20181321 Ver 1_PCN Form Submission_9/26/2018 5:24 PM

DWR
0[a Klan of water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial Review
Has this project met the requirements for acceptance into the review process?*
r Yes
r' No
Is this project a public transportation project?*
C' Yes r No
Change only ff needed.
BIMS # Assigned *
Version#*
20181321
Is a payment required for this project?*
* No payment required
What amout is owed?*
* Fee received
r $240.00
r Fee needed - send electronic notification
r $570.00
Reviewing Office* Select Project Reviewer*
Asheville Regional Office - [phone] Amy Annino:eads\amannino
Information for Initial Review
1a. Name of project:
Forest City - Second Broad River Raw Water Intake 2018 Repair Project
1a. Who is the Primary Contact?*
Barry Spurlin
1 b. Primary Contact Email:* 1 c. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
9/26/2018
Site Coordinates
Latitude:
35.380325
A. Processing Information
County (or Counties) where the project is located:
Rutherford
Is this project a public transportation project?*
r Yes r No
Longitude:
-81.861469
1a. Type(s) of approval sought from the Corps:
rJ Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r- Section 10 Permit (navigable ureters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?
rJ Nationwide Permit (MNP)
r- Regional General Permit (RGP)
r- Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Numbers (for multiple NWPS):

1d. Type (s) of approval sought from the DWR:
* 401 Water Quality Certification - Regular F- 401 Water Quality Certification - Express
* Non -404 Jurisdictional General Permit F Riparian Buffer Authorization
F Individual Permit
*
1e. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: r Yes No
For the record only for Corps Permit: r Yes No
1f. Is this an after -the -fact permit application?*
(- Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r' Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
C Yes r No
1h. Is the project located in any of NC's twenty coastal counties?
f Yes r No
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
W Owner r Applicant (other than owner)
2. Owner Information
2a. Name(s) on recorded deed:
Town of Forest City
2b. Deed book and page no.:
DB 645 P 737. DB 190 P 340
2c. Responsible party:
Barry Spurlin
2d. Address
Street Address
132 Wilkie Street
Address Line 2
P.O. Box 728
City
Forest City
Postal / Zip Code
28043
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Province / ftion
NC
Country
2f. Fax Number:
[phone]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(d appropriate)
N/A
1c. Nearest municipality/ town:
Forest City
2• Project Identification
2a. Property Identification Number: 2b. Property size:
1621990, 1616831 2.18, 2.42

2c. Project Address
Street Address
518 Rock Corner Road
Address Line 2
qty State / Rovince / Fiagicn
Forest City NC
Postal / Zip Cade Country
28043
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Second Broad River
3b. Water Resources Classification of nearest receiving water:*
WS -V
3d. Please provide the 12 -digit HUC in which the project is located
3c. What river basin(s) is your project located in?
Broad
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
The Project Site consists of three sections on the perennial Second Broad River. These sections are up the river from the Forest City Raw Water Intake and Pumping Station (see
Existing Conditions Map).
4b. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
F Yes r- No r Unknown
4c. If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW -0000-00000).
The US Army Corps of Engineers authorized an MNP 3 After -the -Fact Section 404 permit for this same project area on October 6th, 2016. The action ID for this certification was 2016-
01980.
Project History Upload
Army Corps 404 Permit.pdf
2.33MB
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
Topo_Map.pdf
3.18MB
4e. Attach an 8 1/2X11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
Soil_Map.pdf 490.28KB
4f. List the total estimated acreage of all existing wetlands on the property:
N/A
4g. List the total estimated linear feet of all existing streams on the property:
Tributaries and wetlands have not been delineated beyond the scope of the Project Site. Project
Site encompasses approximately 673 linear feet of perennial, Second Broad River. No wetlands
were found in the Project Site.
4h. Explain the purpose of the proposed project:*
The purpose of the Forest City — Second Broad River Raw Water Intake 2018 Repair Project is to make necessary repairs to maintain existing infrastructure which is responsible for
keeping the river elevation to a point that adequate flow can be sustained for the proper function of the rawvater canal and intake to maintain potable water supply to Forest City
residents. If a failure of existing infrastructure (low head dam or rock weir) were to occur due to bank instability issues, the potable water supply to Forest City residents could be
severely and negatively impacted.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The Forest City - Second Broad River Raw Water Intake 2018 Repair Project consists of repairs to 70 feet of the eastern bank beside behind the rock weir (Area 1), 20 feet of the
western bank beside the rock weir (Area 2), and 50 feet of the western bank approximately 100 feet down the river from the rock weir (Area 3). See attached Project Overview map.
Area 1 — The eastern side of the river bank near the rock weir was repaired by driving a small section of steel sheet piling into the river bed on the upriver side of the repair area. The
river bank was armored with rip -rap stone to help prevent future failure. Large boulders were installed along the toe of the bank. A failed tree was also removed.
Area 2 — The eroded stream bank was armored with rip -rap and boulder toe protection to prevent future failure.
Area 3 — This area was repaired by installing sheet piling at the top of the bank and rip -rap on the eroded face of the bank.
Typical construction excavation equipment was used including small excavators and dump trucks.
The work was an emergency action to stabilize and protect approximately 140 linear feet of both river banks to ensure adequate flow was reaching the rawwater intake providing
potable water for the Town of Forest City.
4j. Please upload project drawings for the proposed project.
Existing_Conditions.pdf 617.56KB
Overview Map.pdf 714.5KB

