20141132 Ver 2_Project History_20171030

U.S. ARMY C�RPS OF ENGINEERS
WILMINGT�N DISTRICT
Action Id. SAW-1495-00459 County: Richmoncl L�.S.G.S. Quad: NC-DIGG5
GENERAL PERhiIT (REGIONAL AND NATIQI�IWIDE) VERIFICATIUN
Permirtee: NC Deq�rtment af TrenspartAtion. PDEA
Mr. Ric ard f n o�k, �.E, M pl�eer
Addeess: 1598 MeilSrrvice Center
l��lei�,h. NC Z7699
5ize (acresj n/8
Nearest Waterway Ba�ectts Creek
USGS H1JC 3040ZOt
Nearest Town fiockinpham
River Basin Lower Pee Dee
Coordinates Latitude:349T6921
Langitude: -79.b243b5
I.ocation deseriptian: The projeet site is located afong approximately 3.6 miles of existing 11S Hwv i, from nurth of �ox Road
(SR ibUb} to the northern terminus at lNarstpn Road (SR 1d01), nortbeast of the towo 4f Rnckingham, in Richmand County,
Narth Carolina.
L]eseriplian af projects area and aetiwity; This veritication authorizes imparts associated with the widenin� of US Hwy 1, from
aorth oF Fox Rot�d (SR i6A6) to tht northern terminus at Marston Road (SR 10U1). Permanent impacts suthdrized tots10.Z5
arre o�wetlaAds to be flled Or Otherwise irrlpricted (i.e. mechsnized lgod clearing), in ortler ta f'scilitate the roAd canstruction.
Applicable Law�
Authorization
� Section Ap� (C'lean Wa#er Act, 3� USC 13�4)
❑ Sectian 10 {ftivers and H�rbors Act, 33 i15C 403)
Regional General Pcrmit Number or Nationwide Pennit Number: 14
Sl��'A7'TACIfL�',D RCP ar NWP GENE'RAL, REGlON��. AND SPEC'�AL CONDITlUNS
Y�ur wark is �uRhorized by Ihe �bove referenced permit provided it is accamplished in strlet accordance with the attached
canditioos and yaur submitted application and attached information dated Sentember x9, 2Uld Aay viol�tion vf the attached
conditinns ar deviation fram yvur submitted plans may subject the permittee to a stop wo�k order, a restorAtion urder, a Clasa
I administrati�e penal#y, andlor appropriate legal actin�.
T'his verifiealion wifl remain valid until the expiration date identified below unless the natianwide authorizatian is modified,
suspended ar revoked, lf,, prior ta the expiratian date ide�tified belaw, the nationwide permit authorizati�n is reissued and/or
modified, this verificatipn will remain valid until the expiration date identified below, provided it complies with a!1 requirements of
thc modified nationwide permit. Ifthc natianwidc permit authorixation expires or is suspended. revoked, or is m+�dified, such that rhe
actiyity would no longer comply with the terms and conditions of the naki4nwide permit, aetiuities which have commenced (i.e., are
under canstruction] ❑r are under contract ta commer�ce in relianee upon the natiomvide permit, will remain au[horiz.ed provided ihe
activity is completed within twel�e months pf the date of ihe nationwide pe�rr►it's expiratian_ modification or revocation, unless
discretionary authority has been exereised an a case-by-case basis to madify. suspend or revake the authorizatian.
Activities subject to 5ection �04 (a.s indicated abave? ��y also require an indir�idua! Sectivn 4ql Wazer Quality Certification. Yvu
shauld cont�Ct the NC Division �f Water Quality (telephone [phone]D0) to determine 5ection 401 requirtments.
For activities occurring within the twenty cnastal counties subject to regulation under the Coastxl Area Management Act (CAMA},
prior ta beginnin� work you must contact the N.C. Division of Coastal Management in Marehead City, NC, at (252) 8QS-?$0$.
7his Qepartment of the Army verification does not relie�e the permittee 4f the resppnsibility ta obtain any other required Federal.
State ar local approvals/permits.
