20171101 Ver 1_Bridge 127 NWP 3 cover sheet_20170901

Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name Brid e..� 127 (SR 1541 Williamson Creek Road)
2. Name of Property Owner/Applicant: NC Department of Transportation
3. Name of Consultant/Agent: N/A
*Agent authorization needs to be attached.
4. Related/Previous Action ID number(s): N/A
5. Site Address: N/A
6. Subdivision Name: N/A
7. City: Brevard
8. County: Transylvania
9. Lat: 35.223983° N Long: -82.692193° W (Approx. Project Center)
10. Quadrangle Name: Brevard (35083-B6-TF-024)
11. Waterway: Williamson Creek (C Tr HQV�
12. Watershed: Little Tennessee River (06010105)
13. Requested Action:
X Nationwide Permit # 3
General Permit #
_ Jurisdictional Determination Request
Pre-Application Request
The following information will be completed by Corps office:
AID:
Prepare File Folder Assign number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/ Nature of Activity/ Project Purpose:
Site/Waters Name:
Keywords: