20240726 Ver 1__20240522_Blankenship_PCN_FINAL_20240522

Preliminary ORM Data Entry Fields for New Actions
ACTION ID #: SAW- 2022-00915
Prepare file folder ❑
1. Project Name [PCN Form A2a]: Blankenship Site
Begin Date (Date Received):
Assign Action ID Number in ORM ❑
2. Work Type: VPrivate ❑Institutional ❑ Government ❑ Commercial
3. Project Description / Purpose [PCN Form 133d and 133e]:
The CB Concord Developers, LLC is seeking authorization under NWP #29 for stream and wetland impacts associated with grading
activities necessary to construct the residential development.
4. Property Owner / Applicant [PCN Form A3 or A4]: CB Concord Developers (POC: Tim Kemper)
1905 Woodstock Rd, Suite 9250, Roswell, GA 30075; [e-mail]; (678)-576-0400
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
Chris Tinklenberg, PWS (Kimley-Horn)
6. Related Action ID Number(s) [PCN Form 135b]
7. Project Location — Coordinates, Street Address, and/or Location Description [PCN Form Blb]:
The subject property is located northeast of the North Tryon Street and Old Concord Road intersection in
Charlotte, Mecklenburg County, NC. Project Coordinates (decimal degrees): 35.2723018°,-80.7545389'
8. Project Location —Tax Parcel ID [PCN Form B 1 a] : 04907101, 04913101, 04906101, & 04903208
9. Project Location — County [PCN Form A2b]: Mecklenburg
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Charlotte
11. Project Information — Nearest Waterbody [PCN Form 132a]: Toby Creek
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form 132c]: Yadkin Pee Dee (HUC 03040105)
Authorization: Section 10 ❑ Section 404 ❑✓
Regulatory Action Type:
❑ Standard Permit
❑✓ Nationwide Permit #29
Regional General Permit #
Jurisdictional Determination Request
Section 10 and 404 ❑
::]Pre -Application Request
::]Unauthorized Activity
❑ Compliance
❑No Permit Required
Revised 20150602

Kimley»>Horn
May 22, 2024
Jennifer Lawrence
Wilmington District, Raleigh Regulatory Field Office
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
Stephanie Gross
NC DWR, 401 & Buffer Permitting Unit
512 North Salisbury Street
Raleigh, NC 27604
Re: Pre -Construction Notification (NWP #29 and Individual 401 Water Quality Certification)
Blankenship Site
Charlotte, Mecklenburg County, NC
Dear Regulatory Project Managers:
On behalf of our client, CB Concord Developers, LLC, Kimley-Horn (KH) is submitting the enclosed Section
404/401 Pre -construction Notification (PCN) for the above -referenced project for your review pursuant to
Nationwide Permit #29 and Individual 401 Water Quality Certification (WQC). The proposed project seeks to
construct a residential development with associated parking lots, sidewalks, utilities, and stormwater
drainage infrastructure. Authorization is being requested under Nationwide Permit (NWP) #29 to permanently
impact 287 linear feet (LF)/0.0216-acre of streams, which include both direct and indirect permanent impacts.
Additionally, there is a need to impact 0.043-acre of wetlands, also consisting of direct and indirect permanent
impacts, in order to facilitate the construction of the residential development. The following information is
included as part of this application submittal:
• Project Summary Sheet
• Pre -Construction Notification Form
• Agent Authorization
• Permit Figures
■ Figure 1 —Vicinity
■ Figure 2 — USGS 7.5' Topo (Derita Quadrangle)
■ Figure 3 — Mecklenburg Co. SSURGO Soils and NWI Map (ESRI Aerial Basemap)
■ Figure 4 — Existing Conditions (ESRI Aerial Basemap)
• Permit Drawings
• Approved Jurisdictional Determination
• Agency Correspondence
• Compensatory Mitigation
PROJECT BACKGROUND
CB Concord Developers, LLC is seeking authorization under NWP #29 in order to construct a residential
development on an approximately 153-acre tract located northeast of the North Tryon Street and Old
Concord Road intersection in Charlotte, Mecklenburg County, NC. The project area is currently comprised
of undeveloped forest land and a sanitary sewer easement. The project area is bound by undeveloped forest
land and residential development in all directions. The center of the project area is located at 35.2723018°,
-80.7545389°.

