20160400 Ver 2_Application Attachments_20180430 (6)

U.S. ARMV CORPS OF ENGINEERS
WTLMINGTON DTSTRTCT
Action CD. SAW-2016-00986 Cow�ty: Ha�vood
GENERAL PERMiT (REGiONAL AND NATiONWiDE) VERiFiCATiON
Property Owner / Authorized Agent: North Carolina Department of Transportation
Attn: Mr. Dave McHenrv
Address: 253 Webster Road
Svlva, North Carolina 2$779
Telephone No.: 828-586-2141
Size and location of property (water body, t•oad name/number, town, etc.): The proiect is located at
Brid�e No. 102 on SR 1173 in Wavnesville, Havwood Countv, North Carolina.
Desc1-iption of project area and activity: Tn order to replace the brid�e with a concrete box cuhrert, the
qermittee is authorized to impact waters of the U.S. as follows:
Summar of Authorized im acts and Re uired Miti ation
�Impact �I�D # �p � Opei� Wate1• (ac) �Xretlai�d (ac) St�•ealn (1t)
GP # Temporaiy Pei7nanent Temporary Pei7ranent Temporary Permanent
S;te 1 (Plott S9'
C�•eek) � 4 (eulvert)
s;te t A (P1ott 1 �5'
Creek) � 4 (dewater)
32'
S�te 1B (Plott 14 (headwall
Creek) — and rip rap -
u stream)
Site 1C (P1ott �g�
Creek) 1`� (rip rap —
downstream)
Tmpact Totals 0 0 0 0 145' l39'
Total Loss of waters of the U.S. Total Loss of waters of the U.S. ,
(wetla��ds ai�d�"or open waters ii� ac) � (streams ii� l� 89
Required Wetland Miti�ation (ac) 0 Required Stream 1Vliti�ation (lfi� 178
Applicable T.aw: � Section 404 (C1ean Water Act, � i USC 1 i44)
❑ Section 10 (Rivers and Harbors Act, ;� C,7SC 40i)
Autliori�ation: Regional General Permit Number:
Nation���ide Permit Number: 14
Your work is authori�ed by the above referenced permit pi•ovided it is accomplished in stf•ict accordance with the
attached conditions, your submitted plans, and the following special conditions:
Special Conditions
1. A11 work must be perfoi7��ed in strict compliance with the description of work and plans in the application
dated April 22, 201(. Any modification to the description of work andior the permit plans must be
approved by the USACF, prior to implementation.
2. lii order to compensate for imp�cts associated wifh this pei7rit, mitigation sha11 be provided in accordance
with the provisions ouflined on fhe most recent version of fhe attached Compensatoiy Mitigation
Responsibility Transfer Form. The requirements of this foi7r, 111CIl1Cjlllb any special conditions listed on this
foi7n, are hereby incoi-�orated as special conditions of this permit authori�ation.

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;. The pei7rittee shall ensure that a:ll tree removal activities take p1�ce fi•om October 15�'' to April 15''' of any
year.
4. A11 conditions of the attached Norfh Carolina Wildlife Resoin•ces Commission letter of M ay 2�, 201(, are
hereby incoiporated as special conditions of fhis pei7rit.
5. T1�e pei7rittee shall require its contractors and!`or �gents to comply with the terms and conditions of t1�is
authori�ation letter in fhe consn-�iction and maintenance of this project, and shall provide each of its
contractors and/or agents associated with the consnvction or maintenance of this project with a copy of this
authorization letter, all conditions, and any authori�ed moditications. A copy of this authori�ation letter, all
conditions, and any authorized moditications, shall be available at the project site during constivction and
maintenance of diis project.
Any violation of the attached conditions or deviation fi•om your submitted plans may subject the permittee to a stop
work order, a restoration order, a Class T�dministrative penalty, and!or appropyiate legal action.
