0 C I A T E S
ENVIRONMENTAL • FINANCE
468 NEW MARKET BLVD. SIE B BOONS NC 28607 PH. (828) 3861420

rr", j
2-c'!
�
r
t Pro
i� 3ry
Chandy St/
YA•
/ At{ „ ,.
It
50'x 30" Culvert
to be reDlaced
N .:
2 -foot Contours
2014 Aerial Image
w
,- 100 50
EXISTING
CONDITIONS
PROJECT#
AUGUST 31, 2016 16.00174
0
100 Feet
143 CHANDY STREET
CULVERT REPLACEMENT McG1*11
WATAUGA COUNTY A S S O C I A T E S
NORTH CAROLINA ENGINEERING • PLANNING • FINANCE

Photo One: View looking upstream on UT -Hodges
Creek, above the existing culvert.
Photo Two: View of the inlet to the existing culvert
proposed to be replaced.
Photo Three: View looking downstream the existing
culvert. Note the degree of corrosion along the
bottom of the CMP.
PHOTO SHEET
PROJECT#
AUGUST 31, 2016 1 16.00174
Photo Four: View of a sinkhole that has formed above
the existing CMP due to pipe failure.
143 CHANDY STREET
CULVERT REPLACEMENT
WATAUGA COUNTY
NORTH CAROLINA
0MCG1*11
A S S O C I A T E S
ENGINEERING • PLANNING • FINANCE

36° 12' 16" N
36" 12'11"N
3 Soil Ma
� p—Watauga County. North Carolina 3
$ (CHANDY STREET CULVERT REPLACEMENT) a
3
$ Map Sole: 1:1,070 ffprt>tied on A Wdscape (11" x 8.5') sheet
NMeters
n0 15 30 60 90
/V
0 50 100 200 300
MaP WoJedm: Web Mercator Comermordmahs: WC584 Edge bm: uTm Zone 17N WCS84
USDA Natural Resources Web Soil Survey
3� Conservation Service National Cooperative Soil Survey

Soil Map—Watauga County. North Carolina
(CHANDY STREET CULVERT REPLACEMENT)
MAP LEGEND
MAP INFORMATION
Area of Interest (AOI)
�4 Spoil Area
The soil surveys that comprise your AOI were mapped at 1:12.000.
lJ
Area of Interest (AOI)
Stony Spot
C1Warnin
Soils
g: Soil Map may not be valid at this scale.
Soil Ma Unit Polygons
P Y9
Very Stony Spot
Enlargement of maps beyond the scale of mapping can cause
+�
Soil Map Unit Lines
W
.r Wet Spot
misunderstanding of the detail of mapping and accuracy of soil line
:', Other
placement. The maps do not show the small areas of contrasting
0
Soil Map Unit Points
soils that could have been shown at a more detailed scale.
Special Point Features
Special Line Features
U°:
Blowout
Water Features
Please rely on the bar scale on each map sheet for map
-- Streams and Canals
measurements.
0
Borrow Pit
Transportation
Source of Map: Natural Resources Conservation Service
')K
Clay Spot
Rails
Web Soil Survey URL: hftp://websoilsurvey.nres.usda.gov
Closed Depression
t44
Coordinate System: Web Mercator (EPSG:3857)
Interstate Highways
Maps from the Web Soil Survey are based on the Web Mercator
Gravel Pit
US Routes
projection. which preserves direction and shape but distorts
Gravelly Spot
distance and area. A projection that preserves area. such as the
Major Roads
Albers equal-area conic projection. should be used if more accurate
^
Landfill
Local Roads
calculations of distance or area are required.
Lava Flow
Background
This product is generated from the USDA-NRCS certified data as of
Marsh or swamp
� Aerial Photography
the version date(s) listed below.
Mine or Quarry
Soil Survey Area: Watauga County. North Carolina
Survey Area Data: Version 14. Sep 16. 2015
{l
Miscellaneous Water
Soil map units are labeled (as space allows) for map scales 1:50.000
Perennial Water
or larger.
Rock Outcrop
Date(s) aerial images were photographed: Oct 22.2010—Mar 17.