5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No r Unknown
Comments:
No wetlands within project area.
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r' Preliminary r Approved r Not Verified C Unknown r NA
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): John Vilas
Agency/Consultant Company: McGill Associates, P.A.
Other:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Project area was delineated in 2006 by McGill Associates, P.A. No wetlands were found within the project area.
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
F Wetlands 9 Streams -tributaries r Buffers
F Open Waters 7 Pond Construction
3. Stream Impacts
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
140 0
3i. Total stream and ditch impacts:
140
3j. Comments:
140 total linear feet of impacts to Second Broad River associated with rip rap, gravel, boulders, and sheet piling.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Rock placement was limited to the eroded/damaged areas minimizing disturbance. Special care was taken not to disturb the area during high water or
rain events. The work is also meant to reduce the likelihood of a dam failure that could affect potable water access of Forest City residents.
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name*
3e. Stream Type*
3f. Type of
3g. S. width *
F. Impact
F
(?)
Jurisdiction*
length*
S1
Facility Maintenance
Y
P
Fill
Second Broad River
Perennial
Both
50
70
Average (feet)
(linearfeet)
S2
Facility Maintenance
tY
P
Fill
Second Broad River
Perennial
Both
50
20
Average (feet)
(linear feet)
S3
Facility Maintenance
Y
P
Fill
Second Broad River
Perennial
Both
50
50
Average (feet)
(linearfeet)
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
140 0
3i. Total stream and ditch impacts:
140
3j. Comments:
140 total linear feet of impacts to Second Broad River associated with rip rap, gravel, boulders, and sheet piling.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Rock placement was limited to the eroded/damaged areas minimizing disturbance. Special care was taken not to disturb the area during high water or
rain events. The work is also meant to reduce the likelihood of a dam failure that could affect potable water access of Forest City residents.

1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Riverbanks and disturbed areas were stabilized immediately with rip -rap. There were no sediment and erosion control measures in stream channel.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
f Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The project resulted in little to no loss of stream bed so it is not anticipated that compensatory mitigation will be required.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes No
If no, explain why:
Storm water rules are not applicable. There will be no change in impervious surfaces in the project area.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r^ Yes r' No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
r Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federallstate/local) funds or the use of public (federal/state) land?*
a Yes r No
1b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the requirements of the National or State (North Carolina)
Environmental Policy Act (NEPA/SEPA)? *
C Yes r No
Comments:*
The project falls under the general and specific minimum criteria for land disturbing activities that do not require preparation of an environmental
document according to 15A NCAC 01C.0408.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B.0200)?*
C Yes r No
2b Provide an explanation of the violation(s):
The project was an emergency repair of the Town of Forest City raw water supply. Immediate work was necessary to ensure that the residents and
businesses in the service area received potable water for daily use.
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
C Yes s No
3b. If you answered "no," provide a short narrative description.
The project is meant to repair a damaged stream bank to ensure longevity of exsting infrastructure. There will be no change from the original or
intended use or extension of services. The project will not develop land for commercial or private purposes and will likely not result in additional
development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
C Yes C No r: N/A
5. Endangered Species and Designated Critical Habitat (Corps Requirement)