This veritication will remain valid until the expiration date identified below unless the nationwide autl�ori�ation
is modified, suspended or revoked. Tf, prior to the ex��iration date identified below, the nationwide per�nit
authori�ation is 1•eissued and!oi• modified, fl�is veritication will remain valid until the ex��iration date identified below,
provided it complies wifl� a11 requirements of the modified nationwide permit. Tf the nationwide pel7nit aiithori�ation
expires or is suspended, revoked, or is moditied, such that the activity would no longer comply wifl� the teyms and
conditions of the nationwide permit, activities which have commenced (i.e., are under consti�iction) or are under
contract to commence in reliance upon the nationwide permit, wi11 remain authori�ed provided the activity is
completed ���ithin t���elve months of the date of the nationwide permit's expiration, moditication or revocation, unless
discretionaiy autliority has been exercised on a case-by-case basis to modify, suspend or revoke the authori�ation.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality
Cei�tification. You should contact the NC Division of Water Resources (telephone [phone]) to detef7nine
Section �l� 1 requirements.
For activities occurring within the tv��enry coastal counties subject to regulation under the Coastal Area
Management Act (CAMA), prior to beginning work you must contact the N.C. Division of Coastal Management.
This Department of the Army veritication does not relieve the pef7nittee of the responsibility to obtain any other
required Federal, State or local approvals/pei7rits.
If tl�ere are any questions regarding this veritication, any of the conditions of the Permit, or the Coi-��s of
Engineef•s i•egulatory pro�•am, please contact l.ori Beckwith at R2R-271-79R�.
Digitally signed by
BECKWITH.LORETT DN:�W�s o°�s �o emment ou� DoD,
CorpsRegulatotyOf�cial: Lori Beck��ithp pnlnl 117�d.S77F,/� ou=PKl,oU=usa,
. . �cn=6ECKWITH.LORETfA.ANN.1173452264
Date: 2016.06J 3 1723:10 -04'00'
Date: rune 13, 201G Expiration Date of Verification: March 18, 2017

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Determination of Jurisdiction:
A. � Based on preliminary infoi7i�ation, there appear to be waters of the U S including wetlands within the above
described project area. This preliminaiy detei77�ination is not an appe�lable action under the Regulatory
Prob•am Adminisn•ative Appeal Process (Reference 3 i CFR Part 3� 1).
6. ❑ There are Navigable Waters of the United States within the above described project area subject to the
permit requirements of Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act.
Ui�less there is a change in the law or our published reb ilations, this determination may be relied upon for a
period not to exceed tive years fi•om the date of this notification.
C. ❑ There are waters of the US and/or wetlands within the above described pi•oject area subject to the perinit
requirements of Section 404 of the Clean Water Act (CWA)(>; C�SC S 1�44). Uiiless there is a change in the
1aw or our published regulations, this determination may be relied upon for a period not to exceed tive years
fi•om the date of this notitication.
D. ❑ The jurisdictional areas within the above described project area have been identitied under a previous action.
Please reference jirrisdictional detei7rination issued _. Action ID
E. Qasis of Jurisdictional Determination: N%A for PJD.
,4ttention 11SDA Progi'am Participants
This delineation/detei7rination has been conducted to identify the limits of Coips' G0�111 W1f01' ACf ]llriSC�lCil011 t01'
the pai-ticular site identified in this request. The delineationidetei7rination may not be valid for the wetland
conseivation provisions of the Food Security Act of 19R5. If you or your tenant are USDA Prob •am pai�ticip�nts, or
anticipate pai-ticipation in USDA programs, you should request a cei�titied wetland detei7rination fi•om the local
oftice of the Natural Resources Consei��ation Seivice, prior to starting work.