+
Saline Spot
2011
Sandy Spot
The orthophoto or other base map on which the soil lines were
compiled and digitized probably differs from the background
Severely Eroded Spot
imagery displayed on these maps. As a result. some minor shifting
Sinkhole
of map unit boundaries may be evident.
fib
Slide or Slip
Sodic Spot
211111111111 USDA Natural Resources Web Soil Survey 7/29/2016
Conservation Service National Cooperative Soil Survey Page 2 of 3

Soil Map—Watauga County. North Carolina
Map Unit Legend
CHANDY STREET CULVERT
REPLACEMENT
Watauga County, North Carolina (NC789)
Map Unit Symbol
Map Unit Name
Acres in AOI
Percent of AOI
CkE
Chestnut-Edneyville complex.
30 to 50 percent slopes. stony
3.1
53.5%
EdD
Edneytown loam. 15 to 30
percent slopes
2.4
42.7%
Ud
Udorthents. loamy
0.2
3.8%
Totals for Area of Interest
5.7
100.0%
ga Natural Resources Web Soil Survey 7/29/2016
i Conservation Service National Cooperative Soil Survey Page 3 of 3

NORTH CAROLINA LAND QUALITY SECTION
EROSION CONTROL NOTES
GENERAL ALL EROSION CONTROL MEASURES ARE TO BE PERFORMED IN STRICT ACCORDANCE AN REOUIRNI
EMES OF THE
SECTION CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES. DIVISION OF LAND RESOURCES. LAND QUALITY
SECTION. THE FOLLOWING CONSTRUCTION SEQUENCE SHALL BE COMPLIED WITH FOR ALL WORK.
1. - PRIOR TO BEGINNING WORK ON THE PROJECT THE CONTRACTOR SHALL OBTAN MGM ME OWNER A COPY OF THE
EROSION AND SEGMENT CONTROL APPROVAL' PROM THE NCRM CMOINA DEPARTMENT OF ENVIRONMENT AND
NATURAL RESOURCES. DIVISION OF LAND OUAUTY, OR ME LOCAL AVTHMIZED PROGRAM. THE APPROVAL NOTICE
MUST BE POSTED ON-STE DURING ALL GRADING AND CMSMUC71M ACTIVITIES
2. - INSTALL ALL EROSION CONTROL MEASURES AS REQUIRED BY ME NORTH CAROLINA DEPARTMENT OF ENVIRONMENT
AND NATURAL RESOURCES, DIVISION OF LAND RESOURCES LAND QUALITY SECTION. ALL EROSION CONTROL
MEASURES SHALL BE INSPECTED AT WE END AND BEGINNING OF EACH WORK DAY AND MAINTAINED AS REQUIRED.
NOTE TY W.'T T1lN WITH 2A' DF A B eR 1R BAV': g N AUIQ PER STREAM
PROIFCT.N IRw FYfAVAIid DET 4 sFMXNf. un Y . [SHED . d i RF faL� Fnn D Y
NOTED A< STREAM PRe 110N x e dLT FETNfF W T2s Mi4c eu NST N"TA� I M , BSER TN N A'
FROM t]2EEK D Q I FCS FEL ATOMS AC,,_N T c ENT ' li T FEACf AA.
N�fIE A A M A lEA f R
3. - NO WORK SHALL BE PERFORMED N STREAM FROM OCTOBER 15 TO APRIL 15 (TO ACCOMMODATE COE AND DWO
RECOMMENDATIONS CONCERNING WORK IN TROUT WATERS.)
4. - CONTRACTOR IS TO PUCE PERMANENT STAKES MARKING CLEARLY THE 25' BUFFER FOR STREAMS WHERE SHOWN
ON WE PLANS AND WE MARKERS ARE TO BE VISIBLE AT ALL TINES DURING CONSTRUCTION.
5, - OBTAIN CERTIFICATE OF COMPLIANCE TROUGH ON -Sin INSPECTION BY A REPRESENTATIVE OF THE NORM
CMOLNNA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF LAND RESOURCES, LAND QUALITY
SECTION.
6. - CONSTRUCTION SHALL BE LIMITED TO 2000' OF CQUTGUQIS RoAD CORN," UNTIL ALL CUTS. FILLS, AND DITCHES
ARE STABILIZED FOR MAT 2000' SECTION. IRON STABILIZATION OF MAT SECTION MOTHER 2000' SECTION CM
BE CONSTRUCTED AND STABILIZED.