5a. Will this project occur in or near an area with federally protected species or habitat?*
C Yes
I-- No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r- Yes
G No
5d. Is another Federal agency involved?*
C Yes r No
c Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Data on endangered species was obtained from the US FWS website for Rutherford County, North Carolina:
(https://ecos.fws.gov/ecp0/reports/species-by-current-range-county?fips=37161) and the NatureServe Explorer Species Reports
(http://e)plorer.natureserve.org/index.htm). The list of endangered species potentially present in Rutherford County was reviewed.
Designated critical habitat was reviewed via the US FWS mapping application: (https://NA.maps.arcgis.coo/home/webmap/vievver.html?
webmap=9d8de5e265ad4fe09893cf75b8dbfb77) and the project site was not vnthin one of these designated habitats. Northern long-eared bat habitat
in the western part of the state was checked (https://wow ..fws.gov/asheville/htmis/project_review/NLEB_in_WNC.html). Although some confirmed
hibernation and maternity sites for the Northern long-eared bat are present in Rutherford County, none of these mapped sites were in the project site.
Consultation Documentation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes
r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
Data available of the NOAA fish habitat mapper (https://wvm.habitat.noaa.gov/protection/efh/efhmapper/) was used to determine that the project site
would not impact essential fish habitat.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?*
r' Yes
r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
http://gis.ncdcr.gov/hpoweb/
The closest historical or archaeological resource (RF 00054 Mott Carpenter Sr. House) is approximately 6,000 linear feet from the project area.
7c. Historic or Prehistoric Information Upload
NCHPO Map.pdf 584.54KB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?*
r Yes
C No
8b. If yes, explain how project meets FEMA requirements:
No change in pre and post flood project site elevations.
8c. What source(s) did you use to make the floodplain determination?*
The NC Flood Risk Information System (NC FIRM) mapping tool (http://fris.nc.gov/fris/Home.aspx?ST=NC) was used to determine the project site was
entirely within the 100 year floodplain.
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Photosheets 9-6-18.pdf 2.15MB
Signature
fJ By checking the box and signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Jonathan Herman

Signature
Sign
Date
9/26/2018

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. N/A PLAN NO. NIA PARCEL ID: 1621990, 1616831
STREET ADDRESS: 518 Rock Corner Rd, Forest City. NC 28043
Please print:
Property Owner:
Property Owner:
Town of Forest City - Barry Spurlin (Public Works Director)
o� is 414"60
The undersigned, registered property owners of the above noted property, do hereby authorize
John Vilas . of
(Contractor / Agent)
McGill Associates, PA
(Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
132 Wilkie Street P.S. Box 728 Forest City, NC 28043
Telephone: [phone]
Email: [e-mail]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
dow- Z'
Authoriz Signature
Date:
Authorized Signature
Date:

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION: Existing Utility Easement
LOT N0. N/A PLAN NO. N/A . PARCEL ID: N/A
STREET ADDRESS: Adjacent to 329 Wells Dr. Forest City, NC 28043
Please print:
Property Owner: Town of Forest City - Barry Spurlin (Public Works Director)
Property Ownerair S' a11
The undersigned, registered property owners of the above noted property, do hereby authorize
John Vilas , of
(Contractor / Agent)
McGill Associates, PA
(Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
132 Wilkie St. P.O. Box 728 Forest Citv, NC 28043
Telephone: [phone]
Email: banyspurlin(&townofforestcity.com
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorizedign�ature
p
Date: a — ! ` / pe
Authorized Signature
Date:

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID. 2016-01980 County: Rutherford U.S.G.S. Quad: Sunshine
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: Town of Forest City / Attn.: John Condrey
Address: 128 N. Powell Street
Forest City, NC 28043
Telephone Number: 828-245-4747
Size (acres): 4_6 Nearest Town: Forest City
Nearest Waterway: Second Broad River Coordinates: 35.37977 N, 81.86193 W
River Basin/ HUC: Upper Broad (03050105)
Location description: The project site is located on a tract of land (parcel nos. 1621990 and 1616831) at 518 Rock Corner Road
in Forest City, Rutherford County, North Carolina.
Description of projects area and activity: This after -the -fact permit verification authorizes 30 linear feet of permanent stream
impacts to the Second Broad River associated with emergencv repairs to the Town of Forest City's raw water intake
structures. An existing low -head dam and rock weir had breached and the Town contacted the Corps in late July 2016 to
discuss the damage and proposed repair activities. The Corps granted verbal authorization for the work at this time in order
to ensure water supply was available within the Forest City service area.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number or Nationwide Permit Number: NWP 3 After -the -Fact
SEE ATTACHED RGP or NWP GENERAL, REGIONAL AND SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and attached information dated September 26, 2016. Any violation of the attached
conditions or deviation from your submitted plans may subject the permittee to a stop work order, a restoration order, a Class
I administrative penalty, and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide/regional authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide/regional permit authorization is reissued and/or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of the
modified nationwide/regional permit. If the nationwide/regional permit authorization expires or is suspended, revoked, or is modified,
such that the activity would no longer comply with the terms and conditions of the nationwide/regional permit, activities which have
commenced (i.e., are under construction) or are under contract to commence in reliance upon the nationwide/regional permit, will remain
authorized provided the activity is completed within twelve months of the date of the nationwide/regional permit's expiration,
modification or revocation, unless discretionary authority has been exercised on a case-by-case basis to modify, suspend or revoke the
authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Resources (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty 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 verification does not relieve the permittee of the responsibility to obtain any other required Federal, State
or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory program,
please contact David Brow8-271-7980, ext. 232 or [e-mail].
Corps Regulatory Officia : Date: October 6 2016
David Brown
Expiration Date of Verification: March 18, 2017

Determination of Jurisdiction:
A. ® Based on preliminary information, there appear to be waters of the US including wetlands within the above described project
area. This preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
(Reference 33 CFR Part 331).
B. ❑ 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. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
C. ❑ There are waters of the US and/or wetlands within the above described project area subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
D. ❑ The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued . Action ID: SAW -
Basis for Determination:
The stream channel at the project site is the Second Broad River which flows into the Broad River, a traditional navigable
river (TNW) and Section 10 waters in South Carolina. The Broad Riverjoins the Conagree and Santee Rivers before
entering the Atlantic Ocean. The Second Broad River in the project area has perennial flow, is a blue line feature on the
U.S.G.S. topographic map, and exhibit indicators of ordinary high watermark. This jurisdictional determination is valid for
the impact areas only.
Remarks: None
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B
and C above).
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room IOM15
Atlanta, Georgia 30303-8801
Phone: [phone]
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by N/A.
**It is not necessary to subA form to the Division Office if you do not object to the determination in this correspondence.**
Corps Regulatory Official:
David Brown
Issue Date of JD: October 6, 2016 Expiration Date of JD: Five years from Issue Date

The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete our Customer Satisfaction Survey, located online at bgp://re u¢ latoa.usacesurvey.com/.
Copy famished:
McGill Associates, P.A. / Attn.: John Vilas, 468 New Market Blvd., Suite B, Boone, NC 28607

Action ID Number: 2016-01980 County: Rutherford
Permittee: Town of Forest City / Attn.: John Condrey
Project Name: Forest City Second Broad River Raw Water Intake Repairs
Date Verification Issued: October 6, 2016
Project Manager: David Brown
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:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn.: 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 condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee
Date

SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision. I
Additional information may be found at htto://www.usace.anny.mil/Missions/CivilWorks/RegulatoryProgramandPennits.as�x
or Corns regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. 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 Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
ADMINISTRATIVE APPEAL OPTION
REQUEST FOR APPEAL
Applicant:
Town of Forest Ci / Attn.: John Condre Fi]e Number: SAW-2016-01980 Date: October 6, 2016
Attached is:
See Section below
❑
INITIAL PROFFERED PERMIT Standard Permit or Letter ofpermission)
A
❑
PROFFERED PERMIT (Standard Permit or Letter ofpermission)
B
❑
PERMIT DENIAL
C
❑
APPROVED JURISDICTIONAL DETERMINATION
D
®
PRELIMINARY JURISDICTIONAL DETERMINATION
E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision. I
Additional information may be found at htto://www.usace.anny.mil/Missions/CivilWorks/RegulatoryProgramandPennits.as�x
or Corns regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. 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 Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.

D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
SECTION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT r . ..
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division, Attn.:
Mr. Jason Steele, Administrative Appeal Review Officer
David Brown
CESAD-PDO
828-271-7980, ext 232
U.S. Army Corps of Engineers, South Atlantic Division
60 Forsyth Street, Room 1OM15
Atlanta, Georgia 30303-8801
Phone: [phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any government
consultants, to conduct investigations of the project site during the course of the appeal process. You will be provided a 15 day
notice of any site investigation, and will have the opportunity to participate in all site investigations.
Date:
Telephone number:
Si nature of a ellant ora ent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn.: David Brown, 69 Darlington Avenue, Wilmington, North
Carolina 28403
For Permit denials, Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele, Administrative
Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room IOM15, Atlanta, Georgia 30303-8801
Phone: [phone]

PHOTO SHEET 1
(AREA 1)
SEPTEMBER 26, 2018 A S S O C I A T E SMcGlil
1013 STATE FARM RD.PH. [phone]BOONE, NC 28607
PROJECT #
1800318.000
ENVIRONMENTAL FINANCE
Photo Three: View looking southeast along Second
Broad River at stabilized bank (Area 1). Photo
taken September 20, 2018.
FOREST CITY - SECOND BROAD RIVER
RAW WATER INTAKE 2018 REPAIR
PROJECT
FOREST CITY, RUTHERFORD COUNTY,
NORTH CAROLINA
Photo Two: View looking southeast at sheet piling
on the eastern bank of the Second Broad River (Area
1). Photo taken September 20, 2018.
Photo One: View looking southeast along Second
Broad River at the eroded eastern bank beside the
weir prior to stabilization (Area 1). Photo taken May
2, 2018.
PHOTO SHEET 2
(AREA 2)
SEPTEMBER 26, 2018
A S S O C I A T E SMcGlil
1013 STATE FARM RD.PH. [phone]BOONE, NC 28607
PROJECT #
1800318.000
ENVIRONMENTAL FINANCE
Photo Four: View looking northwest along
Second Broad River at western bank during
installation of rip-rap stabilization (Area 2).
Photo taken May 2, 2018.
FOREST CITY - SECOND BROAD RIVER
RAW WATER INTAKE 2018 REPAIR
PROJECT
FOREST CITY, RUTHERFORD COUNTY,
NORTH CAROLINA
Photo Five: View looking south at rip-rap
stabilization along the western bank near the weir
(Area 2). Photo taken September 20, 2018.
Photo Six: View looking northeast along the
western bank of the Second Broad River at toe
stabilization at Area 2. Photo taken September 20,
2018.
PHOTO SHEET 3
(AREA 3)
SEPTEMBER 26, 2018 A S S O C I A T E SMcGlil
1013 STATE FARM RD.PH. [phone]BOONE, NC 28607
PROJECT #
1800318.000
ENVIRONMENTAL FINANCE
Photo Ten: View looking southeast along Second
Broad River at western bank (Area 2) after
installation of rip rap stabilization. Photo taken
September 20, 2018.
Photo Eight: View looking southeast along
Second Broad River at bank damage at Area 2.
Photo taken September 20, 2018.
Photo Nine: View looking southwest along the
western bank of the Second Broad River at Area 2
during construction. Photo taken August 15, 2018.
FOREST CITY - SECOND BROAD RIVER
RAW WATER INTAKE 2018 REPAIR
PROJECT
FOREST CITY, RUTHERFORD COUNTY,
NORTH CAROLINA
Photo Seven: View looking southwest at the
construction access road to the site. Area 2 is on the
right side of the road. Photo taken September 20,
2018.
Soil Map—Rutherford County, North Carolina
(Forest City - Second Broad River Raw Water
Intake 2018 Repair Project)
Natural Resources
Conservation Service
Web Soil Survey
National Cooperative Soil Survey
8/7/2018
Page 1 of 33915360391539039154203915450391548039155103915540391557039156003915630391566039153603915390391542039154503915480391551039155403915570391560039156303915660421630421660421690421720421750421780421810421840
421630 421660 421690 421720 421750 421780 421810 421840
35° 22' 52'' N 81° 51' 46'' W35° 22' 52'' N81° 51' 37'' W35° 22' 42'' N
81° 51' 46'' W35° 22' 42'' N
81° 51' 37'' WN
Map projection: Web Mercator Corner coordinates: WGS84 Edge tics: UTM Zone 17N WGS84
0 50 100 200 300
Feet
0 20 40 80 120
Meters
Map Scale: 1:1,500 if printed on A portrait (8.5" x 11") sheet.
Soil Map may not be valid at this scale.
MAP LEGEND MAP INFORMATION
Area of Interest (AOI)
Area of Interest (AOI)
Soils
Soil Map Unit Polygons
Soil Map Unit Lines
Soil Map Unit Points
Special Point Features
Blowout
Borrow Pit
Clay Spot
Closed Depression
Gravel Pit
Gravelly Spot
Landfill
Lava Flow
Marsh or swamp
Mine or Quarry
Miscellaneous Water
Perennial Water
Rock Outcrop
Saline Spot
Sandy Spot
Severely Eroded Spot
Sinkhole
Slide or Slip
Sodic Spot
Spoil Area
Stony Spot
Very Stony Spot
Wet Spot
Other
Special Line Features
Water Features
Streams and Canals
Transportation
Rails
Interstate Highways
US Routes
Major Roads
Local Roads
Background
Aerial Photography
The soil surveys that comprise your AOI were mapped at
1:24,000.
Warning: Soil Map may not be valid at this scale.
Enlargement of maps beyond the scale of mapping can cause
misunderstanding of the detail of mapping and accuracy of soil
line placement. The maps do not show the small areas of
contrasting soils that could have been shown at a more detailed
scale.
Please rely on the bar scale on each map sheet for map
measurements.
Source of Map: Natural Resources Conservation Service
Web Soil Survey URL:
Coordinate System: Web Mercator (EPSG:3857)
Maps from the Web Soil Survey are based on the Web Mercator
projection, which preserves direction and shape but distorts
distance and area. A projection that preserves area, such as the
Albers equal-area conic projection, should be used if more
accurate calculations of distance or area are required.
This product is generated from the USDA-NRCS certified data as
of the version date(s) listed below.
Soil Survey Area: Rutherford County, North Carolina
Survey Area Data: Version 18, Oct 3, 2017
Soil map units are labeled (as space allows) for map scales
1:50,000 or larger.
Date(s) aerial images were photographed: Apr 23, 2014—Oct
18, 2017
The orthophoto or other base map on which the soil lines were
compiled and digitized probably differs from the background
imagery displayed on these maps. As a result, some minor
shifting of map unit boundaries may be evident.
Soil Map—Rutherford County, North Carolina
(Forest City - Second Broad River Raw Water
Intake 2018 Repair Project)
Natural Resources
Conservation Service
Web Soil Survey
National Cooperative Soil Survey
8/7/2018
Page 2 of 3
Map Unit Legend
Map Unit Symbol Map Unit Name Acres in AOI Percent of AOI
ChA Chewacla loam, 0 to 2 percent
slopes, frequently flooded
5.9 62.4%
PbC2 Pacolet-Bethlehem complex, 8
to 15 percent slopes,
moderately eroded
1.1 12.0%
SkB Skyuka loam, 2 to 8 percent
slopes
0.9 9.5%
W Water 0.9 9.8%
WeA Wehadkee silt loam, 0 to 2
percent slopes, frequently
flooded
0.6 6.3%
Totals for Area of Interest 9.4 100.0%
Soil Map—Rutherford County, North Carolina Forest City - Second Broad River Raw
Water Intake 2018 Repair Project
Natural Resources
Conservation Service
Web Soil Survey
National Cooperative Soil Survey
8/7/2018
Page 3 of 3
FOREST CITY - SECOND BROAD RIVER
RAW WATER INTAKE 2018 REPAIR
PROJECT
FOREST CITY, RUTHERFORD COUNTY,
NORTH CAROLINA
USGS MAP
SEPTEMBER 26, 2018 A S S O C I A T E SMcGlil
1013 STATE FARM RD PH. [phone]BOONE, NC 28607
PROJECT #
1800318.000
ENVIRONMENTAL FINANCE
N
E
S
W
USGS
SUNSHINE QUADRANGLE
NORTH CAROLINA - RUTHERFORD CO.
7.5 MINUTE SERIES (TOPOGRAPHIC) 215 SW
SITE
1 INCH = FEET
GRAPHIC SCALE
0-500 250 500
500
0
LATITUDE: 35.379994
LONGITUDE: -81.862038
PROJECT AREA
RF 00054
State of North Carolina DOT, Esri, HERE, Garmin, INCREMENT P, NGA, USGS
70 FT.
MAINTENANCE
AREA 1 - IMPACT S1
STOCKPILING STOCKPILING EXCAVATIONACCESS
A
C
C
E
S
S
ACCE
S
S
A
C
C
E
S
S
PROJECT AREA
PROJECT AREA
PIN: 1640751789
PIN: 1640659308
PIN: 1640659872
PIN: 1640655108
20 FT MAINTENANCE
AREA 2 - IMPACT S2)
50 FT MAINTENANCE AREA 3 - IMPACT S3
PROJECT OVERVIEW
SEPTEMBER 26, 2018 A S S O C I A T E SMcGlil
1013 STATE FARM RD PH. [phone]BOONE, NC 28607
PROJECT #
1800318.000
ENVIRONMENTAL FINANCE
FOREST CITY - SECOND BROAD RIVER
RAW WATER INTAKE 2018 REPAIR
PROJECT
FOREST CITY, RUTHERFORD COUNTY,
NORTH CAROLINA
N
E
S
W
1 INCH = FEET
GRAPHIC SCALE
0-80 40 80
80
0
PUMPING
STATION
LOW HEAD DAM;
STEEL SHEET PILING
RAW WATER
INTAKE
ROCK WEIR
RAW
W
ATE
R
C
A
N
A
L
SECO
N
D
B
R
O
A
D
RI
VE
R
50 FT ERODED
SECTION OF BANK (AREA 3)
70 FT. ERODED SECTION
OF BANK (AREA 1)
20 FT. ERODED
SECTION OF BANK (AREA 2)
EXISTING
CONDITIONS
SEPTEMBER 26, 2018
A S S O C I A T E SMcGlil
1013 STATE FARM RD PH. [phone]BOONE, NC 28607
PROJECT #
1800318.000
ENVIRONMENTAL FINANCE
FOREST CITY - SECOND BROAD RIVER
RAW WATER INTAKE 2018 REPAIR
PROJECT
FOREST CITY, RUTHERFORD COUNTY,
NORTH CAROLINA
N
E
S
W
1 INCH = FEET
GRAPHIC SCALE
0-60 30 60
60
0