If there are any questivns regardin¢ this verificatian. ar�y of the conditions of the Permit, or thr Corps af �ngineers regulatory
program, plesse �ontact S�rah Hair ak 910-251-�104�9�ar�SarRh,E.NairCa�usa�e.a.rzr�v.mil.
HAIR.SARAH.E �AIRShRANEA�4f�69351}
aN.�.�s. a.� �. �Y..�,�
Corps Regulatory Offcial: �� a.-wo ���a.•�s+�. Dste: N��+ember 3. 201�
�y ���
Expiration Date af Verification: Maec �,{� ��� �0�1.1141iJ+rS! �1'JO

Determinati�r� q[Jnrisdicfivn:
A. ❑ Based on preiiminary inFarmation, there appear to be wate�s af ihe US including wetlands within the above described project
area. This preliminary determinatior� is not an appexla6le actian under the fiegul�tory Pragrnrn Administrative Appeal Frocess
( Reference 33 CC'R Part 33 I).
B. ❑ There are 1Vavigeble 1�+aters of the l�nited States within the ahove described prpject ares subject io the permit requirements oi'
Sectioa 10 of the Rivers and I-Carbors �+ct and Sectian 40A of the Clean Waier Act. llnless there is a change in the !aw or our
pubiished regul�tions, this cletermination may be relied upon for a period not ta excced fiva years from the daie of this
rtotitication.
C. ❑ Therc are waiers of the [3S and/or wetlands within the abavc described project area subject to the permit requirements of
5eciion 404 ofthc Clean Water Act (CWA}(33 USC � 1344). Unlcss there is a change in the law or aur published regulations.
this determinatinn may be relied upon for a period not ta exceed five years from the date af this notification.
l). � The jurisdictional areas within the aho�e described project area have been identified undcr a previous action. Please reference
jurisdictiona] deurmination issued August 17, Z41 i. Actian 1D: SAW-1995-OU459,
Bssis For Determit��#lori: This site exhibits wetland criteria as described in the I987 Carps Wetland Delineation
h+Ianual and is adiacent to tributaries the Pee Dee River, which is a vaditi�n�l__na�ig�ble water af the United States.
�fh� Sita c ntains water 6odies that exhi6it ardinary hi;�h water marks �s indicated bv the ab5ence of vegetation fro3n
the str�cam channel and the presence �f wrack lines. sediment de�asition and bed an� banks. * Thi$_ d�t_�r�ni�ti�n i�
ba5ed on itlfprnlatiop prpvi�i�d 17yEnvironmental Seruices. ]nc and a site visit conducted bv Ronnie Smi1h of t}te
[J.S. Army_Corps of Engineers on�une 7. 201 l.
Iiemarks: '� This JD anulies unlv to the section �f the nroiect deaigna#ed as R-2501 C; T!►is JD will �x�ire
wikh the M�I'P on Ni�rth 18. 2Q17
E. A#tention USDA Program Participants
This delineatian/determination has beerr conducted to identify the limits of Corps' Clean Water Act jurisdic#ion far tfie particular site
idenlifiec3 in this request. The delinealionldetermination may nol be valid for the wetland oonservatian pravisians af the Food Security
Act af 1985. Ifyou or yaur tenant are [lSI�A F'rogram parkicipan#s, or anticipate participatian in llSDA programs, you ahouid request
a certified wetland determination from the [ocal office of the Naturel Ftesources Canservatiari 5ervice, prior ta starting work.
F. Ap��2�I3 Infi4r'�11�At�dt1 (This infarmatian appl�es only ta spproved jurisdictionsl determingtians as indicated in B
and C above).
