19970550 Ver 2_401 Application_20100915

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PAN LE
ENVUR ONME :NTAL., INC.
Land Planning Permitting • Environmental Consulting • Construction Management • Expert Testimony
LETTER OF TRANSMITTAL
Date: (> It C1
Name:
Company Name: (f.' Dw Q q0 t / W47_ 4wtAUV..%-t'
From: L tl Z e;_ °' RE: p6 m :'" r^_A_ 7?;r 46W4 P?4 104
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WE ARE SENDING YOU: SEI #:
K Attached Under Separate Cover via L<V
Shop Drawings Specifications
Letters Change Order
Reports Computer Disk
COPIES DATE DESCRIPTION

13 ?
THESE ARE TRANSMITTED as checked below:
For Approval Approved as Submitted Resubmit
For Your Use Approvers as Noted Submit
Copies for Approval
Copies for Distribution
As Requested Return for Corrections Return Corrected Prints
For Review & Comment FOR BIDS DUE Other
SIGNED:

Road Raleigh, N.C. 27609 tel [phone] fax [phone]
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Samples
3961-8 Market Street Wilmington, N.C. 28403 tel [phone] fax [phone]-SPANGLER www.sp ng, y snantal.corn
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the Corps: ?X Section 404 Permit ? Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 29 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ?X 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
le. Is this notification solely for the record
because written approval is not required? For the record only for DWQ
401 Certification:
? Yes ? No For the record only for Corps Permit:

? Yes ?X 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.
?X Yes ? No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ?X No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ?X No
2. Project Information
2a. Name of project: Harris Place Phase IV lots 13,14,15,16
2b. County: Cumberland
_-
2c. Nearest municipality / town: Fayetteville
2d. Subdivision name: Seventy-First ,
2e. NCDOT only, T.I.P. or state project no: ti . E) c
3. Owner Information
DEhR • MATER GUfil.{TY
3a. Name(s) on Recorded Deed: King Model Homes Construction Co., Inc. WETW AN " . "
3b. Deed Book and Page No. 4603 848
3c. Responsible Party (for LLC if
applicable): King Model Homes Construction Co., Inc.
3d. Street address: 143 N. Reilly Rd.
3e. City, state, zip: Fayetteville, NC 28303
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 10
PCN Form - Version 1.4 January 2009
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name: SAME AS OWNER
4c. Business name (if applicable):
4d. Street address:
4e. City, state, zip: ""
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: Jim Spangler
5b. Business name
(if applicable): Spangler Environmental, Inc.
5c. Street address: 4338 Bland Road
5d. City, state, zip: Raleigh, NC 27609
5e. Telephone no.: 919 875 4288
5f. Fax no.: 919 875 4287
5g. Email address: [e-mail]
Page 2 of 10
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 9477657964, 9477658932, 9477659805, 9477659893
1 b. Site coordinates (in decimal degrees): Latitude: 35.033086 Longitude: 79.042481
1c. Property size: 1.53 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Lake William
2b. Water Quality Classification of nearest receiving water: Class-C
2c. River basin: Cape Fear
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:
Lots 13,14,15 & 16 are undeveloped plated lots containing wetlands in a developed single family housing development.
3b. List the total estimated acreage of all existing wetlands on the property: 0.968
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 0
3d. Explain the purpose of the proposed project:
These lots are going to be used to place additional single family homes
3e. Describe the overall project in detail, including the type of equipment to be used:
The project consists of 5 undeveloped lots remaining in a single family housing development that need fill to be placed on them to allow for the propose
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past? ?X Yes ? No ? Unknown

Comments:
4b. If the Corps made the jurisdictional determination, what type
of determination was made? Preliminary ? Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Chip Jackson Agency/Consultant Company: Spangler Environmental, Inc.
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
See Attached JD (5-28-10)
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? ? Yes ?X No ? Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ? Yes Q No
6b. If yes, explain.
Page 3 of 10
PCN Form - Version 1.4 January 2009
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
0 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.
Wetland impact
number
Permanent (P) or
Temporary 2b.
Type of impact 2c.
Type of wetland 2d.
Forested 2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other) 2f.
Area of
impact
(acres)
W1 P Fill Cleared Scrub Yes Corps 0.02
W2 P Fill Cleared Scrub Yes Corps 0.121
W3 P Fill Cleared Scrub Yes Corps 0.19
W4 P Fill Cleared Scrub Yes Corps 0.06
W5 Choose one Choose one Yes/No -
W6 - Choose one Choose one Yes/No -
2g. Total Wetland Impacts: 0.39
2h. Comments:
W1- Lot # 16,W2- Lot # 15,W3- Lot* 14, W4- Lot # 13 Final impacts will be further minimized based on allowable driveway slope (SEE Exhibits).
MAX IMPACT = 0.39 acres
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.
Stream impact
number
Permanent (P) or
Temporary (17 3b.
Type of impact 3c.
Stream name 3d.
Perennial (PER) or
intermittent (INT)? 3e.
Type of
jurisdiction 3f.
Average
stream
width
(feet) 3g.
Impact
length
(linear
feet)
S1 - Choose one _
S2 - Choose one - -
S3 - Choose one
S4 - Choose one
S5 - Choose one - _
S6 - Choose one -
3h. Total stream and tributary impacts 0
3i. Comments:
Page 4 of 10
PCN Form - Version 1.4 January 2009
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.
Open water
impact number
Permanent (P) or
Temporary 4b.
Name of waterbody
(if applicable) 4c.

