20090822 Ver 1_Application_20090730

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
U. S. Army Corps of Engineers
151 Patton Avenue, Room 108
Asheville, NC 28801-5006
ATTN: Mr. Steve Lund
t_ - NCDOT Coordinator-
Subject: Application for Section 404 Nationwide Permits 33 for the proposed
replacement of Bridge No. 49 over Crowder's Creek on SR 1103 (Crowder's
Creek Road) in Gaston County, Federal Aid Project No. BRSTP-1103(15);
Division 12; WBS 33741.1.1; TIP No. B-4517
Dear Sir:
The North Carolina Department of Transportation (NCDOT) proposes to replace Bridge No.
49 over Crowder's Creek on SR 1103. There will be 65 feet of temporary surface water
impacts.
Please see enclosed copies of the Pre-Construction Notification (PCN), permit drawings,
design plans and Stormwater Management Plan for the above-referenced project. The
Categorical Exclusion (CE) was completed in January 2009 and distributed shortly
thereafter. Additional copies are available upon request.
This project calls for a letting date of May 18, 2010 and a review date of March 30, 2010.
July 27, 2009
09®822
EUGENE A. CONTI, JR.
SECRETARY
12@1
JUL 3
lanA aS ATS ATER
BRANCH
MAILING ADDRESS:
NC DEPARTMENT OF TRANSPORTATION
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS
1598 MAIL SERVICE CENTER
RALEIGH NC 27699-1598
TELEPHONE: [phone]
FAX: [phone]
WEBSITEI WWW.NCDOT.ORG
LOCATION:
4701 ATLANTIC AVENUE
SURE 116
RALEIGH NC 27604
A copy of this permit application will be posted on the NCDOT Website at:
h http://www.ncdot.org/doh/preconstruct/pe/. If you have any questions or need additional
information, please call Jennifer Harrod at [phone].
Sincerely,
?Gregory J. Thorpe, Ph.D.
Environmental Management Director, PDEA
w/attachment
Mr. Brian Wrenn, NCDWQ (2 copies)
Ms. Marla Chambers, NCWRC
Ms. Marella Buncick, USFWS _
- w/o attachment (see permit website for attachments)
Dr. David Chang, P.E., Hydraulics
Mr. Mark Staley, Roadside Environmental
Mr. Victor Barbour, P.E., Project Services Unit
Mr. Greg Perfetti, P.E., Structure Design
Mr. M.L. Holder, P.E., Division Engineer
Ms. Trish Simon, DEO
Mr. Jay Bennett, P.E., Roadway Design
Mr. Majed Alghandour, P. E., Programming and TIP
Mr. Art McMillan, P.E., Highway Design
Mr. Scott McLendon, USACE, Wilmington
Mr. Hank Schwab, PDEA Project Planning Engineer
O?pF W ATF,?
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
la. Type(s) of approval sought from the
Corps:
®Section 404 Permit E] Section 10 Permit
1 b. Specify Nationwide Permit (NW P) number: 33 or General Permit (GP) number:
1c. Has the NW P or GP number been verified by the Corps? ? Yes ® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
-1e. -Is this-notification solely for the record-.
because written approval is not required? For th"e record only for DWQ 401-
Certification:
® Yes ? No -For the record only for Corps Permit:

? Yes ®No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes ® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ® No
1 In. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Replacment of Bridge No. 49 over Crowder's Creek on SR 1103 (Crowder's Creek Rd.)
2b. County: Gaston
2c. Nearest municipality / town: Gastonia
2d. Subdivision name: not applicable
2e. NCDOT only, T.I.P. or state
project no: 8-4517
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Department of Transportation
3b. Deed Book and Page No. not applicable
3c. Responsible Party (for LLC if
applicable): not applicable
3d. Street address: 1598 Mail Service Center
3e. City, state, zip: Raleigh, NC 27699-1598 -
3f. Telephone no.: (919) 431=6672
3g. Fax no.: [phone]
-3h-Email address: [e-mail]
4. Applicant Information (if different from owner
4a. Applicant is:
? Other, specify:
4b. Name: ? Agent
not applicable
4c. Business name
4d. Street address:
4e. City, state, zip:
4f. Telephone no.
4g. Fax no.:
4h. Email address:
5. AgentlConsultant Information (if applicable)
5a. Name: not applicable
5b. Business name
5c. Street address:
5d. City,
5f. Fax no.:
5g. Email