This corre5pondence cpn5titutCs an appmved jurisdictianal detern�ination for the abbve deseribed site. Iiyou objccS to this
determinati�n, you may request an administrative appeai under Corps regulations at 33 CFR Part 331, �nclosed y�u will find �
?Vatification of Appeal Process (NAP} fact she�t and request for appeal (Rl�Aj farm. ifyou requcst to appeal this determinalion you
must submit a completcd RFA form ta thc following address:
US Army Carps of �ngineers
5outh Atlantic Division
Attn: Jason Steele, Review Off'ccer
60 Forayth Strcet 5W, Roam 1OM15
Atlanta, Georgia 30303-$$01
Phone: [404} 5b2-5137
In order far sn RFA to bc actepted 6y the Corps, the Carps must determine that it is complcte, that it meets the criteria for appeal
undcr 33 CFR part 331.5, and that it has becn rec�i�ed by the Division Qffice within GO days of the date of the NAF. 5hould you
decide ca submit an RFA farm, it must be recei�ed at the above address by i�ecember ?4. 2014.
''•Il is not n�cessary w submit an R.FA form to the Division Uffice if you do not ohject to the determination in this correspondence.••

HAIR.�Il�!"l�r� �lSa1ly�Ij�netllYy
WaIp.SAAIAi.�a.1�45�447517
ON' dlJS, c•US,GWemmbhL o11rGo0,
���s �te�uiata�y o�c�l:14.1 Q54C 935 � � °�"�.°"�'�'
�,�ru�u�,snrtn�+.En, ros,eme, �
- p+n��,,��.. ..�u��,W„ --
Sarsh Hair
Da�e of Ja: November 3, 301A
�xpiration D�co of.ID: March I S, �017
7"he VI''i�ming;ton District is committed to praviding i�e highest 1e�+e1 of suppart to ihe publ9c. To help us ensure we
Gontinue ta do so, please complete our custvrner Sati�faction Survey vrtkir�e at i�tSp;lfr�gul�tory,�us��e�urvay.caml.

SAW-199�-D6159
SPECIAL CONDITIO�T5
I, All work must bc pertarmed in strict complianee with the plans rcaeived 6y this offi�e on Clctober G, 3f114, which are a part
ofthis permit. Any madificatian to the Permit plans must be approved by the USACE priorta 9mplamentation
�. �'ailure ta institute and carry out the detsils of these special conditions will resalt in a directive to eease al! ongving and
permirted wark wtthin wa�ers andJor wetlands associated with the perrnitted praject, ar such other remedies and/ar fines as
the District Engineer or his authatixed representatives may scek.
3. The permitte.c ahall reRuire its contrackars andlor agents to comply with the tetms ar�d tonditio�s of this permit in the
corsstruetion and mainten�nce of this pruject, and shall prqvide each of i#s cantractors andlar agents associated with the
construction or maintenance nF#his prnject with s capy of ihis permit, and ar►y authorixed modificatians. A capy uf this
penr�it, and any autharixed modifications, including sll conditions, shall be available at the projeot site during canstruction
and maintenance of this project.
�. '1'his parmit does not �uthorize temparary placemcnt or dauble handli ng af excavated or fill material within waters qr
wetlands outside the permitted area,
5. The perrriittee will report any vialatiop o�these conditions ar violations of Section 404 af the Clean Watar Act or 5ection 10
of the Rivers and FC�rb+ar5 Act in writing to the Wilmington I]istrict, U. S Army Corps of Engineers, within 24 hours of the
perntittee's discavery of'the vioiation.
b. In order to compensate far impacts a5saciated with this permi[, mitigation shall be provided i� acc4rdance with thc provisions
autiined on the mask recenl version of the aKached Compensatory Mitigstion Respnnsibil it� Transfer Farm. The requiremcn#s
of this form, i�cluding 2�ny speoial conditians listed on this f4rm, are hereby incprporated as special canditians of this permit
autharization.

Action ID Nurnber: SAW-199S-�0459 Caunty: Richrnc�nd
Permittee: NC Department of Transpo�-t$tioo
Prajett Name: NCDUTfR-2SDlClUS HWY 1
Date Verificatiot� Issued; IVovember 3, �014
Project Manager: Sarah Hair
Upon completion oi the activity authorized by this pertnit �ptl �ny mitigativn requir�d by the permi#,
sign this certitieatian �nd retur� it to the folluwiag address:
US ARMY C�12PS OF �NGINEERS
WILMINGT�N DISTRICT
Attn: Sarah Hair
b9 D�rlingtott Avenu�
Wilmington, Plorth Caral�na 28403
Please note that your permitted actiVity i� subject to a epmpliance inspection by a lJ. S. Arm�y Cor�s of
Engineers represent�Xive. Failure to comply with a�y terms or conditions of this aU#horization may
result in the Corps suspendi�g, rnodifying or re�okin� the autharizs�tion �nd/or issuing a Cl�ss 1
administrs�tive penalty, nr initiating other appropriate legs�l �ction.
