20180453 Ver 1_signed_NLEB_form_20180328

Northern Lon -Eared Bat 4 d Rule Streamliued Consultation Form
Federal agencies should use this form for the optionai streamlined consultation framework for the northem long-
eared hat (NLEB}. This framework allows federal agencies to xely upon the U.S. Fish and Wildlife Serv�ice's
(USFWS) January 5, 2016, intra-Service Programmatic Biological Opinion (BO) on the ima14(d) rule for the
NLEB for seciion 7(a}(2) compliance by: (1) notifying the USFWS that an action agency will use the streamlined
framework; {2) describing tbe project with sufficient detail to support the required determ.i.nation; and (3) enabling
the i7SFWS to track effects and determine if reinitiation of consultation is required per 50 CFR 402.16.
This form is not necessary if an agency determines that a proposed action wiIl have no effect to the NLEB or if
the USFWS has concurred in rvriti.ng with an agency's determination that a proposed action may aifect, but is not
likely to adversely affect the NLEB (i.e., tlae standard informal consultation process}. Actions that inay cause
prohibited incidental take require separate formal consultation. Providing tbis information does not address
section 7{a}(2) compliance for any other listed species.
Information to Determine 4(d} Rule Com liance:
1. Does the project occur whoIly outside of the WNS Zone�?
2. Have you contacted the appropriate agencyz to determine if your praject is near
l�own hibernacula or maternit roost trees?
3. Could the project disturb hibernating NLEBs in a known hibernaculum?
4. Could the praject alter the entrance or interior environment of a known
hibernaculum?
5. Does the proj ect remove any trees within 0.25 miles of a known hibernaculuin at
an t�xne of ear?
6. Would the project cut or destroy known occupied maternity roast trees, or any
other trees within a 150-foot radius from the maternity roost tree from June 1
throueh Julv 31.
� 1Z1
■� ►z�
You are eligible ta use this form if you have answered yes to question #1 or yes io question #2 and no to
questions 3, 4, 5 and 6. The remai.nder of the form will be used by the US�'WS to track our assumptions in the
BO.
Agency and Applic�nt� (Name, Email, Phone No.): NCDOT, Division 12, Trish Beam,
pdbeam�a7,ncdot.gov, 980-552-4218
Project Name: Bridge #190 replacement, SR 1045 (Ballpark Road) over Magness Creek, Cleveland
County
Praject Lacation (include coordinates if l�nown):
B$sic Praject Description (prov�ide narrative belaw or attach additional information): Replacement of
timber and steel bridge wi�h a concrete bridge on same location.
1 http:I/www.fws.gov/midwest/endangered/mammals/nleb/pdf/WNSZone.pdf
2 See http://www.fws.gov/midwesdendangered/mammals/nleb/nhisites.html
3 If applicable - only needed for federal actions with applicants (e.g., for a permit, etc.) who are party to the consultation.

A enc Determination:
By signing this form, the action agency determines that this praject may affect the NLEB, but that any
resulting incidental take of �he NLEB is nat prohibited by the fina14{d) rule.
If the USFW� does not respond within 30 days �rom subrnittal of this form, the action agency may
presume 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 LTSFWS January 5,
2016, Prograrnmatic BO. The action agency wi11 update this determination 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 promptly report any departures from the described activities to
the apprapriate USFWS Fie1d Office. The action agency will provide the appropriate USFWS Field
Office with the results of any surveys conducted for the NLEB. Involved parties will promptly notify the
appropriate USFWS Field O£fice upon finding a dead, in}ured, or sick NLEB.
,7
Signature: � -� Date Submitted�� � � � ��
4 Any activity that temporarily or permanently removes suitable forested laabitat, including, but not liznited to, �ee removal
from development, energy production and transmission, znining, agriculture, etc. {see page 4$ of the BO).
5 If the project zemoves less t�an 10 trees and the acreage is unknown, report the acreage as less than 0.1 acre.
`' If the acrivity includes tree clearing in June and July, also include those acreage in April to October.