Kimley»>Horn
AGENCY CORRESPONDENCE
Cultural Resources
Page 2
Kimley-Horn consulted the North Carolina State Historic Preservation Office (SHPO) HPOWEB GIS
service on March 27, 2024. No documented architectural, cultural, or historic sites of significance within the
project boundary were identified. A request letter was submitted to SHPO to determine the presence of
architectural, cultural, or historic resources on March 27, 2024. At the time of this application, a response
from NCSHPO has not been received. The SHPO response will be provided upon receipt.
PROTECTED SPECIES
A review of the North Carolina Natural Heritage Program (NCNHP) database on March 27, 2024, indicated
no known occurrences of threatened or endangered species occurring within one mile of the project
boundary. There is no potentially suitable habitat within the Corps' action areas. Pedestrian surveys were
conducted by LaBella Associates in 2021 for the entire project site. No occurrences of protected species
were identified; however, concurrence of these results were not submitted and verified by USFWS.
PROPOSED IMPACTS TO JURISDICTIONAL WATERS
The proposed development seeks authorization under NWP #29 for impacts to streams and wetlands
necessary to construct the proposed residential development. The following summarizes the proposed
impacts:
• Impact A — Stream G
0 One (1) 114 Linear Feet (LF) 96-inch reinforced concrete pipe (RCP) will be installed
at the crossing of Stream G. The RCP will be buried 24 inches to promote the passage
of aquatic organisms. 20 LF of rip -rap outlet protection will be installed to reduce
discharge velocities in order to meet non -erosive design criteria. The installation of the
RCP and riprap results in 152 LF/0.017-acre of permanent impacts to Stream G.
0 40 LF/0.005-acre of temporary impacts are necessary to install an impervious dike and
pumped diversion to perform the construction activity in dry conditions.
• Impact B — Wetland H
0 0.013-acre of permanent wetland impacts to Wetland H results from grading activities
necessary to construct the proposed single-family development.
• Impact C — Wetland E
0 0.004-acre of permanent wetland impacts to Wetland E results from grading activities
necessary to construct the proposed single-family development.
• Impact D — Stream A and Wetland AB
0 58 LF/0.002-acre of permanent impacts to Stream A results from grading activities
necessary to construct the proposed single-family development.
0 77 LF/0.004-acre of permanent indirect impacts to Stream A resulting from the
proposed stormwater design which will alter the hydrologic input to Steam A.
0 0.026-acre of permanent indirect impacts to Wetland AB resulting from the proposed
stormwater design which will alter the hydrologic input to Steam A, and subsequently
Wetland AB.

Kimley)>)Horn Page
Overall, impacts associated with the proposed development will result in 0.043-acre of
permanent direct and indirect impacts to wetland waters of the US and 287 LF/0.0216-acre of
permanent direct and indirect impacts to non -wetland waters of the US.
AVOIDANCE AND MINIMIZATION
Avoidance and minimization efforts were implemented during development planning and design to the
greatest extent practicable to reduce the overall impacts on the aquatic environment while staying within
nationwide permit thresholds. The final plan demonstrates maximum avoidance and minimization efforts by
reducing the proposed impacts. The rationale to support avoidance and minimization efforts includes the
following:
• Impact 1 — Stream G
o The RCP will be buried 24 inches to promote the passage of aquatic organisms, accelerate
the re-establishment of the channel bed, and maintain the width of the stream channel.
0 8-ft headwalls with a rip -rap apron will be installed to reduce grading fill slopes and reduce
discharge velocities.
• Avoidance of the remaining 3,053 LF of streams on -site
• Avoidance of the remaining 0.231-acre of wetlands on -site.
COMPENSATORY MITIGATION
The proposed residential development does not exceed wetland and stream mitigation thresholds (0.043-ac
of wetland impacts and 287 LF/0.0216-acre of stream impacts); therefore, compensatory mitigation is not
proposed.
Please feel free to contact me at [phone] if you have any questions or if additional information is
necessary.
Sincerely,
KIMLEY-HORN AND ASSOCIATES, INC.
Chris Tinklenberg, PWS
Environmental Scientist

Kimley>>>Horn
Project Name: Blankenship Site
Project Summary Sheet
Applicant Name and Address: Tim Kemper
CB Concord Developers
1905 Woodstock Road, Suite 9250
Roswell, GA 30075
Telephone Number: [phone]
Type of Request: ® Nationwide PCN (NWP # 299 ❑ Individual Permit Application
❑ Jurisdictional Determination ❑ Other:
Included Attachments: ® Project Plans ® USGS Map ® NRCS Soil Survey
® Agent Authorization ❑ Delineation Sketch ® Delineation Survey
❑ Data Forms (Up & Wet) ❑ NCDWR Stream Forms ❑ USACE Stream Forms
❑ NCDMS Confirmation ® Aerial Photo ❑ Site Photos
® Agency Correspondence ❑ Other: ❑ Other:
Check if applicable: ❑ CAMA County ❑ Trout County ❑ Isolated Waters
❑ Section 7, ESA ❑ Section 106, NHPA ❑ EFH
❑ Mitigation Proposed (❑ NC EEP ❑ On -Site ❑ Off -Site ❑ Other)
County: Mecklenburg Nearest City/Town: Charlotte
Waterway: Toby Creek River Basin: Yadkin Pee Dee
H.U.C.: 03040105 USGS Quad Name: Derita
Property Size (acres): 153 Approx. Size of Jurisdiction on Site (acres): 0.274-ac / 3,340 LF
Site Coordinates (in decimal degrees): 35.2723018° °N-80.75453890 °W
Project Location: The subject property is located northeast of the North Tryon Street and Old Concord Road intersection
in Charlotte, Mecklenburg County, NC.
Site Description: The subject property is comprised of undeveloped forestland, Toby Creek, and a transmission easement.
The site is bound by single-family residences and undeveloped forestland in all directions.
Impact Summary (if applicable): Authorization is requested under NWP 29 to impact 0.043-acre of wetland and 287
LF/0.0216-acre of stream associated with activities necessary to construct the proposed residential development.
Stream Channel
Wetland
Intermittent and/or Unimportant Aquatic
Perennial and/or Important
(acres)
NWP
Function
Aquatic Function
#
PerInd
Perm.
Perm.
Temp.
Perm. Direct
Temp.
Perm.
Temp.
re.
Direct
Indirect
if
ac
if
ac
if
ac
if
ac
if
Ac
29
-
0.017
0.026
40
0.005
210
0.019
77
0.0026
-
-
-
-
Total
0.017
0.026
40
0.005
210
0.019
77
0.0026
Total Permanent (Loss) Impact to Non -Wetland
287 LF/0.0216-acre
Waters of the U.S. lf/acres
Total Permanent (Loss) Impact to Wetland
Waters of the U.S.(acres)0.043-acre
Kimley-Horn Contact: Chris Tinklenberg, PWS Direct Number: [phone]
Email: chris.tinklenbergkkimley-hom.com