2
r
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): not applicable
1b. Site coordinates (in decimal degrees): Latitude: 35. 1 9582N Longitude: - 81.2225
(DD.DDDDDD) (-DD.DDDDDD)
860 ft L x 110 ft W= 94,600 sq. ft
1c. Property size: (94,600) sq. ft. / (43,650) sq. ft =
2.17 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Crowder's Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Catawba
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
---application:
Bridge No. 49 will be replaced with a 190' long cored slab bridge on pile bents. The area is disturbed w/ residential roads
and utility easements.
3b. List the total estimated acreage of all existing wetlands on the property:
Wetland B) : (actually less than this since only a small portion of the wetland falls within the project study area)
63ftL x32ftW= 2,016sq.ft
(2,016) sq. ft / (43,650) sq. ft =
0.05 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
381 linear feet (perennial)
3d. Explain the purpose of the proposed project:
To replace a structurally deficient bridge.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project involves replacing a 161-foot bridge with a 190-foot, 4-span bridge on the existing alignment with an off-site
detour. Standard road building equipment, such as trucks, dozers, and cranes will be used.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property / ®yes ? No ? Unknown
project (including all prior phases) in the.past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
? Preliminary ®Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: EcoScience Corporation
(Heather Jean Saunders)
Name (if known): Steve Lund Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
October 22, 2007
5. Project History
5a. Have permits or certifications been requested or obtained for ? Yes ® No ? Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
C. Proposed Impacts Inventory

1. Impacts Summary
la. Which sections were completed below for your project (check all that apply):
? Wetlands ® Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number- Type of impact Type of wetland Forested (Corps -404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
Site 1 ? P ? T ? Yes ? Corps
? No ? DWQ
Site 2 ? P ? T ? Yes ? Corps
? No ? DWQ
Site 3 ? P ? T ? Yes ? Corps
_ ..No---- - - :DWQ----
Site 4 ? P ? T ? Yes ? Corps
? No ? DWQ
Site 5 ? P ? T ? Yes ? Corps
? No ? DWQ
Site 6 ? P ? T ? Yes ? Corps
? No ? DWQ
.2g. Total wetland impacts X Permanent
X Temporary
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 31b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of Average Impact length
number - (PER) or jurisdiction stream (linear feet)
Permanent (P) or intermittent (Corps - 404, 10 width
Temporary (T) (INT)? DWQ-non-404, (feet)
other)
Site 1 ? P ® T Causeway Crowder's Creek ® PER
? INT ® Corps
? DWQ 40 65
Site 2 ? P ? T ? PER ? Corps
? INT ? DWQ
Site 3 ? P ? T ? PER ? Corps
? INT ? DWQ
Site 4 ? P ? T ? PER ? Corps
? INT ? DWQ
Site 5 ? P ? T ? PER ? Corps
? INT ? DWQ
Site 6 ? P ? T ? PER ? Corps
? INT ? DWQ
31h. Total stream and tributary impacts 65 Temp
3i. Comments:
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individual) list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of
impact number- waterbody Type of impact Waterbody type Area of impact (acres)
Permanent (P) or (if applicable)
Temporary T
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts X Permanent
X Temporary
4g. Comments:
5. Pond.or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5_c.___ 5d.. Se:----------
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or (acres)
number purpose of pond Excavat
Flooded Filled ed Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ? Na If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:

6. Buffer Impacts (forDWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer
impacts below. If an impacts require miti gation, then you MUST fill out Section D of this form.
6a.
? Neuse
?Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
61b. 6c. 6d. 6e. 6f. 69.
Buffer impact
number - Reason for impact Buffer Zone 1 impact Zone 2 impact
Permanent (P) or Stream name mitigation (square feet) (square feet)
Temporary (T)
B1 ?P?T ?Yes
? No
B2 ?P?T ?Yes
? No
63 ?P?T ?Yes
? No
6h. Total buffer impacts
-6i-Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
I a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed bridge is 29 feet longer than the existing bridge; the proposed bridge will be at approximately the same
grade as the existing structure; an off site detour will be used, fencing is being utilized to prevent impacts to the UT
coming into Crowder's creek from the west.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
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? ? Yes ® No
If no, explain: NCDOT does not propose mitigation due to
Crowder's Creek is not an ORW, HOW or WS watershed.
The 65 linear of temporary impacts are minimal impacts and
not considered a "loss of waters".
-2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c. If yes, which mitigation option will be used for this
project? ? Mitigation bank

El Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: not applicable
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
E. Stormwater Management and Diffuse Flow Plan (required.by DWQ)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ? No
Comments: if yes, see attached permit drawings.
2. Stormwater'Mana ementPlan
2a. What is the overall percent imperviousness of this project? N/A
2b. Does this project require a Stormwater Management Plan? ® Yes ? No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, na rrative description of the plan:
See attached permit drawings.
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? not applicable
? Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
4a. Which of the following state-implemented stormwater management programs apply ? HOW
(check all that apply): ? ORW
? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ® Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ® Yes ? No
4 11,
10
F. Supplementary Information
1. Environmental Documentation (DWQ' Requirement)
la . Does the project involve an expenditure of public (federal/state/local) funds or the ® Yes ? No
use of public (federal/state) land?
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 ® Yes ? No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered 'yes' to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ® Yes ? No
Comments:
2. Violations (DWQ' Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC_2B .0200)?__
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. ff you answered 'yes' to one or both of the above questions, provide an explanation of the violation(s):
.3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes
additional development, which could impact nearby downstream water quality? ® No
3b. If you answered 'yes' to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discha rge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
not applicable
11
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes No
®
habitat?
5b. Have you checked with the USFW S concerning Endangered Species Act
®Yes ? No
impacts?
?
Raleigh
Sc. If yes, indicate the USFW S Field Office you have contacted.
® Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
http://www.fws.gov/nc-es/es/countyfr.html ; Field investigations within the project study area were conducted by NCDOT
staff resulting in biological conclusions of No Effect (No Habitat Present) for the Bog turtle and No Effect (Habitat Present)
for Schweinitz's Sunflower for Gaston County.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated.as_essential -fish habitat?_. . ? Yes ® No -
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NMFS County Index
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
®No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
71b. What data sources did you use to determine whether your site would impact historic or archeological resources?
NEPA Documentation
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ® No
8b. If yes, explain how project meets.FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA Maps