Type of impact 4d.

Waterbody
type 4e.

Area of impact (acres)
01 - Choose one Choose
02 - Choose one Choose
03 - Choose one Choose
04 - Choose one Choose
4f. Total open water impacts 0
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a.
Pond ID number 5b.
Proposed use or
purpose of pond 5c.
Wetland Impacts (acres) 5d.
Stream Impacts (feet) 5e.
Upland
(acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 Choose one
P2 Choose one
5f. Total: 0
5g. Comments:
5h. Is a dam high hazard permit required? ? Yes ?X No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
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 mitigation, then you MUST fill out Section D of this form.
6a. Project is in which protected basin? ? Neuse ? Tar-Pamlico ? Catawba ? Randleman ? Other:
6b.
Buffer Impact
number -
Permanent (P) or
Temporary 6c.
Reason for impact 6d.
Stream name 6e.
Buffer
mitigation
required? 6f.
Zone 1
impact
(square
feet 6g.
Zone 2
impact
(square
feet
61 Yes/No
B2 Yes/No
B3 Yes/No
B4 Yes/No
B5 Yes/No
B6 - Yes/No
6h. Total Buffer Impacts: 0 0
6i. Comments:
Page 5 of 10
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The typical footprint of the proposed single family home was used to place the proposed structure on the lot as close to the road as possible. This
minimizes the amount of fill/impact in the wetland areas , mandatory setbacks from the road and property boundaries dictates the required setback
from the road
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Earth moving equipment referenced above will only operate in area necessary for the construction of the building pad as well as fill and other
construction materials. Sediment and erosion control measures will be in place in accordance with the approved S& EC plans, which include lot
specific S & EC measures (NCDENR DLR-LQS 3-10-09)
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? ?X Yes ? No
2b. If yes, mitigation is required by (check all that apply): ?X DWQ ? Corps

2c. If yes, which mitigation option will be used for this

pro
project? ? Mitigation bank

X? Payment to in-lieu fee program

? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: N/A

3b. Credits Purchased (attach receipt and letter) Type: Choose one
Type: Choose one
Type: Choose one Quantity:
Quantity:
Quantity:
3c. Comments:
4. Complete if Makin a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: 0 linear feet
4c. If using stream mitigation, stream temperature: Choose one
4d. Buffer mitigation requested (DWQ only): 0 square feet
4e. Riparian wetland mitigation requested: 0 acres
4f. Non-riparian wetland mitigation requested: 0.5 acres
4g. Coastal (tidal) wetland mitigation requested: 0 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.
Page 6 of 10
PCN Form - Version 1.4 January 2009
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:
Page 7 of 10
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ?X No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ?X No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 22.4%
2b. Does this project require a Stormwater Management Plan? ? Yes ?X No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
Because it is less than the required Impervious Surface Criteria
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan? City of Fayetteville
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? City of Fayetteville
?X Phase II
? NSW
3b. Which of the following locally-implemented stormwater management programs ? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ?Yes ?X No
attached?
4. DWQ Stormwater Program Review
?Coastal counties
? HQW
4a. Which of the following state-implemented stormwater management programs apply ?ORW
(check all that apply):
?Session Law 2006-246
?Other:
4b. Has the approved Stormwater Management Plan with proof of approval been ? Yes X? No
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ?X Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ZX Yes ? No
Page 8 of 10
PCN Form - Version 1.4 January 2009
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la. Does the project involve an expenditure of public (federal/state/local) funds or the ? Yes ?X No
use of public (federal/state) land?
1 b. 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
? Yes
? No
letter.)
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 ?X No
or Riparian Buffer Rules (15A NCAC 2B.0200)?
2b. Is this an after-the-fact permit application? ? Yes X? No
2c. If 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 ?X No
additional development, which could impact nearby downstream water quality?
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 discharge) of wastewater generated from
the proposed pro?'ect, or available capacity of the subject facility.
Th
i
l
f
il
h
ill b
i
i
i
d
t
t
e propose
ng
am
y
omes w
n
s
e
e t
ed
o the san
tary sewer infrastruc
ure that already exist. Utilities are already stubb ed to Lots.
Page 9 of 10
PCN Form - Version 1.4 January 2009
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 USFWS concerning Endangered Species Act Yes © No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted. -
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
N/A - developed subdivision, Lots cleared
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes X? No
6b. What data sources did you use to determine whether your site would 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 Yes 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?
N/A - developed subdivision, Lots cleared
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
Plat Map approved by City of Fayetteville & approved S & EC plan Applicant/Agent's Printed Name

