20170194 Ver 1_401 Application_20170217

Kimley»>Horn
February 13, 2017
Mr. James Lastinger
U.S. Army Corps of Engineers
Raleigh Regulatory Field Office
3331 Heritage Trade Drive, Suite 105
Wake Forest, NC 27587
Ms. Karen Higgins
NC Division of Water Resources
401 & Buffer Permitting Unit
512 North Salisbury Street
Raleigh, NC 27604
RE: Nationwide Permit 39 Application — KARTS — Henderson Site
Henderson, Vance County, North Carolina
Dear Mr. Lastinger and Ms. Higgins:
On behalf of our client, Kerr Area Transportation Authority, Kimley-Horn is submitting the attached
application for authorization under Nationwide Permit (NWP) 39 for the above referenced project in
Vance County. Kerr Area Transportation Authority is proposing to develop the KARTS - Henderson
Site within an undeveloped 10.2 -acre property just north of Henderson, North Carolina. The proposed
development will consist of an administration building, a maintenance building, a parking lot, two
access roads, and a stormwater wet pond.
One intermittent stream (S1) was delineated within the project study area in the southeastern portion
of the property. The feature was confirmed by the US Army Corps of Engineers (USACE) on July 30,
2015. A portion of Stream S1 will be permanently impacted by the construction of a parking lot.
Impacts to Stream S1 have been avoided and minimized to the extent practical by intentionally
aligning the parking lot and steepening the fill slopes to reduce the amount of stream feet affected.
To assist in your review of this NWP application, the following information has been included:
• PCN Application Form 0 Preliminary JD Documentation
• Signed Agent Authorization Form 0 Stream Data Forms
• Figures 0 Plan Sheets
• Proposed Impact Map 0 NCDWR 401 Application Fee of $240
If you need any additional information to assist in your review of this NWP application, feel free to
contact me at 919-678-4155 or Jason. [e-mail].
Sincerely,
Jason Hartshorn, PWS
kimley-horn.com 421 Fayetteville Street, Suite 600, Raleigh, NC 27601 919 677 2000