7. - ALL STREAM CROSSINGS AND PERENNIAL STREAMS NLL K ALIGNED WITH THE NATURAL STREAM PATTERNS ABOVE
MD BELOW ME PROPOSED ROAD. MON CULVERTS WILL BE USED AND FOOTERS WILL BE CONSTRUCTED N
UNDISTURBED BANKS AWAY FROM THE STREAM ROW.
8. - PROCEED MIM GRADING, CLEARING AND GRUBBING. NOTE, NO OFT STE DISPOSAL OF MATERIAL IS ALLOWED
UNLESS ME DISPOSAL STE HAS AN APPROVED EROSION CONTROL PUN.
B. - SEED AND PLACE EROSION CONTROL MATTING ON ALL CUT AND RLL SLOPES MAT ME NOT ROCK IMMEDIATELY
UPON COMPLETION OF SLOPE STABILIZA110N.
10. - ALL TEMPORARY STREAM AND CREEK CROSSINGS FOR EQUIPMENT DURING CONSTRUCTION SHALL BE MADE USING
TEMPORARY BRIDGES. NO STREAM BANK OR STREAM BED DISTURBANCE SHALL BE ALLOWED FOR EQUIPMENT
CROSSINGS
11. - sm Au CN bF .�' LL BE ;EW
WITH - RFT 1GROUNDGRND SURFACES NOT
CLA59F1ED AS OPE1N Ems SHALOOSETED TO A DEPTH G ALL ALL BE PLACED ON A
EMM LARGE ROOKS CLUMPS G
AND EXCESSIVE SPOIL MATERIAL REMOVED. SEED AND SOIL AMENDMENTS SH
PREPARED SEEDBED AT THE FOLLOW NG RATES PER ACRE. STRAW MULCT SHALL H TACKED NM TACKING
RENT APPUED BY HYDROSEEDER.
UME 4.000 Los
FERTIUZER (Io -lo -lo) 1,ODO LBS
KY -31 FESCUE (POA PRATENSS) 100 LBS (MOWED AND MAINTAINED AREAS ONLY)
OR
CREEPING RED FESCUE 100 LBS (NATURAL MEAS AND STREAMBMKS)
STRAW MULCH 60-M BALES
FOR SUMMER SEEDING ADD TO THE MOVE:
GERMAN MALLET (SETARIA ITALICA) 4o Los
SMALL -STEMMED SUDAN GRASS (SORGHUM BICOLOR) 50 LBS
FOR WINTER SEEDING ADD TO TIME ABOVE
RYE GRAIN (SECASE fiREALE) 120 Los
IF IYDROSEEDNG, WOOD CELLULOSE MAY BE USED N ADDITION TO STRAW MULCH AT THE RATE OF 1,000 LBS
PER ACRE
AL SEEDING SHALL BE MAINTAINED• WATERED ETC... UNTIL A PERMANENT VEGETATIVE GROUND COVER IS
ESTABLISHED OVER ALL DISIURBFD AREAS.
FOR
S eP c T DR IST 1D -
"w "r SEFO SNTLNGRAS 4 LBS
BROWNTOP MILLET OR PEARL MILLET (PENNISETUM OLAUCUM) 5 LBS
GRAIN SORGHUM (SORGHUM BCOLOR (L) MOENCI SSP. BICOLOR) Z LBS
is .1 OR cTENf Bi .MER B M C.I.IR iG
NATIVE SEEDING
ME CORRECT SEEDBED PN IS 5.5 70 6.5.
APPLY ZERO NITROGEN AT PLANTING
INCORPORATE SOIL AMENDMENTS INTO TOPSOL/RCOT ZONE BELDBE SEEDING.
FIRM SEEDBED BEFORE SEEDING (TRAVEL NTH DOZER CLEATS).
SEEDING DEPTH FOR ALL NAIVE SSP. EXCEPT E.GAMAGRAS (TRIPSACUM DACTYBIDES) NEED TO BE 1/4• - 1/2•.
GREATER DEPTHS CAUSE HIGH SEED MORTAUTY.
