20170261 Ver 1_signed_NLEB_consultation_form_20170306

Northern Lon -Eared Bat 4 d Rule Streamlined Consultation Form
Fedaral agencies should use this form for the optional streamlined consultation framework for the northezn long-
eared bat (NLEB). This framework allows federal agencies to rely upon the U.S. Fish and Wildlife Service's
{i]SFWS) January 5, 2016, intra-Service Programmatic Biological Opinion (BO) on the fina14(d) rule for the
NLEB for section 7(a)(2) co�npliance by: (1) notifying the USFWS tt�at an action agency �will use the streamlined
framework; {2) describing the project with suffcient detail to support the required det ;nation; and (3) enabling
the USFWS to track effects and deter�nine if reinitiatian of consultation is required per 50 CFR 402.I6,
This farm is not necessary if an agency determines that a proposed action will have no effect ta the NLEB or if
the USFWS has concurred in writi.ng with azi agency's determination that a proposed action may affect, but is not
likely to adversely affect the NLEB (i.e., the standard informal consultation pmcess). Actions that rnay cause
prohibited incidental take require separate formal consultation. Praviding this zn�'ormation does not address
section 7{a)(2) compliance for any other listed species.
Information to Determine 4(d) Rul.e
1. Does the project occur wholly outside of the WNS Zone�?
2. Have you contacted the appmpriate agencyz to determine if your proj ect is near
known hibernacula or materni roost trees?
3. Cou1d the project disturb hibernating NLEBs in a known hibernaculuin?
�. Could the proj ect alter the entrance or interior environment of a l�own
hibernacul�m?
5. Does the project remove any trees within 0.25 miles of a l�own hibernaculum at
an time of year?
b. Would the project cut or destroy known occupied matemity roosi trees, or any
other trees r�vithin a 150-foot radius from the mateznity roost tree from June 1
through Julv 31.
You are eligible to use this form if yau have answered yes to question #i or yes to question #2 and no to
questions 3, 4, 5 and 6. The remai�der of the form wil� be used by the USFWS to track our assumptions in tb�e
BO.
Agency and Applicant� (Name, Email, Phone No.): NCDOT, Division 12, Trish Beam,
pdbeam(a7ncdot.�, 704-480-9(}44
Project Name: Bridge #177 replacement, SR 1$37 over Hoyle Creek (Hoyles Creek Road), Gaston
County
Project Location (include coordinates if known}: 35.3698�5 -81.946175
B�sic Project Description (provide narrative below or attach additional information}: Replacement of
121-foot long, 3 span timber and steel bridge with a 130-foot long, 3 span concrete bridge in the same
location.
1 http;//www.fws.govlmidwesdendangered/mammalslnleblpdflWNSZone.pdf
Z See http:l/www.fws.gov/midwest/endangered/m8mmals/nlebinhisites.htzzil
3 If applicable - only needed for federal actions with applicants {e.g., for a permit, etc.) who are party to the consultation.

A�v Determination:
By signing this form, the action agency determines that this project may affect the NLEB, but that any
resulting incidental take o£ the NLEB is not prohibited by the fina14(d} ru1e.
If the USFWS does nat respond within 3Q days from subrnittal af this form, the action agency may
presuxne that its determination is informed by the best available information and that its project
responsibilities under 7(a){2) with respect to the NLEB are fulfilled through the USFWS January 5,
201b, Programn�atic BO. The action agency will update this deternunation annually for multi-year
activities.
The action agency understands that the USFWS presumes that all activities are implemented as
described herein. The action agency will prornptly report any departures from the described activities to
the appropriate USFWS Field Office. The acnon agency will provide the appropriate USFWS Field
Office with the results of any surveys conducted for the NLEB. Involved parkies wili promptly notify the
appropriate USFWS Field Office upon finding a dead, injured, or sick NLEB.
Signature:
Date Submitted: � T � —
4 Any activity that temporarily or permanen�ly removes suitable forested habitat, including, but nat limited to, tree removal
from development, energy production and tzamsmission, mining, agriculture, etc. (see page 48 of the �O).
5 If the project removes less than 10 trees and the acreage is unlrnown, report the acreage as less than 0.1 acre.
6 If the activity includes tree clearing in June and July, also include those acreage in April to October.