Yes
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
© No
11D (e
/` Date
Page 10 of 10
KING A40DEL FIO1VNlES BIALDING CO.
143 N Reilly Road
Fayetteville, NC 28303
PhDac. 910-967-9116
Fax: [phone]
February 10, 2410
To Whom It May Concern:
The letter serves to inform you that King Mo&l Homes located at 143 N Reilly Road,
Fayetteville, NC 28303, hereby authorizes Spangler Enviro ental, inc. to act as our technical
agent for the purposes ol'environmental issues, inch dirsg wetland and stream identiflaWon,
permitting;, mitigation planning and regulatory agcmcy coordination at the property known, as
Harris Place Lou 12, 13, 14,15 and 16, and as shown in Cumberland County records as 9477-
65-7964, 9477-65-8932, 9477-65-9945, 9477-65-9843, 9477-75-0896. All site visits Fry
regulatory personnel must be coordinated in advance with our agent, Spangler Environmental,
Inc. This letter super des all previous Agent-Mated correspondence.
The rol lowing; contact persons should be copied on all correspondence:
Property Owner (or Legal Agcat/Represertative):
Clyde T. Wood, Jr.
Ring Model Homes E1d. Co.
143 N Reilly Rd
Fayeneville, NC 28303
91€1-867-8116
T"hnical Agent:
Chip Jackson
Spangler Environmental, Inc
3961-E 1 ket Street
WiL ington, NC 28411
Office - [phone]
Faux -(91%343-8351
sin rer
l
Clyde T. Wood, it
President:
J.S. W CORPS OIL ENGMERS.
WILMINGTON DISTRICT
Property description
Size (acres) $ Nearest Town EUISMdk
Nearest Waterway I AI River Basin Qgj ftag
USCS HUUC 03 Coordinates A M&AU { W -7; I147
Location description The nr221rty 1 . r r
in Fa et eville C mb-e n ,2._ 9477-6-9-9905. 94714SAWA and