Digitally signed by
BECKWITH.LORETT DN:�W�S o°�s �o emment ou� DoD,
Coi�s R�gulatoiy Ofticial: _C,ori Beckwith a Q nl nl 1 17�d.��F,a °"=PKi, °"; usn^nr�
� � A.ANN.1 1 73452 264
Date: 2016.06.13 17:23:30 -04'00'
Tssue Date: June 13, 2016 Expiration Date: N%A for P:ID

Permit Number:
Permit Type:
Name of County:
Name of Permittee
Date of issuance
Project Manager:
SAW-2016-00986
NW14
Haywood
North Carolina Department of Transportation, Attn: Mr. Dave McHenry
June 13, 2016
Lori Beckwith
Upon completion of the activity authorized by this permit and any mitigation required by the
permit, sign this certification and return it to the following address:
U.S. Army Corps of Engineers
Attention: CESAW-RG-A
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army
Corps of Engineers representative. Failure to comply with any terms or conditions of this
authorization may result in the Corps suspending, modifying or revoking the authorization and/or
issuing a Class i administrative penalty, or initiating other appropriate legal action.
i hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and conditions of the said permit, and required mitigation was
completed in accordance with the permit conditions.
Signature of Permittee Date

NUTTFTCATTON OF ADMINTSTRATTVE APPEAL OPTTONS AND PRUCESS AND
REQUEST FOR APPEAL
Applicant: Nor•th C�rolina Department of File Nur}ibe�•: SAW-201 E- Date: June 13, 2016
Tr�nsportation, Attn: Mr. Dave McHenry 00986
Attached is: See Section below
TNiTTAL PROFFERED PERMTT (Standard Permit or Letter of permission) A
PROFFERED PERMTT (Standard Pern�it or Letter of permission) B
PERMTT DENTAL C
APPROVED JURiSDiCTTONAL DETERMINATTON D
X PRELTMINARY JURTSDTCTTONAL DETERMINATTON E
SECTTON i- The follov�ring identities your rights and options regarding an �dministr�tive appeal of the above
decisio��. Additional inforn�ation may be found at
http:!/www.usace.army.miUCF,CW/Pages/reg_matel•ials.aspx or Corps regulations at 33 CFR Pat-t 331.
A: TNTTTAL PROFFERED PERMTT: You may accept or object to the pert»it.
• ACCEPT: Ifyou received a Standard Pei7nit, you may sign the pei7nit document and 1•ehu•n it to the district engineer for tinal
authorization. If you received a l.etter of Permission (LOP), you may accept fl�e �,OP and your work is authori�ed. Your
signature on the Standard Pei7nit or acceptance of the T.OP means that you accept the permit in its entirety, and waive al1 rights
to appeal the pei7nit, including its terms and conditions, and approved jurisdictional determinations associated with the per�nit.
• OBJF,CT: Tf you object to the permit (Standard or T.OP) because of certain tei7rs and conditions therein, you may request that
the permit be modified accordingly. l'ou must complete Section TT of this foi7r and reh»7� the forir to the district engineer.
Your objections must be received by the disn•ict engineer �vithin 6� days of the date of this notice, or you v��ill forfeit your rigl�t
to appeal the pei7rit in the tutirre. Upon receipt ofyour letter, the district engineer will evaluate your objections and may: (a)
modify the pei7rit to address a11 of your concerns, (b) modify the permit to address some of your objections, or (c) not modify
the pei7rit having determined that the permit should be issued as previously w�ritten. After evaluating your objections, the
district engineer will send you a proffered permit for your reconsideration, as indicated in Section B below.
B: PROFFERED PERMiT: You may accept or appeal the permit.
• ACCEPT: If you received a 5tandai•d Pei�rnit, you may sign the pei7nit document and return it to the district engineer for tinal
authori�ation. If you received a Letter of Permission (LOP), you may accept the L,OP and your work is authori�ed. Your
signature on the Standai•d Permit or acceptance of the LOP means that you accept the pei7rit in its entirety, and waive all rights
to appeal the pei7rit, including its terms and conditions, and approved jurisdictional determinations associated with the pei7nit.
• APPFAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein, you
may appeal the declined per��it under the Coi-�s of Engin�ers Administrative Appeal Process by completing S�ction TI of t1�is
form and sending the fori� to the division engineer. T1�is foi7r must be received by the division engineer within 6� days of the
date of t1�is notice.