SPECIALIZED SEEDING IMPLEMENTS ARE REGUIRED. SEED MIXES MD RATES TO MATCH SEEDER USED. A NO -TILL
DROP SEEDER OR BROADCASTER NTH PRECISION METERING TO CONTROLSM
MALL SEED ROW AND PICKER WELL
AGITATORS TO HMDLE FLUFFY SEED MFOR E BEST SUITED FNATIVE SEED.
NATIVE PLANT SEEDING MIX FOR STREAM OR RIVERBANK STABILIZATION
SEEDING FOR STREAM OR NVERBAN STABILIZATION SHALL BE A MIXTURE OF NATIVE GRASSES, PLANTS MD
TREES. NATIVE PLANT MX SHALL INCLUDE THE FOLLOWING:
MASSES - BG pLUESTEM (MDROPOGM GAMDS). ROM GRASS (SORGASTRUM NUTANS). LITTLE BUUESIEY
(SCHZA04YRIUM SCOPMIUA, SWITCHGRASS (PANICUM VIROATUM). 15 LBS/ACRE EACH
AUGUST TRU MAY - GREENRYE (SECALE CEREALS) 25 LBS/ACRE EACH
MAY 1 TABU AUGUST - MILLET (PENRSETUM CLLA)CUM) 25 LBS/ACRE EACH
TREES - SMY DOGWOOD (CORNUS AMONUM). SLKY WILLOW (SAUX SERICEA), HAZEL ALDER (ALMUS SERRULATA)
AND ELDERBERRY (SAMBUEUS CANADENSS)
NATIVE PLANT MIX VARIATIONS SHALL BE APPROVED BY ENGINEER.
NOTE: NO FERTIl1ZEF SMALL BE USED WITHIN 10' OF TDP OF STREAM OR RIVER BANK.
NPDES PERMITS - NOTE -FOR PROJECTS REQUIRING NPDES PERMITS THE
FOLLOWING STABILIZATION SCHEDULE SHALL APPLY:
STE ARE.
DESCRIPTION
11"A
STABILIZATION
TM2 ONc
PERIMETER DIKES, SWALES
7 DAYS
NONE
DITCHES AND SLOPES
\ 6'FOUNI)DEPTH \
HIGH QUALITY WATER
M
UNCEIN
AS DIRECTED ByVfNGNNE. ON Y
(HOW) ZONES
7 DAYS
NONE
SLOPES STEEPER THAN 3:1
7 DAYS
F SLOPES ARE 10' OR LESS IN LENGTH AND ARE
UNDERCUT EXCAVATION
NOT STEEPER THAN 2:1. 14 DAYS ARE ALLOWED
SLOPES 3:1 OR FLATTER
14 DAYS
7 -DAYS FOR SLOPES GREATER
MIRE TIES
THAN 50 FEET N LENGTH
AL OTHER AREAS WITH
14 DAYS
NONE (EXCEPT FOR PERIMETERSADIPES
Mi7FR THAN 4:1
AND HOW ZONES)
12. - MANTAN SOIL EROSION CONTROL MEASURES UNTIL PERMANENT GROUND COVER is ESTABLISHED. INSPECT ALL
EROSION CONTROL MEASURES WEEKLY. AFTER EVERY RAN AND DAILY DURING PROLONGED RAIN EVENTS.
13. - REMOVE SOIL EROSION CONTROL MEASURES AND STABILIZE THESE AREAS.
14. - REQUEST FNA. APPROVAL BY THE NORTH CAROUNA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES,
DIVISION OF LAND RESOURCES, LINO QUALITY SECTM.
BACKI U. MATERIAL
COMPACTED N V u'IS
BACKFILL MATER. 1 �`
COMPACTED N 3• LFR
d�
UND'
6EAATH
URBED
STANDARD EXCAVATION OVERCUT EXCAVATION
DUCTILE IRON GRAVITY SEWER
0ACgX1 MATENAL
mMPACTm w B• LFTs
SPRING u2 O PIPE ' \
GLASS I , WIN /
EYRDLIENT
0105
STANDARD EXCAVATION
IN WET CONDITIONS
BACKFMLYAnA.
wIRACTEDw B• uTs
SPRING LINE O PIPE pY.