111dicate W
A. Preliminary Determination
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 De t of the Army (DA) jurisdiction, To be considered final, a
jurisdictional. determination must be verified by the Corps. This prelim" determination is not an appealable action
under the k gulatary Plr*-atn Adtiitisn rani ie Appehl ocess ( Wereatce 33 C Part 331}.
B. Apprcived tk4jA tati n
_ There 'are Navi?le Waters,of'the United States.withiu the &Wye 40scribed.Property subject to the ,permit a?gtaire umts of
Section} i Q of fine lovers and Harbors. Act apd Section 404 of the.tlsan utter Act. Unless there is a 'kAn a 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 `t'here are wetlands an the above described property subject to the permit requirements of Section 404 of tha .Clean. Water
Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations, this detsrtatit ion 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
nrc'F0??I ?vnrkler??i, the C'Orpa may not be ahl trt aixnplish this wetLtl.61€Iineatioan in tidy iµ,ar tr4?r? ti"Ik,1y
delineatioa, you inay wish to obtain a consultant. To be corns ' final, aany delineation mast be vc?ri ?yah$?s,
X The wetland on your property have been delineated. and the delineation has been verified by the Carps. We strongly
suggest you, have this delineations 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.
The wetlands have been delineated and surveyed and.are.accurately depicted on the Z at. igispci by,tha. (Corns..
Regulatory Offikial, identified below on Unless' there is a chars in ho law or our. publas d t a.
determination hsay 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
pulslished regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
Page 1 of 2
Act o ID: m o4 Og
The property is located in one of the 20 Coastal Counties seat to replation tender the Coastal Area MaWOMMU Act
(LAMA). You should comet the Division of Coastal in Washington, NC, at [phone] to def.
their requirements.
Placement of dredged or fill material within waters of the US aa&or wedsn& without a De
,partmaetnt of the Amity petit may
constitute a violation of Section 301 of the Clean. WSW Act (33 USC $1311). If you have any questions raggr&g this
detonn ation and/or the Corps regulatory program, please contact ffa1 at 1 -4,...17..
C. Basis For Determination
Wetlan _w ar d zt 7
U Lem
D. Remarks
E. Attention USDA Program Participants
This de'iIoation/determination has been conducted to identify the limits of corps, Clean Water Act jurisdiction for the
p aru ? u ; ar Y ° . 4 eel s rest The defiaeatiota/dete oa say t be valid for the w 1. l c rva a
provisions of t ae Fc od Security Act of 1985- If you or your team are USDA Program putic'. , or a? ` top ici?at?an
in. USDA programs, you should request a certified wetland determination frorn the local office of the Nau Lases
Conservation Service, prior to starting work.
F. Appeals Inforrnatiart ('t'his informatio ; applies only to approved jurisdictional determinations as tadicated In
B. above)
This correspondence constitutes an approved jurisdictional detemi tio.n 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
Notifwation 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.
District Engineer, Wilmington Regulatory Division
Attn: Crystal Arnschler, Proyect Manager,
Wilmington Regulatory Field Office
69 Darlington Ave
Wilmington, North. Carolina 28403
In order for an RFA to be accepted by the Corps, the Carps roust determine that it is complete, that it (Hoots the criteria for
appeal under 33 CF.R part 331.5, and that it has been, received by the District 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 ?a7MI
**It is not necessary tto submit an RF°'A tbn?m to the District Uffice
correspondence.* * 1;1
Corps Regulatory Official:
Date 05/28/2014 Expiration Date 051281 0;15
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 the Customer Satisfaction Survey located at our website at Ipi[/.par n ; ?•t W Q v l
to complete the survey online.
Date: 58I0
See Section. below
INI"T"IAL PROFFERED PERK iT (Standard Permit or Letter of
A
J LJ PRC3P`FFJ ED PERMIT (Standard Permit or Letter of r ermissionl I R
APPROVED
JURISDICTIONAL DETERMINATION
PRELIMINARY JURISDICTIONAL DETERMINATION ?-? RD 1
SEC",
ti.??41J?u
A: INITIAL PROFFERED IT: You may accept or object to the permit.
• ACCEPT; If you received a Standard Penrit, 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 paeans 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 11 of this forth and return the form to the district engineer. Your
objections trust be received try 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 array: (a) modify the
pernai t 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. Mier 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
• ACCEP'T': If you received a Standard Permit, you may sign the permit document and return it to the district engineer for rm.al
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 LEAP 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 pwoffered pa rdt (S d er ) be ear%in ?, eerae ?i ther+sira; you
ma" appQ'al the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section. II of this form
and sending, the forth to the division engineer. This farm 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 lT of this forth and sending the form to the division engineer. 't'his form roust 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 oil days of the date of
this notice, means that you accept the approved JD in its, entirety, and waive alI rights to appeal the approved :IDD..
APPEAL:. If you disagree with the approved JD, you may appeal die approved JD under the Corps of EngUieers ,A (buinistmtive
Appeal Process by completing Section II of this form and sending the form to the district engineer. This forth roust be received by
the division engineer within 60 days of the date of this notice.
E "PRELIMINARY JURISDICTIONAL DETE ATION: You do not need to respond to the Corps
regarding the preliminary JD. The Prefiminary JD is not appe"le. If you wish, you may request an approved
JD (which may be appealed), by contacting the Corps duct for further instruction. Also you may provide new
information for further consideration by the Corps to reevaluate the JD.
f
REAS£3I FOR APPEAL OR OBJEC'TI(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 NFOR1 A'TION: The appeal is limited to a review of the admimistralive reao4 the Corps
memorandum for the record of the appeal conference or meeting, and any supplemental information that
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 alread in the administrative record.
n4 ?
?
if, you
have questions regarding this decision If you only have questions regarding the appeal: press you
and/or the appeal process you may contact: may also contact:
District .Engineer, Wilmington Regulatory Division Mr. Mike Bell, Administrative Appeal Review Officer
Attn Crystal Amschler, Project Manager, CE AD-ET-CO-R
Wilmington Regulatory Field Office U.S. Army Corps of Engineers, South Atlantic Division
69 Darlington Ave 60 Forsyth Street, Room 9M15
Wilmington, North Carolina 28403 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 appear process. You
will be provided a 15 day notice of any site investigation, and will have the opportunity to pa cipek in all site

.
investigations.
Date: Telephone number:
S 1 gnature of appellant or agent.
For appeals on Initial Proffered Permits and approved Jurisdictional Determinations send dais
form to:
District Engineer, Wilmington Regulatory Division, Attn: Crystal Amschler, Prot Manager,
Wilmington Regulatory Field Office, 69 Darlington Ave, Wilmington, North Care ina 2W3
For Permit denials and Proffered Permits send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Mike Bell,
Administrative Appeal Officer, CESAD-ET-CO-F4 60 Forsyth Street, Boom 9 MI5, A ta.,
Georgia 30,303-8901
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