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version
Pre -Construction Notification (PCN) Form
A. Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1 b.
Specify Nationwide Permit (NWP) number: 39 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):
® 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
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes ® No
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
❑ Yes
® No
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:
KARTS - Henderson Site
2b.
County:
Vance County
2c.
Nearest municipality / town:
Henderson
2d.
Subdivision name:
n/a
2e.
NCDOT only, T.I.P. or state
project no:
n/a
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Kerr Area Transportation Authority
3b.
Deed Book and Page No.
01275-10547
3c.
Responsible Party (for LLC if
applicable):
Rob Brink
3d.
Street address:
943 W. Andrews Ave., Suite 1
3e.
City, state, zip:
Henderson, North Carolina, 27536
3f.
Telephone no.:
[phone]
3g.
Fax no.:
n/a
3h.
Email address:
[e-mail]
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4.
Applicant Information (if different from owner)
4a. Applicant is:
® Agent ❑ Other, specify:
4b.
Name:
4c.
Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f.
Telephone no..-
o.:4g.
4g.
Fax no.:
4h.
Email address:
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Jason Hartshorn
5b.
Business name
(if applicable):
Kimley-Horn
5c.
Street address:
421 Fayetteville St., Suite 600
5d.
City, state, zip:
Raleigh, North Carolina, 27601
5e. Telephone no.:
919-678-4155
5f.
Fax no.:
n/a
5g.
Email address:
[e-mail]
Page 2 of 11
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
021005001
1 b. Site coordinates (in decimal degrees):
Latitude: 36.342952 Longitude: - 78.424428
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size:
10.2 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Nutbush Creek
proposed project:
2b. Water Quality Classification of nearest receiving water:
C
2c. River basin:
Roanoke
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 property parcel is currently undeveloped and exists as a mixed hardwood and pine forest. A utility easement
intersects the northern portion of the parcel. The 10.2 -acre parcel is bounded by Ross Mill Road to the north, commercial
development to the southwest, and low-density residential areas to the east.
Land use in the project vicinity is primarily composed of forestland interspersed with low-density residential sites and
commercial developments.
3b. List the total estimated acreage of all existing wetlands on the property:
0 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
168 LF
3d. Explain the purpose of the proposed project:
The proposed project would construct a transit operations and management facility to serve the greater Kerr Area.
3e. Describe the overall project in detail, including the type of equipment to be used:
The proposed project involves the construction of an administration building, a maintenance building, a parking lot, and
two access roads. Additionally, a stormwater wet pond will be created to collect and treat stormwater runoff from the
facility. Typical site development and structural construction equipment will be utilized, including dump trucks, graders,
bulldozers, asphalt pavers, excavators, and concrete trucks.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
® Yes ❑ No ❑ Unknown
Comments: A preliminary jurisdictional determination has
been issued by the USACE (Action ID SAW -2015-01663).
4b. If the Corps made the jurisdictional determination, what type
®Preliminary El Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency/Consultant Company: Kimley-Horn
Name (if known): Jason Hartshorn
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
The USACE issued a preliminary jurisdictional determination for the project study area on July 30, 2015 (Action ID SAW -
2015 -01663).
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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.
n/a
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ® No
6b. If yes, explain.
n/a
Page 4 of 11
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. 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
❑ No
❑ Corps
❑ DWQ
❑ Yes
❑ Corps
W2 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W3 ❑ P ❑ T
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
❑ Yes
❑ Corps
W6 ❑ P ❑ T
❑ No
❑ DWQ
2g. Total wetland impacts
0
2h. Comments: No wetlands will be impacted as a result of the proposed project.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g•
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ®P ❑ T
Fill
Stream S1 - UT to
Nutbush Creek
❑ PER
® INT
® Corps
® DWQ
4
127
❑ PER
❑ Corps
S2 ❑ P ❑ T
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
❑ PER
❑ Corps
S6 ❑ P ❑ T
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
127 LF
3i. Comments: Unavoidable impacts to stream S1 will result from the proposed project. S1 will be permanently impacted as a
result of grading and parking lot construction associated with the project.
Page 5 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
4b. I4c.
4d.
4e.
Open water
Name of waterbody
impact number -
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑P❑T
02 ❑P❑T
03 ❑ PEI T
04 ❑P❑T
4f. Total open water impacts
0 acres
4g. Comments: No open water impacts will result from the proposed project.
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments: No ponds or lakes will be constructed
as a result
of the proposed construction.
5h. Is a dam high hazard permit required?
❑ Yes No If yes, permit ID no:
5i. Expected pond surface area (acres):
n/a
5j. Size of pond watershed (acres):
n/a
5k. Method of construction:
n/a
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
im act
required?
B1 ❑ PEI T
El Yes
❑ No
B2 ❑P❑T
El Yes
❑ No
B3 ❑ PEI T
El Yes
❑ No
6h. Total buffer impacts
0 sq. ft.
0 sq. ft.
6i. Comments: No NCDWR regulated buffers will be impacted as a result of the proposed project.
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Impacts have been avoided and minimized to the extent practical by designing the development to be located as close to the
overhead utility easement and the Ross Mill Road frontage as possible in order to minimize impacts to stream S1. Additionally,
the grade lines associated with the development were tightened to reduce the length of stream impacts.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Impacts to the stream within the study area will be minimized to the extent practical throughout the construction process by
avoiding the stream wherever possible. Where feasible, staging and construction access will be located in upland areas away
from the stream. Silt fencing will be installed around the limits of disturbance to help ensure that all construction equipment will
remain within the project area throughout the construction process. Stormwater controls and erosion control features will be
utilized to avoid impacts to downstream waters and to help minimize runoff from the project.
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: n/a
3b. Credits Purchased (attach receipt and letter)
Type n/a
Quantity n/a
3c. Comments: n/a
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
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.
n/a
Page 7 of 11
PCN Form — Version 1.3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
❑ Yes ® No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
n/a
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).
n/a
6h. Comments: n/a
Page 8 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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 ® No
within one of the NC Riparian Buffer Protection Rules?
1 b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ®No
Comments: n/a
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
30%
2b.
Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why: n/a
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative
description of the plan:
Stormwater from the site will be collected and treated in the proposed stormwater dry
detention pond located in the
southwest portion of the site. Treated stormwater will discharge through a rip -rap dissipater
pad to ensure non-erosive
velocities at the bottom of the fillslope outside of stream S1.
® 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?
The City of Henderson
® Phase II
3b.
Which of the following locally -implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
4.
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a.
Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
❑ 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 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes ® No
use of public (federal/state) land?
1 b.
If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑Yes ❑ No
letter.)
Comments: n/a
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after -the -fact permit application?
❑ Yes ® No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s): n/a
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
The proposed project will construct an administration building, a maintenance building, a parking lot, and two access
roads to serve the greater Kerr Area public transportation system. The construction of these facilities is not anticipated to
drive new development within this area.
4.
Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
Wastewater generated by the proposed development will be directed to an existing manhole near the southwestern corner
of the property via a combination of gravity main and force main. Wastewater generated by the proposed wash bay will be
initially
treated by an oil/water separator, before entering the sanitary sewer system.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5.
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a.
Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b.
Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
E:1 Raleigh
5c.
If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d.
What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
According to the NC Natural Heritage Program Element Occurrence Database (updated October 2016), there are no
known occurrences of any federally threatened or endangered species within 1.0 mile of the project area. Suitable habitat
is not present within the project area for dwarf wedgemussel due to the lack of perennial streams.
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?
NOAA Essential Fish Habitat Mapper (Accessed January 9, 2017)
7.
Historic or Prehistoric Cultural Resources (Corps Requirement)
7a.
Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b.
What data sources did you use to determine whether your site would impact historic or archeological resources?
North Carolina State Historic Preservation Office HPOWEB GIS Service (Accessed January 9, 2017)
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: n/a
8c.
What source(s) did you use to make the floodplain determination? FEMA Firm Panel 3720196400J eff. 4/16/2007
Jason Hartshorn
2/13/2017
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
Page 11 of 11
PCN Form — Version 1.3 December 10, 2008 Version