B' MAX STANDARD STRENGTH FABRIC WITH MARE FENCE
+\
GLAS I
EL0FD T
6• MiN
\'
\ 6'FOUNI)DEPTH \
TON STONE
M
UNCEIN
AS DIRECTED ByVfNGNNE. ON Y
EMM
STANDARD EXCAVATION
IN WET CONDITIONS
BACKFMLYAnA.
wIRACTEDw B• uTs
SPRING LINE O PIPE pY.
B' MAX STANDARD STRENGTH FABRIC WITH MARE FENCE
+\
GLAS I
EL0FD T
6• MiN
\'
\ 6'FOUNI)DEPTH \
TON STONE
M
UNCEIN
AS DIRECTED ByVfNGNNE. ON Y
\ \
UuOTMTURBED
v
(j•
UNDERCUT EXCAVATION
IN UNSTABLE SOILS TYPES
PIPE IN WET OR UNSTABLE CONDITIONS
ALL PIPE TYPES
(AS DIRECTED BY ENGINEER)
NOTES:
1. CONSTRUCTION OF TRENCHES SHALL COMPLY NTH ALL FEDERAL STATE AND LOCAL SAFETY AND HEALTH
REGULATIONS WHICH HAVE JURISDICTION AT THE PROJECT SITE. IT 15 THE CONTRACTOR'S RESPONSBIUTY TO BE
FAMILIAR NTH THE APPUCABLE REGULATIONS AND FOLLOW MEM ACCORDINGLY.
2. FOR UNIT PRICE CONTRACTS ONLY, PAYMENT FOR ROCU( EXCAVATION AND SELECT BACKFILL IN TRENCH
SHALL BE FOR ACTUAL QUANTITIES AND SHALL NOT EXCEED THE WIDTH OF TRENCH SHOWN ON THIS DETAIL,
3. FOR UNIT PRICE CONTRACTS ONLY, PAYMENT FOR FOUNDATION STONE UNDERCUT SHALL BE FOR THE
LENGTH OF THE TRENCH REQUIRING UNDERCUT X 6• DEPTH INCREMENTS TO THE DEPTH REWIRED.
4. CUSS 1 EMBEDMENT SHALL BE NCDOT STANDARD / 67 STONE OR APPROVED EQUAL FOUNDATION STONE
SHALL BE NCDOT STANDARD / 57 OR / 67 STONE OR APPROVED EQUAL.
TYPICAL GRAVITY SEWER TRENCHING DETAILS
NOT TO SCALE
BACKFILL MATERIAL
COMPACTED N 6• LIFTS
HDPE STORYDIUIN PIPE 6 MINI • Mp \�
\
SPRING UNE OF PIPE\ dY.
6' MN
5D7
N0. WASHED STONE
NO. NT
UNDISTURBED EARTH
STANDARD EXCAVATION
WUES
1. CONSTRUCTION OF TRENCHES SHALL COMPLY NTH ALL FEDERAL, STATE AND LOCAL SAFETY
MD HEALTH REGULATIONS WICH HAVE LNSDICTON AT THE PROJECT STE IT IS THE
CONTRACTOR'S RESPONSIBILITY TO BE FAMIUM WITH ME APPLICABLE REGULATIONS AND FOLLOW
THEM ACCORDINGLY.
2. PAYMENT FOR ROCK EXCAVATION ANDSELECT BACKFILL N TRENCH SHALL BE FOR ACTUAL
DUMMIES SHALL HOT EXCEED THE NOW OF TRENCH TRENCH SHORN ON THIS DETAIL
TYPICAL TRENCHING DETAIL
HDPE PIPE WITH WASHED STONE EMBEDMENT
NOT TO SCALE
SEDIMENTATION/SILT FENCE - -
NOT TO SCALE
REVISION
W LTJ
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1"4
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z
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SLOPE LENGTH(FT) MAXIMUM AREA(SOFT)
E FOUND TO BE N DISREPAIR.
QK
100
10.000
21' �.\�
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2 TO y1E
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AGR EACH STORM EVENT AND WHEN
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SECTION VIEW
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FABRIC
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SEDIMENTATION/SILT FENCE - -
NOT TO SCALE
REVISION
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1. FILTER BARRIERS SHALL BE INSPECTED
IMMEDIATELY AFTER EACH RAINFALL AND
DAILY DURING PROLONGED RAINFALL
REPAIR SHALL BE MADE AS NECESSARY.
2. FABRIC SHALL BE REPLACED PROMPTLY
SLOPE
SLOPE LENGTH(FT) MAXIMUM AREA(SOFT)
E FOUND TO BE N DISREPAIR.
QK
100
10.000
3. SEOMENT DEPOSITS SHALL BE REMOVED
2 TO y1E
7y
7'5"
AGR EACH STORM EVENT AND WHEN
5 TO In
50
5•�
DEPOSO REACH APPROXIMATELY 1/3
HEIGHT" Or BARPoEA.
10 lO 20i
MOIL
25
15
2,500
1,500
4. REFERENCE NCDENR LAND OVAUTY
SECTION DESIGN MANUAL 6.62.
SEDIMENTATION/SILT FENCE - -
NOT TO SCALE
REVISION
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Note:
Ensure To Anchor All Pipes Securely
Source: NCDOT BMP's for Construction and Maintenance Activities (August 2003)
STREAM CHANDY STREET
DIVERSION PROJECT # STORMWATER DRAINAGE
DETAIL 16.00174 IMPROVEMENTS
OCT. 25, 2016
Drawing Not Scaled
McGill
ASSOCIATES
468 NEW MARKET BLVD. STE B BORNE, NC 28607 PH. [phone]

APPROVED JURISDICTIONAL DETERMNATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION:
State: North Carolina County/parish/borough: Watauga City: Boone
Center coordinates of site (lat/long in degree decimal format): Lat. 36.2041 ° (V, Long. -81.67920 !.
Universal Transverse Mercator:
Name of nearest waterbody: Hodges Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: New
Name of watershed or Hydrologic Unit Code (HUC): 05050001
Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a
different JD form.
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
Office (Desk) Determination. Date:
Field Determination. Date(s):
SECTION II• SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There KIM "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 subject to the ebb and flow of the tide.
Waters are presently used, or have been used in the past, or maybe susceptible for use to transport interstate or foreign commerce.
Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There W "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): t
TNWs, including territorial seas
Wetlands adjacent to TNWs
Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
Non-RPWs that flow directly or indirectly into TNWs
Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
Impoundments of jurisdictional waters
Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non -wetland waters: 50 linear feet: 5 width (ft) and/or acres.
Wetlands: acres.
c. Limits (boundaries) of jurisdiction based onietati#IM1.
Elevation of established OHWM (if known):
Non-regulated waters/wetlands (check if applicable):3
[] Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional.
Explain:
1 Boxes checked below shall be supported by completing the appropriate sections in Section III below.
z For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally"
(e.g., typically 3 months).
3 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 IILA.1 and 2
and Section III.D.1.; otherwise, see Section IILB below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent'
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
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 M.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, for
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 IILB.1 for
the tributary, Section HLB.2 for any onsite wetlands, and Section IILB.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: 835
Drainage area: 23
Average annual rainfall: 53 inches
Average annual snowfall: 34 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
❑ Tributary flows directly into TNW.
® Tributary flows through 0 tributaries before entering TNW.
Project waters areriver miles from TNW.
Project waters are1102
river miles from RPW.
Project waters are aerial (straight) miles from TNW.
Project waters are �§*- is) aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW: UT -Hodges Creek; Hodges Creek; Winklers Creek; South Fork New River.
Tributary stream order, if known:
Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
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) General Tributary Characteristics (check all that apply):
Tributary is: ❑ Natural
❑ Artificial (man-made). Explain:
® Manipulated (man -altered). Explain: Culvert; stream bank shored with landscape rock.
Tributary properties with respect to top of bank (estimate):
Average width: 5 feet
Average depth: 2.5 feet
Average side slopes: R.
Primary tributary 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: Stable.
Presence of run/fifflelpooll complexes. Explain: Riffle pool sequences present.
Tributary geometry: 910WR
Tributary gradient (approximate average slope): 5 %
(c) Flow:
Tributary provides for:
Estimate average number of flow events in review area/year:
Describe flow regime: Strong normal flow during the winter months and weaker during the summer.