C: PERMTT DENiAL: You may appeal the denial of a pei7nit under the Coi-��s of Engineers Administrative Appeal Process
by cornpleting Section I1 of this form and s�nding t1�e for�� to th� division engineer. T1�is for�n must be received by the division
engineer within 6� days of the date of this notice.
D: APPROVED JCJRTSDTCTTONAL DETERMTNATTON: You may accept or appeal the approved JD or
provide new infiormation.
• ACCEPT: l'ou do not need to notify the Coi-�s to accept an approved JT�. Failure to notify the Corps within 60 days of t1�e
date of this notice, means that you accept the approved 7D in its entirety, and ��aive all rights to appeal the approved 7D.
• APPF,AL: If you disagree with the approved JD, you may appeal the approved :CD under the Corps of F,ngineers Administrative
Appeal Process by completing Section CI of this forir and sending the form to the division engineer. This foi7r must be received
by the division engineer within (0 days of the date of fhis notice.

E: PRELTMTNARY JURTSDTCTTONAL DETERMTNATTON: You do not need to respond to the Corps
regarciing the preliminary JD. The Preliminary JD is not appealable. Tf you wish, you may request an
approved JD (which may be appealed), by contacting the Corps district for further instruction. Also you m�y
provide ne�v information for further consideration by the Corps to reev�luate the JD.
SECTTON TT - REQUEST FOR APPEAL or OBJECTTONS TO AN 1NTTTAL PROFFERED PERMTT
REASONS FOR APPEAL UR OBJECTTONS: (Describe your reasons for a��Ue,alin� the. deci;ion or your objections to an
initial proffered pei7rit in clear concise statements. You may attach additional information to this form to clarify where youi• reasons
or objections are addi•essed in the administrative record.)
ADDTTTONAI. T1��FORiVIATTON: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the ap7�eal conference or meeting, and any supplemental infol7ration that the review ofticer has detei7nined is needed to
clarify the admini�trative record. Neither the appellant nor the Cor��s may add new infoi•mation or analyses to the record. Ho���ever,
vou iray provide ad�itional informatiori to clarifv the locatiori of infoi7nation that is already in the administrative record.
POINT OF CONTAC'T FOR QiJESTiONS OR 1NFORMATiON:
If youu have questions re�ardin� this decision and�or the appeal Tf you only have questions 1•e�ardin� the appeal process you
process you may contact: may also contact: � �
l.ori Beckwith, Project Manager Mr. Jason Steele, Administrative Appeal Review Ofticer
IJSACE, Asheville Regulatory Field Office CESAD-PDO
151 Patton Ave U.S. Army Corps of Engineers, South Atlantic Division
RM 2�R 60 Forsyth Street, Room l OM15
Asheville, NC 2RR01 Atlanta, Georgia 30303-8801
R2R-271-79R� Phone:[phone]
RTGHT OF ENTRY: Youi• signatui•e below b•ants the right of enny to Coi�s of Fngineers personnel, and any govei7iment
consultants, to conduct investigations of the project site during the course of the a}�pea1 process. l'ou will be provided a 15 day
notice of any site investigation, and will have the opporhmity to participate in al1 site investigations.
Date: Telephone number:
Signature of appellant or agent.
For appeals on rnitial Proffered Permits and approved Jurisdictional Determinations send this
form to:
District Engineer, Wilmington Regulatory Division, Attn: Lori Beckwith, Project Manager, 69
Darlington Avenue, Wilmington, NC 28403.
For Permit denials and Proffered Permits send this form to:
Division Engineer, Commander, U.S. Ar►ny Engineer Division, South Atlantic, Attn: Mr. Jason
Steele, Administrative Appeal Ofticer, CCSAD-PDO, 60 Fors3�th Street, Room 1OM15, Atlanta,
Georgia 30303-8801
Phone: [phone]