AGENT AUTHORIZATION
FORM

AGENT AUTHORIZATION FORM
Name: Rob Brink
Address: 943 W. Andrews Ave. Henderson NC 27536
Phone: [phone]
Project Name/Description: KARTS — Henderson Site
Date: 6/24/15
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
Attention: Mr. James Lastinger
Field Office: Raleigh Regulatory Field Office
Re: Wetland Related Consulting and Permitting
To Whom It May Concern:
The Kerr Area Transportation Authority hereby designates and authorizes Kimley-Horn and
Associates, Inc. to act in my/our behalf as my/our agent solely for the purpose of processing
Jurisdictional Determinations, Section 404 permits/Section 401 Water Quality Certifications
applications, and to furnish upon request supplemental information in support of applications, etc. from
this day forward until successful completion of the permitting process or revocation by the owner.
In addition, I, the undersigned, a duly authorized owner of record of the property/properties identified
herein, do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps)
to enter upon the property herein described for the purpose of conducting on-site investigations and
issuing a determination associated with Waters of the U.S. subject to Federal jurisdiction under Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899.
Authorized this the 24
Rob Brink
day of June , 2015
Print Property Owner's Name
Cc: Karen Higgins
NC Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
rope Owner's Signature

FIGURES

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Figure 1: Vicinity Map
KARTS Henderson Site
Henderson, Vance County, NC
May 2015

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KARTS Henderson Site
Henderson, Vance County, NC
May 2015