I hereby certify that the work aathorized by the a6ove re!'erenced permit has been completed in
�eeordanc� with the terms and condition of the ssid permit, and required rniti��tion was eompleted in
accordance with the permit conditio�s.
Signature of Permittee Date

NOT[FICATlON QF ADMlNISTRAT[VF APPEAL OPTIONS AND PROCESS AND
RE(�UEST FOR APPEAL
Applica�t: NC Repartment of 7'ransportAtion File Number: SAW-199S-4U4S9 Date: �(ovember 3, �D14
Attached is:
TNITIAL PROFF�REa P�.RMIT �Standard Permit or L.erier of
YROI'f �RED P�RM[T {Standard Yermit ar Letter of permissio
P�RMTT I��NIAL
APPROVED JURISDICTI4NAL DETERMINATION
PREGiM1NARY JIJRISDICTIONA[. D�T�RMINATION
See Section 6elow
�
�
C
d
SLC'I'ION I- T'h� folluwin� ideniilits ti��ur ri�lsts and t��7ticsr,s regardin� an administrativc appcal of tltc abov� di�isiotl.
Additioi�al information may be found at or http:�l�►,vw.«5ace.armv.millMissiansiC'ivilWarks� Iteeulatcan�l>rneramc�n�Permits.��tii�r
ar the Corvs re�ulations at 33 CFR Part 33 I.
A: INITIAI� PR�FFERED PERMIT: You may acrept ar object to th� permit.
• ACCEPT: IFyou received a Standard Permit, you may sign the pernut document and retum it ta the district enginecr for final
authurizatian. ]fyou received a Letter af Pernzission (LDP), you may accept the L�P and your work is authorized. Yqur
signature on the Standard Permit ar accaptance of the C�OP rneerts that you accept the permit in its entirety, and waive a!1
rights ta appeal the permit, includiag its terms and conditians, and approved jurisdictianal determinations associated with the
permit.
• OBlECT: ]f yau object to khe permit (Standard ar L.OP) because aFcertain terms and conditions therein, yau may request
that the permii be madified accordingly. Y�u must camplete Sectian [[ ofthis farm and relurn the form to the district
engineer. Yaur ahjections must be received by the district engineer within 6� days ofthe date af this notice, or you will
farfeit yaur right ta appeal the permit ia the future. Uport receipt ofyaur letter, the district engineer will evaluate your
objections and may: (a) madify ihe permit to address a1l afyour concerns, (b) modify the permit to address some of}+aur
ohjectians, or (c} not madify the permit having determined that the permit should be issued as previously wtirien. After
evaluating your pbjections, the district engineer will send yau a proffierad perrnit For your recansideration, as indicated in
Section B below.
B: pRd�'RER�D ��RMiT: You mey accept or �ppeal the permit
+ ACCEPT: If you received a Standard Permit, you may sign the patmit dacument afld retum it to the district ettgineer far final
authoriz.ation. If you received a Letter of Perrnission (LOP), you may accept the LOP ar►d your work is authorixed. Your
signature an the Standard Permit or acceptance ofthe LOP means that you accapt the permit in iLs entirety, and waive a1l
rights to appeal the permit, including its terrns attd canditians, and approved jurisdictional determinations assaciated with the
permit.
• APPEAL: If yau chaose ta decline the psoffered permit (Slandard vr LOP) because of certain terms and conditions therein,
you may appeal the dec1inad permit undcr the Corps of Engineers Adminish-ative Appeal Pracess by completing Section I I of
this form and sending the farm to the division engineer. This form must be receiyed by the division engineer within b0 days
of the date of this natice.
C: PERMIT dENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Sectian lI af this form and sending the form to the di�ision engineer. This form must be �eceived by khe divisipn
enginee� within 6U days of the date of this natice,
D: APPRQVED dURI$UICTIONAL DETERMINATION: You may accept or appeal the approved JD ar provide new
information.
ACCEPT: You da npt need ta nptify the Corps to accep[ an apprnved JD. Failure to notify the Corps within b0 da�s of the
date of this notice, means that you aecepl the approved JD in its enkirety, and wai�e all rights to appeal the approved JD.
■ APPEAL: If yau disagree with the approved JD, you may appeal the appraved JD under the Corps of Engineers
Administrative Appeal Process b� completing 5ection C[ of this form and sending the Form to the district engineer. This farm
must be received by ihe division er►gi�eer within b0 days �fthe daie oftliis notice.

E: PR�LIMIAIARY JURISDICTlONAL DETERMINATIUN: Y�u da not need ta respond ta the Corps regarding i}te
preliminary 7D. T�ie Preliminary JD is nat appealable. Ifyou wish, yau may requesi art appraved JD {which may be appealed),
by contacting the Corps district #ar further instructian. Also you may provide new infarmation for further consideratian by the
Corps to reevaluate the JD.
S�CT10N lI - R� �1�5�' FOR APPEAL or URJEGTIONS TO AN [NITIAL PROFFERED PERMIT
R�ASONS FOR APP�AI� OR OB.iFCTI�NS: {pescribe yoUt reasons for appealing the decision or your objections to an initial
proffered permit i�i clear concise statements. You may attaCh additicrnal inFormatian ta ihis fonn Co �f8rify whCre your rea.snnS Crr
objectians are addressed in the administrative record.) '
ADa1TT4NAL 1NFORMATION: The appeal is limited to a re�iew ofthe administr�ti�e record, the Corps memarandum for the
recard of the appeal conference ar meeting, and any supplementa] information that the re�iew of�cer has determined is needed to
clarify the �dminisirative reeord, Neither the �ppell�nt �vr ihe Corps may add new information or analyses to the recard.
Hawever, you may provide additianal infarmation to clarify the location of inforrnatian that is already in �he administrative
recard.
POINT OF CANTACT FOR UESTION9 OR INFORMATIaN:
Ifypu ha�e questions regarding this decision andlor the If you only have questi�ns regarding khe appeal process you may
appaal process you may contact: also cantact:
district En�ineer, VVilmiogton Regul�tory Divisiun, Attn: Mr. Jasor� Steele. Administtative Appeal Iteview Ofticet
Sarah Hair CESAD-PDO
G9 Darlingtan Avenue U.S. Anny Carps af L"ngineers, Sauth AtEantic I7ivision
Wilmin�ton, North Carolina 28403 CO Farsyth Street, Roam I OMI I S
Atlanta� Georgia 30303-$$Ol
Phane: 404 5b2-S137
RLGHT dF ENTRY: Yaur signature belaw grants the right ofentry tp Corps of Engineers personnel, and any governm�nt
consultants, to conduct investigations of the project site during the course of the appeal process. You wiil bc provided a 1 S day
natice aPan site investi ation, and will have the o ortunil to attici ate in al] site investi aiians.
bate: 'I'elephone number:
Si ature of a llant or a ent.