Dr. Gregory J. Thome, Ph D T Z 7 ?l
'
Applicant/Agent
s Printed Name Appl anUAg nt's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
12
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2006-32951-318 County: Gaston U.S.G.S. Quad: Gastonia South
NOTIFICATION OF JURISDICTIONAL
Property Owner/Agent: Gregory J. Thorpe, Director D
Address: Project Development and Environmental Analysis Branch
1548 Mail Service Center, Raleigh, NC 27699-1548 0
North Carolina Department of Transportation Property description: 0 2007
LOFFICEOF u v L4
Telephone No.: 919-733-3141
AL ENVIRO NMENT
Size (acres) 1approx. Nearest Town Gastonia
Nearest Waterway Crowder's Creek River Basin Catawba
USGS HUC 03050101 Coordinates N35.1953 W81.2231
Location description Bridge No. 49 on SR 1103 south of Gastonia, TIP B-4517
Indicate Which of the Following Apply:
Based on preliminary information, there may be wetlands on the above described property. We strongly suggest you have
this property inspected to determine the extent of Department of the Army (DA) jurisdiction. To be considered fmal,-a__
----- -- - -jurisdictional determHation must be verified by the Corps. This preliminary determination is not an appealable action
under the Regulatory Program Administrative Appeal Process ( Reference 33 CFR Part 331).
There are Navigable Waters of the United States within the above described property 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.
X There are wetlands and surface waters on the above described property 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.
We strongly suggest you have the wetlands on your property delineated. Due to the size of your property and/or our
present workload, the Corps may not be able to accomplish this wetland delineation in a timely manner. For a more timely
delineation, you may wish to obtain a consultant. To be considered final, any delineation must be verified by the Corps.
The wetland on your property have been delineated and the delineation has been verified by the Corps. We strongly
suggest you have this delineation surveyed. Upon completion, this survey should be reviewed and verified by the Corps.
Once verified, this survey will provide an accurate depiction of all areas subject to CWA jurisdiction on your property
which, provided there is no change in the law or our published regulations, may be relied upon for a period not to exceed
five years.
X The wetlands and surface waters have been delineated and surveyed and are accurately depicted on the GPS plat
provided by EcoScience Corporation and dated 13 March 2006. 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.
There are no waters of the U.S., to include wetlands, present on the above described property which are subject to the
permit requirements of Section 404 of the Clean Water Act (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.
The property is located in one of the 20 Coastal Counties subject to regulation under the Coastal Area Management Act
(CAMA). You should contact the Division of Coastal Management in Washington, NC, at [phone] to determine
their requirements.
Page 1 of 2
Action ID:
SAW-2006-32951-318
Placement of dredged or fill material within waters of the US and/or wetlands without a Department of the Army permit may
I constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). If you have any questions regarding this
determination and/or the Corps regulatory program, please contact Steven Lund at 828-271-7980.
Basis For Determination: Crowder's Creek is a Traditionally Navigable Water that exhibits a distinct ordinary high water mark
and flows directly to the Catawba River at Lake Wylie which is a navigable water. Delineated wetlands are adjacent and
subject to the regular and unimpeded exchange of water flow with Crowder's Creek, are dominated by hydrophytic vegetation
and exhibit wetland hydrology and hydric soil.
Remarks: Consultant's report dated 13 March, 2006 identifies 2 wetlands (#1 and #2), Crowder's Creek and 2 unnamed
tributaries in the project area consisting of an approximate 1200-foot long by 400-foot wide corridor centered on the existing
bridge site.
Corps Regulatory Official: Steven W. Lund, Project Manager, Asheville Regulatory Field Office
Date: October 22, 2007 Expiration Date: October 22, 2012
Corps Regulatory Official (Initial):
FOR OFFICE USE ONLY:
--- - ---^• - A plat or sketch of the property arid -the wetland data form must be attached to the file copy -of.this . form.
-• A copy of the "Notification Of Administrative Appeal Options And Process And Request For Appeal" form must be
transmitted with the property owner/agent copy of this form.
• If the property contains isolated wetlands/waters, please indicate in "Remarks" section and attach the
"Isolated Determination Information Sheet" to the file copy of this form.
Copy Furnished: Ms. Heather Jean Saunders, EcoScience Corporation, 1101 Haynes Street, Suite 101, Raleigh, NC
27604
Page 2 of 2
'The term "adjacent" means bordering, contiguous, or neighboring. Wetlands separated from other waters of the U.S. by man-made dikes or barriers, natural
n river berms, beach dunes, and the like are also adjacent.
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Applicant: NC Dept. of Transportation File Number: 2006-32951-318 Date: 22 Oct 2007
Attached is: See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter of A
permission)
PROFFERED PERMIT (Standard Permit or Letter of permission) B
PERMIT DENIAL C
X APPROVED JURISDICTIONAL DETERMINATION D
PRELIMINARY JURISDICTIONAL DETERMINATION E
SECTIONT
aTheafollowmg tdentLfies your rights and options regari mgia dm plstratrve appeal of the above
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decision Ad2lrtronal information"'may be>found at http
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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 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.
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 division 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.
'T . ?S t-t? iiE i ?.t .qUq zk ?,
=A q l,m' tau"`4a a F
y i',v Pb.Y^i' (" ?« t:ir?v
e
.
SECTION
.II"? REQiJEST±F
OR=APPEAE,or
0139ECTI0NS.T@ AN;INITIALAPROFFEREDgPERIvIIT
.
.
,
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.
WOINPOPGON,TACT FORiQUESTIONS ORJNF ORMATJON

If you have questions regarding this decision "
If you only have questions regarding the appeal process you
and/or the appeal process you may contact: may also contact:
Mr. Steven W. Lund, Regulatory Project Manager Mr. Michael F. Bell, Administrative Appeal Review Officer
CESAW-RG-A CESAD-ET-CO-R
Asheville Regulatory Field Office U.S. Army Corps of Engineers, South Atlantic Division
151 Patton Avenue, Room 208 60 Forsyth Street, Room 9M15
Asheville, North Carolina 28801-5006 Atlanta, Georgia 30303-8801
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:
Signature of appellant or agent.
DIVISION ENGINEER:
Commander
U.S. Army Engineer Division, South Atlantic
60 Forsyth Street, Room 9M15
Atlanta, Georgia 30303-3490
Peffm wary
Sheet & Jtt>

2009
JUN 2 9 p I - ",
OFF1CEOf NA?NMENT

OWNERS NAME ADDRESS
(D Lindley. William B. 702 W. Second Ave.
Gastonia, NC 28052
O Boyd. C.F. Heirs 15077 W. Belmont Dr.
Casa Grande, AZ 85294
O3 Stove, Jr_ Jasper Carl 148 Jasper's Troll
Gastonia, NC 28052

PROPERTY OWNER
NAME AVID ADDRESS
B-4517
%CDOT
DIVISION OF HIGHWAYS
GASTON COUNTY
PROJECT: 33741JJ (B-4.517)
BRIDGE NO.49 ON
SR 1103 (CROIVDERS CREEK RD)
OVER CROWDERS CREEK
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