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t
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End at Natural Berm
No Feature Present 1
in Study Area '' Legend
0 75 150 225 300
' Feet Project Study Area

i�
t
r. t
Ap
i
r
m
Legend
r 0 250 500 750 1,000 Project Study Area
Feet
Figure 4: NRCS Soil Survey (Vance County, 1980)
Kimley>>> HornKARTS Henderson Site
Henderson, Vance County, NC
May 2015

11.14 (�D�2j
\ 4 \
\ \ \ \1\
\
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i x \
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Legend
/ S-2 I \\ ^I%o~ Permanent Stream Impacts
0 50 100 INV OUT. 40.00 /
Feet _ 7� i // Project Study Area
Kimley)))Horn
Figure 5: Permit Impacts Figure
KARTS Henderson Site
Henderson, Vance County, NC

STREAM DATA FORMS

North Carolina Division of Water Quality - Stream Identification Form, Version 4.11
Date: 5/26/2015
Project/Site:
KARTS
Stream S1 -INT
Latitude:
36.342463
Evaluator: B. Reed (KHA)
County:
Vance
Longitude:
-78.424081
J. Hartshorn (KH A)
2
3
2
2.
Total Points: 22.5
Stream Determin tion (circle one)
Other
Henderson
Stream is at least intermittent
Ephemer
Intermittent rennial
e.g. Quad Name:
Quad
,if >_ 19 or perennial if >_ 30
3
2
4.
Particle size of stream substrate
A.
Geomorphology Subtotal = 12.5
Absent
Weak
Moderate
Strong
Score
1a.
Continuity of channel bed and bank
0
1
2
3
2
2.
Sinuosity of channel along thalweg
0
1
2
3
1
3. In -channel structure: ex. riffle -pool, step -pool, ripple-
poolsequence
0
1
2
3
2
4.
Particle size of stream substrate
0
1
2
3
1
5.
Active/relic floodplain
0
1
2
3
2
6.
Depositional bars or benches
0
1
2
3
1
7.
Recent alluvial deposits
0
1
2
3
1
8.
Headcuts
0
1
2
3
1
9.
Grade control
0
0.5
1
1.5
0.5
10.
Natural valley
0
0.5
1
1.5
1
11.
Second or greater order channel
No
Yes
= 3
0
artificial ditches are not rated; see discussions in manual
B. Hydrology Subtotal =
12.
Presence of Baseflow
0
1
2
3
0
13.
Iron oxidizing bacteria
0
1
2
3
0
14.
Leaf litter
1.5
1
0.5
0
0.5
15.
Sediment on plants or debris
0
0.5
1
1.5
0.5
16.
Organic debris lines or piles
0
0.5
1
1.5
1
17.
Soil -based evidence of high water table?
No = 0
0 0.5
Yes = 3
1.5
3
C. Biology Subtotal =
18.
Fibrous roots in streambed
3 2
1
0
2
19.
Rooted upland plants in streambed
3 2
1
0
3
20.
Macrobenthos (note diversity and abundance)
0 1
2
3
0
21.
Aquatic Mollusks
0 1
2
3
0
22.
Fish
0 0.5
1
1.5
0
23.
Crayfish
0 0.5
1
1.5
0
24.
Amphibians
0 0.5
1
1.5
0
25.
Algae
0 0.5
1
1.5
0
26.
Wetland plants in streambed
FACW = 0.75; OBL =
1.5; Other = 0
0
"perennial streams may also be identified using other methods. See p. 35 of manual.
Notes: S1 -INT is a linear weak intermittent channel within a tor)ooraphic
crenulation. The right bank is well defined but the left bank is less distinct.
Hem leaf litter is present at two debris jams, but the rest of the channel is
largely clear. At S1-1 (end), a natural berm has formed from alluvial/debris
deposition. Channel is trying to re-eastablish around the berm but is light
and is split between the two new channels.