Other information on duration and volume:
Surface flow is:
Characteristics:
Subsurface flow: UJIM. Explain findings:
❑ Dye (or other) test performed:
Tributary has (check all that apply):
® Bed and banks
® OHWM6 (check all indicators that apply):
❑ clear, natural line impressed on the bank
® changes in the character of soil
❑
® shelving
❑
❑ vegetation matted down, bent, or absent
ED
❑ leaf litter disturbed or washed away
❑
❑ sediment deposition
❑
❑ water staining
❑
❑ other (list):
❑ Discontinuous OHWM 7 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):
[ High Tide Line indicated by: Mean High Water Mark indicated by:
❑ oil or scum line along shore objects ❑ survey to available datum;
❑ fine shell or debris deposits (foreshore) ❑ physical markings;
❑ physical markings/characteristics ❑ vegetation lines/changes in vegetation types.
❑ tidal gauges
❑ other (list):
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality, general watershed characteristics, etc.).
Explain: Water color is mostly clear.
Identify specific pollutants, if known: Sediment present.
6A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where
the OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow
regime (e.g., flow over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
Tid.

(iv) Biological Characteristics. Channel supports (check all that apply):
® Riparian corridor. Characteristics (type, average width): Varies: passes through yards and forested areas.
❑ Wetland fringe. Characteristics:
® Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fish/spawn areas. Explain findings:
❑ Other environmentally -sensitive species. Explain findings:
® Aquatic/wildlife diversity. Explain findings: No macrobenthics observed; juvenile salamanders observed.
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Explain:
Surface flow is: RM
Characteristics:
Subsurface flow: ISM. Explain findings:
❑ Dye (or other) test performed:
(c) Wetland Adiacency Determination with Non-TNW
❑ Directly abutting
❑ Not directly abutting
❑ Discrete wetland hydrologic connection. Explain:
❑ Ecological connection. Explain:
❑ Separated by berm/barrier. Explain:
(d) Proximity (Relationshin) to TNW
Project wetlands are river miles from TNW.
Project waters are aerial (straight) miles from TNW.
Flow is from:
Estimate approximate location of wetland as within the IMM floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed
characteristics; etc.). Explain:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
❑ Riparian buffer. Characteristics (type, average width):
❑ Vegetation type/percent cover. Explain:
❑ Habitat for:
❑ Federally Listed species. Explain findings:
❑ Fish/spawn areas. Explain findings:
❑ Other environmentally -sensitive species. Explain findings:
❑ Aquatic/wildlife diversity. Explain findings:
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: t
Approximately ( ) acres in total are being considered in the cumulative analysis.

For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
A significant nexus analysis will assess 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 significant nexus based solely on any specific threshold of distance (e.g. between a
tributary and its adjacent wetland or between a tributary and the TNW). 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 wetlands (if any), have the capacity to carry pollutants or flood waters to
TNWs, or to reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, 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 tributary, 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. Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into
TNWs. Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its
adjacent wetlands, then go to Section III.D:
3. Significant nexus 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 APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
TNWs: linear feet width (ft), Or, acres.
Wetlands adjacent to TNWs: acres.
RPWs that flow directly or indirectly into TNWs.
[] Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial: Well defined OHWM, continuous bed and bank features, strong baseflow conditions, evidence of
periodic high flow events.
19 Tributaries of TNW where tributaries have continuous flow "seasonally' (e.g., typically three months each year) are
jurisdictional. Data supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows
seasonally: Well defined OHWM, continuous bed and bank features, moderate baseflow conditions, evidence of periodic high
flow events.

Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: 50 linear feet 5 width (ft).
Other non -wetland waters: acres.
Identify type(s) of waters:
Non-RPWs8 that flow directly or indirectly into TNWs.
Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a
TNW is jurisdictional. Data supporting this conclusion is provided at Section III.C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non -wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale
indicating that tributary is perennial in Section M.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 IH.B and rationale in Section IH.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 not directly abutting an RPW that flow directly or indirectly into TNWs.
IM Wetlands that do not directly abut an RPW, but when considered in combination 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 IH.C.
Provide acreage estimates for jurisdictional wetlands in the review area: acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
j Wetlands adjacent to such waters, and have when considered in combination 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.
7. Impoundments of jurisdictional waters!
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Demonstrate that impoundment was created from "waters of the U.S.," or
Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
Demonstrate that water is isolated with a nexus to commerce (see E below).
E. ISOLATED [INTERSTATE OR INTRA -STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE,
DEGRADATION OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY
SUCH WATERS (CHECK ALL THAT APPLY):"
which are or could be used by interstate or foreign travelers for recreational or other purposes.
from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
y which are or could be used for industrial purposes by industries in interstate commerce.
Interstate isolated waters. Explain:
Other factors. Explain:
BSee Footnote # 3.
9 To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
10 Prior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for
review consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.

Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
Tributary waters: linear feet width (ft).
Other non -wetland waters: acres.
Identify type(s) of waters:
Wetlands: acres.
NON -JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers
Wetland Delineation Manual and/or appropriate Regional Supplements.
Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
❑ Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the
"Migratory Bird Rule" (MBR).
Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
Other: (explain, if not covered above):
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
udgment (check all that apply):
Non -wetland waters (i.e., rivers, streams): linear feet width (ft).
Lakes/ponds: acres.
Other non -wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
Provide acreage estimates for non jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such
a finding is required for jurisdiction (check all that apply):
Non -wetland waters (i.e., rivers, streams): linear feet, width (ft).
Lakes/ponds: acres.
Other non -wetland waters: acres. List type of aquatic resource:
Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall 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 applicant/consultant.
❑ Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/dehneation 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: Boone, NC 1:24,000 quad.
USDA Natural Resources Conservation Service Soil Survey. Citation:
National wetlands inventory map(s). Cite name:
StateUcal wetland inventory map(s):
FEMA/FIRM maps:
100 -year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ® Aerial (Name & Date): 2014 NC One.
or ® Other (Name & Date): Field- August 2016.
g 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:

NC DW® Stream Identification Form Version 4.11
Date: C' 30 I tv
ProjecUSite: 'f
Latitude:
Evaluator:
r'f ift t+.r i fl
County:t� �1�sT
Longitude:
Total Points:
Stream Dete ircle one)
Other LCI ^ GKer
Stream Is at least Intermittent 2 (p
If t 19 or erenMaf If t 30'
Ephemera) ntermitten Perennial
e.g. Quad Name: �O e o
A. Geomorphology Subtotal = ' • :
Absent
Weak
Moderate
Strong
10, Continuity of channel bed and bank
0
1
2
LV
2. Sinuosity of channel along thalweg
0
1
0.5
3
3. in -channel structure: ex, riffle -pool, step -pool,
ri le ool sequence
0
1
3
4. Particle size of stream substrate
0
1
1
3
3. Active/relict floodplain
Cd1
0.5
2
3
6. Depositional bars or benches
0
0.5
2
3
7. Recent alluvial deposits
0
0.5
2
3
8. Headcuts
1
2
3
9. Grade control
0
0.5
1
Notes:
10. Natural valley
0
0.5
1
1.5
11. Second or greater order channel
No
Yes = 3
Sketch:
arnnaat ancnes are not ratea; see oiscussions in manual
B. Hvdroloav (Subtotal = 5 1
12. Presence of Baseflow
0
1
2
3
13. Iron oxidizing bacteriaEEd
1
2
3
14. Leaf litter
1
0.5
0
15. Sediment on plants or debris
0
-0.!L
1
1.5
16. Organic debris Ines or piles
0
0.5
1
1.5
17. Soil -based evidence of high water table?
No tai
0.5
Yes = 3
1.5
C:.1310100V (Subtotal= '1."/5 1
18. Fibrous roots in streambed
rD
2
1
0
19. Rooted upland plants in streambed
2
1
0
20. Macrobenthos (note diversity and abundance)
0
1
2
3
21. Aquatic Mollusks
1
2
3
22. Fish
0
0.5
1
1.5
23. Crayfish
0
0.5
1.5
24, Amphibians
0
0.5
1
1.5
25. Algae
0
0.5
1
1.5
26. Wetland plants in streambed
FACW 0.7
OBL =1.5 Other = 0
'perennial streams may also be identified using other methods. See P. 35 of manual.
Notes:
Aj Q,,
Sketch: