20160979 Ver 1_PCN signatory page_20190103

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or 0 Yes ❑ No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act Yes ❑ No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted. Raleigh
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USFWS IPAC and Natural Heritage Program Database
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes Q No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NOAA Essential Fish Habitat Mapper
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 ❑ Yes ❑X No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
NC SHPO GIS Database
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain? ❑ YesX❑ No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
FEMA National Floodplain Hazard Layer
Bob White ©r - 03 -I©l�
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization
letter from the applicant isprovided.)_
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