USACE AID# DWQ # Site # (indicate on attached map)
M STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
1. Applicant's name: Kerr Area Transportation Authority 2, Evaluator's name: B. Reed (KHA), ]. Hartshorn (KHA)
3. Date of evaluation: 05/26/2015 4. Time of evaluation: 11:00 am
5. Name of stream: KARTS - Stream S1 6. River basin: Roanoke
7. Approximate drainage area: 16 acres 8. Stream order:. First Order
9. Length of reach evaluated: 200' 10. county: Vance
11. Site coordinates (if known): prefer in decimal degrees.
Latitude (ex. 34.872312):
36.342463
12. Subdivision name (if any): n/a
Longitude (ex. —77.556611): -78.424081
Method location determined (circle): �PS❑I'opo SheetE13rtho (Aerial) Photo/GIS[Dther GIS[Dther
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location):
Stream S1 is located in the SE corner of the property, approx. 250' SW of Ross Mill Road.
14. Proposed channel work (if any): n/a
15. Recent weather conditions: Sunny and dry, no rain within 5 days prior to field evaluation
16. site conditions at time of visit: Sunny and clear, approximately 85 degrees (F)
17. Identify any special waterway classifications known: FISection 10 Tidal Waters Essential Fisheries Habitat
II,Trout Waters 00utstanding Resource Waters F Nutrient Sensitive Waters .❑.,Water Supply Watershed. (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? NO If yes, estimate the water surface area: n/a
19. Does channel appear on USGS quad map? NO 20. Does channel appear on USDA Soil Survey? YES
21. Estimated watershed land use: _% Residential _% Commercial _% Industrial _% Agricultural
95 % Forested % Cleared / Logged 5 % Other ( Road Right of Way
22. Bankfull width: 4' 1 23. Bank height (from bed to top of bank): 2'
24. Channel slope down center of stream: ,Flat (0 to 2%) _zGentle (2 to 4%) ElModerate (4 to 10%) _❑ Steep (>10%)
25. Channel sinuosity: Straight 00ccasional bends 01requent meander -very sinuous 013raided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points
to each characteristic within the range shown for the ecoregion. Page 3 provides a brief description of how to review the
characteristics identified in the worksheet. Scores should reflect an overall assessment of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the scoring box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (e.g., the stream flows from a pasture
into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form used to evaluate each
reach. The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
Total Score (from reverse): 39 Comments:
Stream S1 is a linear feature within a natural topographic crenulation. The right bank is well defined but the left bank is less
distinct. Heaw leaf litter is present at two debris jams but the rest of the channel is relatively clear. At Si -1 (end), a natural
berm has formed from alluvial/debris deposition The channel is trying to re-establish around the berm but evidence of flow is
light and appears to split between the two new channels.
Evaluator's Signature YGVVO'"' .(am7,Uo-rm, Date 05/26/2015
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in
gathering the data required by the United States Army Corps of Engineers to make a preliminary assessment of stream
quality. The total score resulting from the completion of this form is subject to USACE approval and does not imply a
particular mitigation ratio or requirement. Form subject to change — version 06/03. To Comment, please call 919-876-8441 x 26.