�'nr appeals on lnitia! Proffered PNrmlts send �his fprm 10:
[?istrict Engineer, Wllmingtun Rp�ulatary Divisidn, Attn. Sarah Hair, 69 �Aflrlington Ave�ue, Wilmin�ton. Nqrth Carolina
284p3
For Permil deniuls, Proffered Permlls anrl approred JurlSdiclionq! derer»rinallnns send this form to:
diVision Engineer, Cammander, �I.S, Army k�ngineer Divisian, 5outh Atlant�c, Attn: Nlr. J�san 5teelc, Administrative A�pe�l
Officer, CESAD-PDO, 60 Farsyti� Street, Room 10M iS, Atlant�, Gcnrgia 30303-8901
Pf�one: {4Q4) 562-5137

U.S. ARMY tORPS O� �NGIN�ERS
Wilm€ngtvn alstriGt
Comaensatarv Miti�atian Resnonsibilitv Transfer Form
Permittee: NC DOT; POEAjMr. Rlchard Mancack
PraJect Narnec fi-Z501 C/US Hwy 1 widening
Acllnn ID: 5AW-1995-0Q459
County: Richmond
Ir�structions ta Permittee: Tlte Permitt�e must provide a capy of this forrn to the Mitig�tion S�onsor, efther �n approved
Mitfgadon eank or the North C�rolina �casystem �nh�neement Program (NCEEPj, who will then sign the farm to verify the
transfer of the mitigatian respansibillty. �nce the Sponsor has sfgned this farm, it is the Permittee's responsibility to
ensure that ta the U.S. Army Corps nf Engineers (USACE) Praject Manager identified pn page twa is in retefpt of a signed
copy of this fnrm 6efare candueting authorized fmp�cks, unle55 o#herwise sp�ci�ed below. If more than one mitigatlon
5ponsor will be used ta prauide the mitigatian assoclated with the permlt, ar if the impacts and/or the rnitlgation will occur
(n mora than one 8-dfglt Hydraloglc untt Code (HUCj, multiple fvrms will he attached to the permlt, and the separate forms
for each Sponsor and/or HUC must be provlded #o the appraprlate mitlgatlon Spansars.
Instructlons ta Sponsor: The Sponsor must verlfy that the mftigatian requirements {credlts) shown below are aUailahle at
the identified site. By signing belaw, the 5ponsor is accepting full responsibility fo� the identified m}tigatfon, regardless of
whether ar nat they h�ve reteived p�yment from the Permittee. Once the form is s(gned, the 5ponsar must update the
bank iedger and provide � copy af tt�e signed farm and the updated bank ledger to the Permittee, the US.AC� Prpjecc
hnanager, and the Wilmingtdn Oistri�t Mitigation Dffice (see contact infarmation on p�ge Z). The Sponsor must �Iso comply
with all reporting requfrements establlshed ln thafr authori:ing instrument.
Pemtltted Impacts and Compensatory Mitlgatlon aequirements:
Permitted Impacts R2qulring Mltigation* 8-dlgit HUC
"If more than one mitigatian sponsor will be used for the perm{t, only include impacts to be mitlgated by this sponsor.
5trp�m Miti 8tipn (Credits}
Warm Coal Cold
$-digk HUC and Basin: 03040201, Yadkfn River easin
WEtland Miti ation (�reditsj
Rlparian River�ne Rfparian Nan-Rlverfne Non-Rlparian
0.50
Coastai
Mitigation Site Dehited: NC EEP
(List the name of the b�nk to be dehited, For umhrefla banks, also Ilst the specific site. Far NCEEP, list NCEEP. If the NCEEP
a�ceptance letter identifies a specific site, alsa Ifst the speciflc site ta be debited�.
Sectlon tn be com�rleted by che Mfilp�artlon 5ponsor
Statement of Mitigatfon LiabiNty Acceptance: I, the undersigned, verify that I am authorized to apprave mltigakion
transactians for the Mitigatian 5pansor shown below, and I certify that the 5ponsor agrees to accept full respansibility far
praviding the mitigatian Identffied in thfs dacument (see the table abave}, assoclated with the LISACE Permittee and Actian
I� numher shown. I afsn verify that released credits {andfor advance credits for NCEEP?, �s appraued by the USACE, ere
currently available at the mitigation site identified above. further, I understand that if the Sponsvr fails to provide the
requlred campensatory mitigation, the USACE Wilmington Distrirt Engineer may pursue rrreasures aga�nst the 5ppnsvr to
ensure compliance assoclated with the mitigation requirements.
Mitigation Sponsor Name:
Name of Sponsors Authocized Representative:
of 5ponsQrs Autharized Representative Date of
Page 2 of 2 Form Updated 12 September, 2014

USACE Wilmington District
Campensatory Mitigation ResponsibilityTransf�r Form, Page 2
Conditions forTransfer of Compansatory Mitigatlon [redit:
• Once this document has bee� signed hy the Mitigation Spansor and the USAC� is in receipt af the signed form, the
Permittee is n� longer respqnsible for providing the mitigation identified in this farrn, though the Permittee remains
respansible for any other mitigatlon requirements stated in the permit conditians.
• ConstrUctlpn wfthin jurisdicti�ndl �reas authorized by the permit identified on page ane of thfs form can begin only
after the USACE is in receipt of a cvpy of this document signed by the Sponsor, eonfirming #hat the Spansor has
accepted responsi6ility for pravEding the mftfgation requirements Ilsted herein. For autharized impacts canducted by
the North Caralina Departrnent of Transpartatlon �NCdpTj, constructi4n within jurfsdi�tianal are�s may pr4ceed upon
permit issuance; however, a capy of thls form signed by the Spansar must be provided to the USACE within 3� day5 of
permit issuance. NCQOY remalns fully respansible for the mitigation until the USACE has received this form, confirming
that the 5ponsor has accepted respanslblllty for pravlding the mitlgatian requlrements listed heref n.
• Signed eopies of this document must bc retafned by the permittee, Mitigatfon 5ponsor, and In the USACE
administrative records for both the permit and the BankJILF Instrument, It is the Permittee's responsibility to ensure
that the U5ACE Prpject Manager jaddress belov►+j is provided wikh a signed copy of this form,
■ If changes are prapased ta the type, amount, or loeatiQn of rnitigation after this form has been signed and returned to
the USACE, the Sponsor must abtain case-by-case �pprqval from the USACE Prpject M�nag�r �nd/or IVorth C�rolina
lnterageney Review Tesm �NCIRT). If approved, hlgher mitigatian ratlos may be applled, as per current District
guidance 2nd a new versian of t�is form must 6e completed and included in the USACE adminfstrative recards for hafh
the permit and the BankflLF Instrument,
Comments/Additional Candklons:
Thls farm i5 not �alid unless slgned belnw by the USACE Project Manager and by the Mitigation 5ponsar an Page 1. Once
signecl. the Sponsor shnuld provlde coples of rhls form alan� wlth an updaried bank led�er to: Ij rhe PermiKee, �J tf�
USACE Project Mana�er at the oddre,ss 6e1ow, and 3J the WilmPrtpton �i3trlct A?hiQarlon �Jfilce, Attr�: Todd tuQwell,
3i405 Falls af Afeuse Road, Woke Fores� NCZ7587 (email: rodar.euowerr�usace.arrr►y.mif). Que5tians regarciing this farm
ar any af the permit conditians may be directed to the U5ACE Project Manager below.
USACE Project Manager: Liz Hair
USACE Fieid Offlce: Wllmington Regulatary Field Office
U5 Army Ccrps af Engineers
Email:
fi9 D�rlingtan Avenue
Wllmington, NC Z8403
HAIR.SARAH.E Dlgi�allyslgnedby
HAI H.SARAH.EA.1454693512
PN: c=U5. �U.S. Gavernment, ou�od.
A.145469351 � °�_� �'-U5",
_ rn=HAIH.SARAH.EA.105464351� November3,�D1d
USACE Project Man�ger 5ignaLure Da[e of Signature
Current Wilmic►gton Districc mitlg�tfpn guid8rlGe, inGluding information on mitlgaklon ratios, functiOn31 �55e5smentS, 0nd
mitigation bank location and avafla6ility, and credit classificatipns (including stream temperature and wetland groupings] is
availabl� at httq://ribits.usace.armv.mil.
Pdge 2 of 2
!he witm�ngtan olstntt is commined [o pro4iding the Mghest level nf wpport to ihe publlc to help us ensu�e we cnnklrn�p to Ao w. p�ease camplete 1he
Customer 5atistactivn 5urveY lotated at ourwedsite at hrtq.ilr��ui�r�rY.�,��4 surv�v c�rn/ to cornplete the survev anUne-