KARTS - Stream S1
STREAM QUALITY ASSESSMENT WORKSHEET
* These characteristics are not assessed in coastal streams.
ECOREGION POINT
RANGE
#
CHARACTERISTICS
SCORE
Coastal
Piedmont
Mountain
1no
Presence of flow / persistent pools in stream
0 — 4
0-5
flow or saturation = 0; strongflow = maxpoints)0-5
2
Evidence of past human alteration
0 — 5
0-5
4
extensive alteration = 0; no alteration = maxpoints)0-6
3
Riparian zone
0-6
0-4
0-5
4
no buffer = 0; contiguous, wide buffer = maxpoints)
4
Evidence of nutrient or chemical discharges
0-5
0-4
0-4
4
extensive discharges = 0; no discharges = maxpoints)
aGroundwater
discharge
0 — 4
0-4
1
U5no
discharge = 0; springs, see s, wetlands, etc. = maxpoints)0-3
6
Presence of adjacent floodplain
0 — 4
0-2
2
no floodplain = 0; extensive floodplain = maxpoints)0-4
x
Entrenchment / floodplain access
0-5
0-4
0-2
1
(deeply entrenched = 0; frequent flooding = maxpoints)
8
Presence of adjacent wetlands
0 — 4
0-2
0
no wetlands = 0; large adjacent wetlands = maxpoints)0-6
9
Channel sinuosity
0 — 4
0-3
1
extensive channelization = 0; natural meander = maxpoints)0-5
10
Sediment input
0 — 4
0-4
2
extensive deposition= 0; little or no sediment = maxpoints)0-5
11
Size & diversity of channel bed substrate
NA*
0-4
0-5
1
fine, homogenous = 0; large, diverse sizes = maxpoints)
12
Evidence of channel incision or widening
0-5
0-4
0-5
1
}�
(deeply incised = 0; stable bed & banks = maxpoints)
13
Presence of major bank failures
0 — 5
0-5
2
severe erosion = 0; no erosion, stable banks = maxpoints)0-5
14
Root depth and density on banks
0 — 4
0-5
2
Ey
no visible roots = 0; dense roots throughout = maxpoints)0-3
15
Impact by agriculture, livestock, or timber production
0-5
0 4
0-5
3
substantial impact =0; no evidence = maxpoints)
—
16
Presence of riffle-pool/ripple-pool complexes
0-3
0-5
0-6
2
no riffles/ripples or pools = 0; well-developed = maxpoints)
H
17
Habitat complexity
Habitat
0 — 6
0-6
2
or no habitat = 0; frequent, varied habitats = maxpoints)0-6
18
Canopy coverage over streambed
0-5
0-5
0-5
4
x
no shading vegetation = 0; continuous canopy = maxpoints)
19
Substrate embeddedness
NA*
0-4
0-4
1
(deeply embedded = 0; loose structure = max
20
Presence of stream invertebrates (see page 4)
0-4
0-5
0-5
0
no evidence = 0; common, numerous types = maxpoints)
21
Presence of amphibians
0-4
0-4
0-4
0
O
no evidence = 0; common, numerous types = maxpoints)
22
Presence of fish
0-4
0-4
0
no evidence = 0; common, numerous es = max points
H0-4
23
Evidence of wildlife use
0-6
0-5
0-5
2
no evidence = 0; abundant evidence = maxpoints)
Total Points Possible
100
100
100
TOTAL SCORE (also enter on first page)
39
* These characteristics are not assessed in coastal streams.

PRELIMINARY
JURISDICTIONAL
DETERMINATION

ATTACHMENT A
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD): July 30, 2015
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
Jason Hartshorn, on behalf of the Kerr Area Transportation Authority
3001 Weston Parkway, Cary, NC 27513
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
CESAW-RG-R, KARTs Operations Facility, SAW -2015-01663
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
The project site is 10 acres of forested land located adjacent to Ross Mill Rd. as indicated on the attached
map and waters location table, near the town of Henderson. Vance County, North Carolina.
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT
SITES)
State: N C
County/parish/borough: vance
City: Henderson
Center coordinates of site (lat/long in degree decimal format):
Lat. 36.343037 ON; Long, -78.424573
oW
Universal Transverse Mercator: 17
Name of nearest waterbody: Nutbush creek
Identify (estimate) amount of waters in the review area:
Non -wetland waters:
174 linear feet: 4 width (ft) and/or nia acres.
Cowardin Class: Riverine
Stream Flow: intermittent
Wetlands: 0 acres.
Cowardin Class: nia
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal: n/a
Non -Tidal: nia

E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
© Office (Desk) Determination. Date: July 30, 2015
❑ Field Determination. Date(s):
SUPPORTING DATA. Data reviewed for preliminary JD
(check all that apply - checked items should be included in case file and,
where checked and requested, appropriately reference sources below):
❑✓ Maps, plans, plots or plat submitted by or on behalf of the
applicant/consultant: Kimley-Horn
❑✓ Data sheets prepared/submitted by or on behalf of the
appli 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: 1:24k, Henderson Quad
❑✓ USDA Natural Resources Conservation Service Soil Survey.
Citation: Vance county - 1980
❑ 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): 2014 NC one Map
Other (Name & Date), site Photos - May 2015
❑ Previous determination(s). File no. and date of response letter:
❑ Other information (please specify):
2
or

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
necessarily been verified by the Corps and should not be relied upon for
later jurisdictional determinations.
Digitally signed by
LASTINGER.JAME 1363642400
6/15/2015
S.C.1363642400 cnI-ASTINGERJAMES.0 363642400
Date: 2015.07.301007:28 -04'00'
Signature and date of
Regulatory Project Manager
(REQUIRED)
0
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)

Estimated
amount of
Class of
Site
Latitude
Longitude
Cowardin
aquatic
aquatic
number
Class
resource in
resource
review area
Stream
36.3425
-78.4241
Riverine
174 linear feet
non -section 10
S1
INT
— non -tidal

PLAN SHEET

1 1 2 3 4 5 6 7 8 9 10 11 12 13 14
ALL CONS7RUCTIW TO BE IN ACCORDANCE N11H ALL qTY OF \ 1
HENDERSON AND/OR NCDOT STANDARDS AND SPECIFlCATWS \ I
SURVEY NOTE: .\�\\\ ` �O RIM: 2421.30
INV IN: 415.94 (W-28)
A EXISTING BOUNDARY AND TOPOGRAPHIC INFORMATION SHOWN\ \ 1 NV OUT: 415.84 (DI -23) CO
BASED ON A BOUNDARY & TOPOGRAPHIC SURVEY RECEIVED Fc \ " / / -
AUGUST 18. 2015 PROVIDED BY KCI ASSOCIATES OF NC. \ y,./ d \ M:: 425.68
4
1 I INV
OUT. 423.00 (CB -28) LEGEND.
FRENCH DRAIN (T R.)Nv 28 PVC PP sroaa aawEa wvwcaX: nml
0 6.87Emw
. sroaN aeaa Iaoa aaErlo�I
/ O \\ \ l`� sreaN sawea �caaaRa
CB -2B
RIM: 424.47
t ✓ \ ) \INV IN: 421.19 (CO -29) Faa[oew secrronlresi Z
INV WL 421.09 (CB -27) sronmas*Ea coxrsoc sraucnaa:Icsl O
B_420- a aoPo,EDWN­
PIM: 421.52) � d /\ \ c q��\ \\ `- ^ \\ \ � HEADWALL PER NCDOT STANDARDS (IYPJ .. _.. 42:._ _- eusnxs --
INV
INV WT: 41&47 (n -3 y
/ \ \ \ \ \ HN -17 zFFE:420.00 sso*cs^rE C3
INV T. 42&83 C
149 LF OF ^ \ i t`� \ \ \ z Hp^
le RCP ^ "- fl?� 9 �- OOOFFF\\\ \ \ \ 43 LF OF x Lp coy °Car O
O 4.961[ 15' \ 18' RCP CLASS IV
" O04.95 \ O77% 0. Z
De maw ls•Xaoauar a.axl
FE5 38 DI °
INV OUT: 428.50 CB
69 LF OF / j/�} _ \\ c \ •\ J DI -24 n Yctewalxc uwn
15' R -__-_ ^^ ��\ \ \ n .\ / \ RIM: 417.15 DI- _CL
O 5.56% \ a \ NV IN: 41202 (DI -25) RIM: 417.38
IP7`i.�.v `.,� \ e�^ \�;;� m. \\ a,,ss\ \ \ NV OUT. 411.92 (DI -23)
C ^ - - \ t J i \ i \ INV IN: 413.46 (DI -26) s uwm
r,
INV OUT, 413.36 (DI -24)
i,l t
^ ^ \
134 LF OF
f ^ - 421 15,RCP 79 LF OF
^ 428 \ \ O 1.00% 15' RCP
11-32 \ ... rte° -- \ 427
\ \ \ O 1.001[
RIM: 415.74 \ - 1 ^ - " 428 . \ .
INV IN: 411.05 (n-33) \ - • ^ - _ _ 01-26
INV OUT: 410.56 (n-31) \ "� - - --28 lF 0 424` Q-�?� M: 417.79
\ \ B ^, ^- m - 4}2 \INV OUT: 414.25 (DI -25)
RIM: 1&
ce-zznam g . ..._ter..
440 da - - - - --
INV IN: 470.86 (DI -23) \ \ \ \ / nmm --- - ^ - _ _ ^ \ \ \ \ \ \ PROTECT IN PLACE POWER POLE
INV OUT: 410.76 (CB -21) \ I , y Sl� -419 \ \ NO GRADING IS TO BE DONE WITHIN 20' OF EXISTING STRUCTURE
D 79 LF OF \ \ \ \ \ '41"1 _ 418 \\ \ \
24' RCP \ \ \ ♦ _ - _ 418 \ \ \ \ \ \
O 1.001E 419
,ti m
/ \
\ \ , 4t 4 \ 10. 6 -- �k \\\ \ \\ \ \
RIM: 418.09 \\ \\\ \ \ \ \ \\ _Y�I-- + A... _ am T8' -RCP.-_-_---- \ \\ \ \ \ \ \ INV OUT: 422.35
\ \ \/ 4 - O 0.99% \ \ \�
INV IN: 409.9] (CB - 22) \ \ \ \ t"C''P Mnn DI �''� ADMINISTRATION OPERATIONS -' \\ \ \ \ ^ ^ ^ ,�. \� \ \ 70 LF OF
INV IN. 411.09 (DI 35) \ \\ \ \ \ `rI M: 41657 / \ 4, \ � \ \
\ \ \ \ \ \ aw BUILDING - _. _ Iw \ / ^ { \ Q \ 18' RCP CLASS IV
INV OUT: 4D9.87 (CB -20) \ \ \ \ \ I \ �\ \ W INV �R� 412.09 (CB-2]),�-419.50 _ _ _ 4 \ \ \ \ \ ,\
4,4.
277 LF of \ \ \ \ \ \ ^INV IN: 4111.1 (d -2a) t4zT \ \ \ \ Ma..m a Oso%
241.i4S 98 lF OF \ \ \ \ \-\..._\ e \ \.\ _ < .16e INV ouT: 4n.la (��zT -'B*+� of _ ^ ' °` ,
_ \s
24' RCP C \ \ �\ \ nsm ^ ^ -'' O 1.50% - - ^ K o `t` ` ^ FES -40
01.00%
ui� OF/, \ \ \ \ >�s \ \ \\ \ \ \ \ \ \\ \\ \\ \ INV N: 42200
N"
\\ \ 0
4 lap\ 1.WXI
E
RIM: 416.05
INV IN: 408.91 (CB -21)
INV IN: 410.00 DB -30 - �-
INV OUT: 408.81 (CB -11)
105 LF OF c 17 \ \ \' v' \°>. • / "'L\
24' RCP / / N \ _. \ - Y. y' s �I \ \ \ \ \ -�•� \�` e
01.0 / / \ \ .� \ d].yo1 4Dm
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cONSTmIcnaN To BE NccaRDAH
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INV OUT4412.80C(DBL CB -13) 01.50% NORTH CONSTRUCTION
DOCUMENTS
DRAWING TOLE;
GRADING PLAN
CITY OF HENDERSON, NC
DEVELOPMENT SERVICES SHEET:
ENGINEERING 0-400
1 2 3 4 5 6 7 81 9 1 10 1 11 7 12 13 14 DAM*JANUARY 31, 2017