x STAi
�Wsao. na\ �D
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NORTHCAROLINA
Environmental Quality
Water Resources
Office Use Only
Corps Action I D no. [Click to enter.]
DWR project no. Click enter.]
Site Coordinates:
Date received: [Click to enter.]
Date received: [Click to enter.]
Latitude (DD.DDDDDD): 35.2723018'
Longitude (DD.DDDDDD): 80.7545389'
Form Version 4.3, 1210412023
Pre -Construction Notification (PCN) Form
(Ver. 4.2, 1210412023)
For Nationwide Permits and Regional General Permits and corresponding Water Quality Certifications
Please note: fields marked with a red asterisk are required. The form is not considered complete until all
mandatory questions are answered.
The PCN help document may be found at this link:
https://edocs.deq. nc.qov/WaterResources/DocView.aspx?dbid =0&id=2196924&cr=1
Page 1 of 22 PCN Form Version 4.3- December 4, 2023

A. Processing Information
County (counties) where project is located: *
Mecklenburg Additional (if needed).
Is this an ARPA project? *
❑ Yes ❑x No
If yes, ARPA project number:
* The project number can be found on the "Letter of Intent to Fund"
(LOIF) or "Offer and Acceptance Letter". If you are unable to locate
Click or tap here to enter text.
your DWI ARPA Funding Project Number, please contact Corey
Basinger at core y.basinger(a)ncdenr.gov for further assistance.
Is this a NCDMS project? *
(Click yes only if NCDMS is the applicant or co-
❑ Yes ❑x No
applicant)
Is this a public transportation project?
(Publicly funded municipal, state, or federal road, rail,
❑ Yes ❑x No
or airport project)
Is this a NCDOT project? *
❑ Yes ❑x No
If yes, NCDOT TIP or state project number:
Click to enter.
If yes, NCDOT WBS number: *
Click to enter
❑x Section 404 Permit (wetlands, streams, waters,
Clean Water Act)
1 a. Type(s) of approval sought from the Corps: *
❑ Section 10 Permit (navigable waters, tidal
waters, Rivers and Harbors Act)
Has this PCN previously been submitted? *
❑ Yes ❑x No
Please provide the date of the previous submission. *
Click to enter a date.
❑x Nationwide Permit (NWP)
1 b. What type(s) of permit(s) do you wish to seek
*
El Regional General Permit (RGP)
authorization?
❑ Standard (IP)
This form may be used to initiate the standard/ individual permit process with the USACE. Please contact your Corps
representative concerning submittals for standard permits. All required items can be included as attachments and
submitted with this form.
1 C. Has the NWP or GP number been verified by the Corps? *
® Yes ❑ No
NWP number(s) (list all numbers ):
29
RGP number(s) (list all numbers ):
Click to enter.
Are you a federal applicant?
❑ Yes ❑ No
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act
Click to enter text.
1 d. Type(s) of approval sought from DWR (check all that apply):
❑ 401 Water Quality Certification — Regular
❑ 401 Water Quality Certification— Express
❑ Non-404 Jurisdictional General Permit
❑ Riparian Buffer Authorization
❑x Individual 401 Water Quality Certification
Is this a courtesy copy notification
❑ Yes ❑x No
1 e. Is this notification solely for the record because written approval is not required? *
Page 2 of 22 PCN Form Version 4.3- December 4, 2023

For the record only for DWR 401 Certification: *
❑ Yes
❑x No
For the record only for Corps Permit: *
❑ Yes
❑x No
1f.
Is this an after -the -fact permit/certification application? *
❑ Yes
❑x No
1g.
Is payment into a mitigation bank or in -lieu fee program proposed for
❑ Yes
❑x No
mitigation of impacts?
If yes, attach the acceptance letter from mitigation bank or in -lieu fee program.
1 h.
Is the project located in any of NC's twenty coastal counties? *
❑ Yes
❑x No
1 i.
Is the project located within an NC DCM Area of Environmental
❑ Yes
❑x No ❑ Unknown
Concern (AEC)? *
1j.
Is the project located in a designated trout watershed? *
❑ Yes
❑x No
If yes, you must attach a copy of the approval letter from the appropriate
Wildlife Resource Commission Office.
Trout information may be found at this link: http://www.saw.usace.army.mil/Missions/Requlatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 3 of 22 PCN Form Version 4.3- December 4, 2023

B. Applicant Information
1 a.
Who is the primary contact?
Chris Tinklenberg
1 b.
Primary Contact Email:
[e-mail]
1 c.
Primary Contact Phone: (###)###-####
[phone]
1 d.
Who is applying for the permit/certification? (check
all that apply)
❑ Owner ❑x Applicant (other than owner)
1 e.
Is there an agent/consultant for this project?
® Yes ❑ No
2.
Landowner Information
2a.
Name(s) on Recorded Deed:
TRUST BLANKENSHIP TIMBER GST 2,
MALCOLM B BLANKENSHIP JR
2b.
Deed Book and Page No.:
38408/924, 27255/451
2c.
Contact Person (for corporations):
UICK LU 15-11L
2d.
Address
Street Address:
2250 Godbey Road
Address line 2:
Click to ent4
City:
Woodleaf
State/ Province/ Region:
NC
Postal/ Zip Code:
27054
Country:
USA
2e.
Telephone Number: (###)###-####
Click to enter.
2f.
Fax Number: (###)###-####
N/A
2g.
Email Address:
Click to enter.
3.
Applicant Information (if different from owner)
3a.
Name:
Tim Kemper
3b.
Business Name (if applicable):
CB Concord Developers, LLC
3c.
Address:
Street Address:
1905 Woodstock Road
Address line 2:
Suite 9250
City:
Roswell
State/ Province/ Region:
GA
Postal/ Zip Code:
30075
Country
USA
3d.
Telephone Number: (###)###-####
[phone]
3e
Fax Number: (###)###-####
N/A
Page 4 of 22 PCN Form Version 4.3- December 4, 2023

3f. Email Address: [e-mail]
4.
Agent/ Consultant (if applicable)
4a.
Name:
Chris Tinklenberg
4b.
Business Name:
Kimley-Horn and Associates, Inc.
4c.
Address:
Street Address:
580 Kingsley Park Drive
Address line 2:
Suite 125
City:
Fort Mill
State/ Province/ Region:
SC
Postal/ Zip Code:
29715
Country:
USA
4d.
Telephone Number: * (###)###-####
[phone]
4e
Fax Number: (###)###-####
N/A
4f.
Email Address:
[e-mail]
Agent Authorization Letter:
Attach a completed/signed agent authorization form or letter. A sample form may be found at this link:
https://www.saw. usace.army. mil/Missions/Reg ulatory- Perm it- Program/Permits/2017-Nationwide-Permits/Pre-
construction-Notification/
Page 5 of 22 PCN Form Version 4.3- December 4, 2023

C. Project Information and Prior Project History
1. Project Information
1 a. Name of project: *
Blankenship Site
1 b. Subdivision name (if appropriate):
Click to enter.
1 c. Nearest municipality/town: *
Charlotte
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
04907101, 04913101, 04906101, & 04903208
2b.
Property size (in acres):
153
2c.
Project Address:
Street Address:
6607 Old Concord Road
Address line 2:
Click to enter.
City:
Charlotte
State/ Province/ Region:
NC
Postal/ Zip Code:
28213
Country:
USA
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point): *
Latitude (DD.DDDDDD): * 35.2723018°
Longitude (-DD.DDDDDD): *-80.7545389°
3. Surface Waters
3a. Name of nearest body of water to proposed project: *
Toby Creek
3b. Water Resources Classification of nearest receiving
C
water: *
The Surface Water Classification map may be found at this link:
htti)s://ncdenr.mai)s.arcgis.com/apes/webappviewer/index.html?id=6el 25ad7628f494694e259c80dd64265
Yadkin-PeeDee
3c. In what river basin(s) is your project located?
Choose additional (if needed)
3d. Please provide the 12-digit HUC in which the project is
030401050103
located:
The Find Your HUC map may be found at this link:
htti)s://ncdenr.maps.arcqis.com/apes/Publiclnformation/index.html?appid=ad3a85aOc6d644aOb97cdO69db238ac3
Page 6 of 22 PCN Form Version 4.3- December 4, 2023

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 proposed project is located on an approximately 153-acre tract located northeast of the North Tryon Street
and Old Concord Road intersection in Charlotte, Mecklenburg County, NC. The project area is currently
comprised of undeveloped forest land, Toby Creek, and a sanitary sewer easement. The project area is bound
by undeveloped forest land and residential development in all directions.
4b. Have Corps permits or DWR certifications been obtained for this
❑ Yes ❑x No ❑ Unknown
project (including all prior phases) in the past? *
If yes, please give the DWR Certification number and/or Corps
[Click to enter.]
Action ID (ex. SAW-0000-00000):
jClick to enter.]
Attach any pertinent project history documentation
4b2. Is any portion of the work already complete? *
❑ Yes ❑x No
If yes, describe the completed work.
Click to enter text.
4c. List of other certifications or approvals/denials received from other federal, state or local agencies for work
described in this application not related to the 404 or 401.
Click to enter text.
4d. Attach an 8'h x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e. Attach an 8'h x 11" excerpt from the most recent version of the published County NRCS Soil Survey map
depicting the project site.
4f. List the total estimated acreage of all existing wetlands on the
0.274 acres
property:
4g. List the total estimated linear feet of all existing streams (intermittent
3,340 linear feet
and perennial) on the property:
4g1. List the total estimated acreage of all existing open waters on the
N/A acres
property:
4h. Explain the purpose of the proposed project:
The proposed project seeks to construct a residential development with associated parking lots, sidewalks, utilities,
and stormwater drainage infrastructure. Authorization is being requested under Nationwide Permit (NWP) #29 to
permanently impact 287 linear feet (LF)/0.0216-acre of streams, which include both direct and indirect permanent
impacts. Additionally, there is a need to impact 0.043-acre of wetlands, also consisting of direct and indirect permanent
impacts, in order to facilitate the construction of the residential development.
4i. Describe the overall project in detail, including the type of equipment to be used:
The overall project consists of the construction of a residential development with associated parking lots,
sidewalks, utilities, and stormwater drainage infrastructure. General construction equipment includes, but is not
limited to, bulldozers, excavators, front-end loaders, etc. will be used for construction purposes.
4j. Attach project drawings/site diagrams/depictions of impact areas for the proposed project.
4k. Will this activity involve dredging in wetlands or waters? *
❑ Yes ❑x No
If yes, describe the type of dredging, the composition of the dredged material, and the locations of disposal area.
Click to enter text.
Page 7 of 22 PCN Form Version 4.3- December 4, 2023

5.
Jurisdictional Determinations
5a.
Have the wetlands or streams been delineated on
the property or in
® Yes ❑ No ❑ Unknown
proposed impact areas?
Comments:
.:lick to enter text.
5b.
If the Corps made a jurisdictional determination,
❑ Preliminary ❑x Approved ❑ Emailed concurrence
what type of determination was made?
❑ Not Verified ❑ Unknown ❑ n/a
Corps AID number (ex. SAW-0000-00000):
SAW-2022-00915
Name (if known): Click to enter
5c.
If 5a is yes, who delineated the jurisdictional
Agency/Consultant Company: LaBella Associates
areas?
Other: Click to enter
5d.
List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
7/15/2022.
5d1.
Attach jurisdictional determinations.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ❑x No
6b. If yes, explain.
Click to enter.
Are any other NWP(s), regional general permit(s), or individual permit(s) used, or intended to be used, to
authorize any part of the proposed project or related activity? This includes other separate and distant crossings
for linear projects that require Department of the Army authorization but don't require pre -construction
notification.
Click to enter.
7. Addresses of adjoining property owners, lessees, etc. whose property adjoins the waterbody (if more than can be
entered here, please attach a supplemental list)
Click to enter.
8. Scheduling of activity:
Click to enter.
Page 8 of 22 PCN Form Version 4.3- December 4, 2023

D. Proposed Impacts Inventory
1. Impacts Summary
❑x Wetlands ❑x Streams - tributaries
1 a. Where are the impacts associated with your project ❑ Buffers ❑ Open Waters
(check all that apply):
❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, complete this table for each wetland area impacted.
2a.
Site #
2a1.
Impact
Reason/Type
2b.
Impact
Duration
2c.
Wetland Type
2d.
Wetland Name
2e.
Forested
?
2f.
Jurisdiction
Type
2g.
Impact Area
(ac)
Impact
B
Fill (Incl.
Riprap)
Permanent
Bottomland
Hardwood
Forest
Wetland H
Yes
Both
0.013
Impact
C
Fill (Incl.
Riprap)
Permanent
Bottomland
Hardwood
Forest
Wetland E
Yes
Both
0.004
Impact
D
Fill (Incl.
Riprap)
Permanent
Bottomland
Hardwood
Forest
Wetland AB
No
Both
0.026
W4
Choose one
emp/ Perm
Choose onE
Click to enter
Y/I`
Choose one
Click to enter
W5
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W6
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W7
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W8
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W9
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W10
Choose one
-emp/ Perm
Choose onE
Click to enter
Y/N
Choose one
Click to enter
W11
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W12
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W13
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W14
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W15
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
2g1. Total temporary wetland impacts
Click to enter. ac
2g2. Total permanent wetland impacts
0.043 ac
2g3. Total wetland impacts
0.043 ac
2h. Type(s) of material being discharged and the amount of each type in cubic yards:
Click to enter text.
Page 9 of 22 PCN Form Version 4.3- December 4, 2023

2i. Comments:
The proposed development seeks authorization under NWP #29 in order to impact 0.043-acre of wetlands necessary to
construct the proposed development. The following summarizes the proposed impacts:
• Impact B — Wetland H
o 0.01-acre of permanent wetland impacts to Wetland H results from grading activities necessary to construct the
proposed residential development.
• Impact C — Wetland E
o 0.004-acre of permanent wetland impacts to Wetland E results from grading activities necessary to construct the
proposed residential development.
• Impact D — Wetland AB
o 0.026-acre of permanent wetland impacts to Wetland AB resulting from the proposed stormwater design which will
alter the hydrologic input to Steam A, and subsequently Wetland AB.
Page 10 of 22 PCN Form Version 4.3- December 4, 2023

3. Stream Impacts
If there are perennial or intermittent stream/ tributary impacts (including temporary impacts) proposed on the site,
complete this table for all stream/ tributary sites impacted.
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
Site #*
3a
Impact
Reason*
3b.
Impact
Duration*
3c.
Impact Type*
3d.
Stream Name*
3e.
Stream
Type*
3f.
Jurisdiction
Type*
3g.
Stream Width
(avg ft) *
3h.
Impact length
(linear ft)
Impact
A
Stream
Crossing
Permanent
Crossing/
Culvert
Stream G
Intermittent
Both
4
152
Impact
A
Pumped
Diversion
Temporary
Crossing/
Culvert
Stream G
Intermittent
Both
4
40
Impact
D
Grading
Permanent
Fill (Incl.
Riprap)
Stream A
Intermittent
Both
2
58
Impact
D
Grading
(indirect)
Permanent
Fill (Incl.
Riprap)
Stream A
Intermittent
Both
2
77
S5
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S6
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S7
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S8
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S9
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S10
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S11
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S12
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S13
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S14
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S15
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S16
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S17
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S18
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S19
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S20
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
3i1. Total jurisdictional ditch
impact:
Click to enter. linear ft
3i2. Total permanent stream
impacts:
287 linear ft
M. Total temporary stream
impacts:
40 linear ft
3i4. Total stream and ditch
impacts:
327 linear ft
Page 11 of 22 PCN Form Version 4.3- December 4, 2023

3j. Comments:
The proposed development seeks authorization under NWP #29 for impacts to streams necessary to construct
the proposed development. The following summarizes the proposed impacts:
• Impact A — Stream G
o One (1) 114 Linear Feet (LF) 96-inch reinforced concrete pipe (RCP) will be installed at the crossing of
Stream G. The RCP will be buried 24 inches to promote the passage of aquatic organisms. 20 LF of rip -rap
outlet protection will be installed to reduce discharge velocities in order to meet non erosive design criteria. The
installation of the RCP and riprap results in 152 LF/0.017 acres of permanent impacts to Stream G.
o 40 LF/0.005-acre of temporary impacts are necessary to install an impervious dike and pumped diversion to
perform the construction activity in dry conditions.
• Impact D — Stream A
o 58 LF/0.002-acre of permanent wetland impacts to Stream A results from grading activities necessary to
construct the proposed single-family development.
o 77 LF/0.004-acre of permanent indirect impacts to Stream A resulting from the proposed stormwater design
which will alter the hydrologic input to Steam A.
Page 12 of 22 PCN Form Version 4.3- December 4, 2023

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., individually list all open water impacts in the table below.
4a.
Site #*
4a1.
Impact Reason
4b.
Impact
Duration*
4c.
Waterbody Name*
4d.
Activity Type*
4e.
Waterbody
Type*
4f.
Impact area
(ac)*
01
Click to enter.
Temp/ Perm
Click to enter.
Choose one
. hoose one
Click to enter.
02
Click to enter.
Temp/ Perm
Click to enter.
Choose one
choose one
Click to enter.
03
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
04
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
05
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
4g.
Total temporary open water impacts
Click to enter. ac
4g.
Total permanent open water impacts
Click to enter. ac
4g.
Total open water impacts
Click to enter ac
4h.
Comments:
Click to enter.
5.
Pond or Lake Construction
If pond or lake construction is proposed, complete the table below. (*This
does NOT include
offline stormwater
management ponds.)
5a.
5b.
5c.
5d.
5e.
Pond ID
Proposed use or
Wetland Impacts
(ac)
Stream
Impacts (ft)
Upland
#
purpose of pond
Impacts (ac)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
entF
P2
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
ente
P3
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
ente~
5f.
Total
Click to
Click to
Click to
Click to
Click to
Click to
Click LU
enter.
enter.
enter.
enter.
enter.
enter.
enter
5g.
Comments:
Click to enter.
5h.
Is a dam high hazard permit required?
❑ Yes ❑ No
If yes, permit ID no.:
Click to enter.
5i.
Expected pond surface area (acres):
Click to enter.
5j.
Size of pond watershed (acres):
Click to enter.
5k.
Method of construction:
Click to enter.
Page 13 of 22 PCN Form Version 4.3- December 4, 2023

6. Buffer Impacts (DWR requirement)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts.
6a. Project is in which protected basin(s)?
(Check all that apply.)
❑ Neuse ❑ Tar -Pamlico ❑ Catawba
❑ Jordan ❑ Goose Creek ❑ Randleman
❑ Other: .,;K to ern.
Site #*
6b.
Impact Type*
6c.
Impact Duration*
6d.
Stream Name*
6e.
Buffer
Mitigation
Required?*
6f.
Zone 1 Impact*
(sq ft)
6g.
Zone 2 Impact*
(sq ft)
131
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B2
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B3
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B4
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B5
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B6
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B7
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B8
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B9
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B10
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
1311
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B12
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B13
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B14
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B15
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B16
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B17
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B18
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B19
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B20
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
6h. Total temporary impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6h. Total permanent impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6h. Total combined buffer impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6i. Comments:
UICK to enter.
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 14 of 22 PCN Form Version 4.3- December 4, 2023

E. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts through project design:
Avoidance and minimization efforts were implemented during development planning and design to the greatest extent
practicable to reduce the overall impacts on the aquatic environment while staying within nationwide permit thresholds.
The final plan demonstrates maximum avoidance and minimization efforts by reducing the proposed impacts. The
rationale to support avoidance and minimization efforts includes the following:
- Impact 1 — Stream G
- The RCP will be buried 24 inches to promote the passage of aquatic organisms, accelerate the re-establishment
of the channel bed, and maintain the width of the stream channel.
- 8-ft headwalls with a rip -rap apron will be installed to reduce grading fill slopes and reduce discharge velocities.
- Avoidance of the remaining 3,053 LF of streams on -site
- Avoidance of the remaining 0.231-acre of wetlands on -site.
1 b. Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques:
Temporary erosion control measures, including but not limited to skimmer basins and silt fence, will be
implemented to minimize sediment laden runoff from exiting the site.
2. Compensatory Mitigation for Impacts to Waters of the U.S., Waters of the State, or Riparian Buffers
2a. If compensatory mitigation is required, by whom is it required? * ❑ DWR ❑ Corps
(check all that apply)
2b. If yes, which mitigation option(s) will be used for this ❑ Mitigation Bank
project? * (check all that apply) ❑ In Lieu Fee Program
❑ Permittee Responsible Mitigation
3. Complete if using a Mitigation Bank
(Must satisfy NC General Statute143-214.11 (d1).)
3a. Name of mitigation bank:
Click to enter.
3b. Credits purchased/requested:
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c. Comments:
Click to enter.
4. Complete if Using an In Lieu Fee Program
4a. Attach approval letter from in lieu fee program.
4b. Stream mitigation requested:
Click to enter. linear feet
4c. If using stream mitigation, what is the stream temperature:
Choose one
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington
District's RIBITS website: (Please use the filter and select Wilmington district)
https://ribits.usace.army.mil/ribits apex/f?p=107:27:2734709611497::NO: RP:P27 BUTTON KEY:O
4d. Buffer mitigation requested (DWR only):
Click to enter. square feet
Page 15 of 22 PCN Form Version 4.3- December 4, 2023

4e. Riparian wetland mitigation requested:
Click to enter. acres
4f. Non -riparian wetland mitigation requested:
Click to enter. acres
4g. Coastal (tidal) wetland mitigation requested:
Click to enter. acres
4h. Comments:
lick to enter.
5. Complete if Providing a Permittee Responsible Mitigation Plan
5a. If proposing a permittee responsible mitigation plan, provide a description of the proposed mitigation plan,
including mitigation credits generated.
.IR,R LU CI IICI
5b. Attach mitigation plan/documentation.
6.
Buffer Mitigation (State Regulated Riparian Buffer Rules) — DWR requirement
6a.
Will the project result in an impact within a protected riparian buffer
❑ Yes ❑ No
that requires buffer mitigation?
If yes, please complete this entire section — please contact DWR for more information.
6b.
If yes, identify the square feet of impact to each zone of the riparian buffer that requires
mitigation. Calculate the
amount of mitigation required in the table below.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
Click to enter.
Click to enter.
Choose one
Click to enter.
Zone 2
Click to enter.
Click to enter.
Choose one
Click to enter.
6f. Total buffer mitigation required
Click to enter.
6g.
If buffer mitigation is required, is payment to a mitigation bank or
❑Yes El No
NC Division of Mitigation Services proposed?
6h.
If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
6i.
Comments:
Click to enter.
Page 16 of 22 PCN Form Version 4.3- December 4, 2023

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers
❑ Yes ❑x No
identified within one of the NC Riparian Buffer Protection Rules?
1 b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the
project is subject to a state implemented riparian buffer protection program, include a plan that fully documents
how diffuse/dispersed flow will be maintained.
All Stormwater Control Measures (SCM) must be designed in accordance with the NC Stormwater Design
Manual (https://deg.nc.,qov/about/divisions/energv-mineral-land-resources/energv-mineral-land-permit-
guidance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
❑ Level Spreader
What Type of SCM are you
❑ Vegetated Conveyance (lower seasonal high water table- SHWT)
providing?
❑ Wetland Swale (higher SHWT)
(Check all that apply)
❑ Other SCM that removes minimum 30% nitrogen
❑ Proposed project will not create concentrated stormwater flow through the
buffer
For a list of options to meet the diffuse flow requirements, click here.
Attach diffuse flow documentation.
2.
Stormwater Management Plan
2a.
Is this an NCDOT project subject to compliance with NCDOT's
Individual NPDES permit NCS000250?
❑ Yes ❑x No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)?
El Yes ❑x No
To look up low density requirements, click here:
http://reports.oah.state. nc.us/ncac/title%2015a%20-%20environmental%20guaIity/chapter%2002%20-
%20environmental%20man age ment/subchapter%20h/15a%20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP)
❑ Yes ❑x No
reviewed and approved under a state stormwater program or state -
approved local government stormwater program?
❑ n/a — project disturbs < 1 acre
Note: Projects that have vested rights, exemptions, or grandfathering from state or locally implemented
stormwater programs or projects that satisfy state or locally -implemented stormwater programs through use of
community in -lieu programs should answer "no" to this question.
2d.
Which of the following stormwater management program(s) apply?
❑x Local Government
(Check all that apply.)
❑ State
If you have local government approval, please include the SMP on their overall impact map.
❑x Phase II ❑ USMP
Local Government Stormwater Programs
❑ NSW ❑ Water Supply
Page 17 of 22 PCN Form Version 4.3- December 4, 2023

Please identify which local government stormwater program you are using.
Mecklenburg County
State Stormwater Programs * ❑ Phase II ❑ HQW or ORW
❑ Coastal Counties ❑ Other
Comments:
Click to enter.
Page 18 of 22 PCN Form Version 4.3- December 4, 2023

G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local)
❑ Yes ❑x No
funds or the 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 (North Carolina) Environmental
❑ Yes ❑x No
Policy Act (NEPA/SEPA)?
1 c. 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
❑ Yes ❑x No
NEPA or SEPA final approval letter.)
Comments:
Click to enter.
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),
Federally Non -Jurisdictional Wetlands /Classified Surface Waters
❑ Yes ❑x No
(15A NCAC 2H. 1400) DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. If you answered "yes" to the above question, provide an explanation of the violation(s):
UTICK to enter.
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future
impacts) result in additional development, which could impact nearby
❑ Yes ❑x No
downstream water quality?
3b. If you answered "no", provide a short narrative description:
The proposed development is not anticipated to result in any future development.
3c. If yes, provide a qualitative or quantitative cumulative impact analysis in accordance with the most recent DWR
policy. (Attach .pdf)
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? I ® Yes ❑ No ❑ N/A
4b. If yes, describe in detail the treatment methods and dispositions (non -discharge or discharge) of wastewater
generated from the proposed project. If the wastewater will be treated at a treatment plant, list the capacity
available at that plant.
Wastewater generated from the site will be collected and routed using the proposed sanitary sewer gravity
network. The proposed sewer system falls to an existing sanitary sewer main located on along Toby Creek.
Page 19 of 22 PCN Form Version 4.3- December 4, 2023

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected
❑ Yes ❑x No
species or habitat? (IPAC weblink: https://www.fws.gov/ipac/ ffws.govl)
5b. Have you checked with the USFWS concerning Endangered Species
❑ Yes ❑x No
Act impacts? *
5c. If yes, indicate the USFWS Field Office you have contacted.
Choose one
5d. Is another federal agency involved? *
❑ Yes ❑x No ❑ Unknown
If yes, which federal agency?
Click to enter.
5e. Is this a DOT project located within Divisions 1-8? *
❑ Yes ❑x No
5f. Will you cut any trees in order to conduct the work in waters of the
U.S.? *
®Yes El No
5g. Does this project involve bridge maintenance or removal? *
❑ Yes ❑x No
5g1. If yes, have you inspected the bridge for signs of bat use such as
staining, guano, bats, etc.? Representative photos of signs of bat use
❑ Yes ❑x No
can be found in the NLEB SLOPES, Appendix F, pages 3-7.
Representative photos of signs of bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7. Link to
NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed NLEB-SLOPES&apps.pdf
If you answered yes to 5g1, did you discover any signs of bat use? *
❑ Yes ❑ No ❑ Unknown
If yes, please show the location of the bridge on the permit drawings/ project plans
5h. Does this project involve the construction/ installation of a wind
turbine(s)? *
❑ Yes ❑x No
If yes, please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdf)
5i. Does this project involve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
❑ Yes ❑x No
mechanized pile drivers, etc.? *
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this
activity on the property (attach .pdf)
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical Habitat? *
A review of the North Carolina Natural Heritage Program (NCNHP) database on March 27, 2024, indicated no known
occurrences of threatened or endangered species occurring within one mile of the project boundary. There is no
potentially suitable habitat within the Corps' action areas. Pedestrian surveys were conducted by LaBella Associates in
2021 for the entire project site. No occurrences of protected species were identified; however, concurrence of these
results were not submitted and verified by USFWS.
Attach consultation documentation.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as
an Essential Fish Habitat? *
❑ Yes ❑x No
Page 20 of 22 PCN Form Version 4.3- December 4, 2023

Is there submerged aquatic vegetation (SAV) around
the project vicinity?
El Yes ❑x No El Unknown
Will this project affect submerged aquatic vegetation?
❑ Yes ❑ No ❑x Unknown
Explain: Click to enter.
6b. What data source(s) did you use to determine whether your site would impact Essential Fish Habitat?
NCNHP element occurrence database did not indicate the presence of EFH within the project boundary.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):
http://gis.ncdcr.gov/hpoweb/
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 (e.g., National Historic Trust designation or
❑ Yes ❑x No
properties significant in North Carolina history and archaeology)?
7b. What data source(s) did you use to determine whether your site would impact historic or archeological
resources?
Kimley-Horn consulted the North Carolina State Historic Preservation Office (SHPO) HPOWEB GIS service on
March 27, 2024. No documented architectural, cultural, or historic sites of significance within the project
boundary were identified. A request letter was submitted to SHPO to determine the presence of architectural,
cultural, or historic resources on March 27, 2024. At the time of this application, a response from NCSHPO has
not been received. The SHPO response will be provided upon receipt.
7c. Attach historic or prehistoric documentation.
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.,qov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
❑ Yes ❑x No
8b. If yes, explain how the project meets FEMA requirements.
,lick to enter
8c. What source(s) did you use to make the floodplain determination?
FI RM panels 3710457600K (effective 11 /16/2018) and 3710457500L (effective 11 /16/2018).
H. Miscellaneous
Comments:
Click to enter.
Attach pertinent documentation or attachments not previously requested
Page 21 of 22 PCN Form Version 4.3- December 4, 2023

I. Signature *
❑x By checking the box and signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete, to
the best of my knowledge and belief;
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401
certification request within the applicable reasonable period of time;
• The project proponent hereby agrees 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");
• The project proponent hereby agrees to conduct this transaction by electronic means pursuant to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• The project proponent hereby understands that an electronic signature has the same legal effect and can be
enforced in the same way as a written signature; AND
• As the project proponent, I intend to electronically sign and submit the PCN/online form.
Full Name: * Chris Tinklenberg
Signature:
Date: * 5/16/2024
Page 22 of 22 PCN Form Version 4.3- December 4, 2023

AGENT AUTHORIZATION

AGENT AUTHORIZATION FORM
Ntnnc: Tim Kemper
Address: 1905 Woodstock Road Suite 9250 Roswell CA 30075
Phone: [phone]
Email: tim.kemper(uexeterdevco.com
PrgjectName/DescriptiomBlankenship Site
Date: 05/07/2024
The Department of the Army
U.S. Army Corps ofFngincers, Wilmington District
Charlotte Regulatory Field Office
Attention: Jennifer Lawrence
Re: Wetland Related Consulting and Permitting
CB Concord Developers, LLC , hereby designates and authorizes Kimlq-Horn and Associates,
Inc. to act in my/our behalf as my/our agent solely for the purpose of processing Jurisdictional
Determinations, Section 404 permits/Section 401 Water Quality Certifications applications and
to furnish upon request supplemental information in support of applications, etc. from this day,
forward until successful completion of the permitting process or revocation by the owner,
In addition, 1, the undersigned, under contract to purchase the property/properties identified
herein, do authorize representatives of the Wilnuirtgton District, U.S. Army Corps of Engineers
(Corps) to enter upon the property herein described for the purpose of conducting on -site
investigations and issuing a determination associated with Waters of the U.S. subject to Federal
jurisdiction under Section 404 of the Clean Water Act and/or Section 10 of the Rivers and
Harbors Act of 1999.
Authorized this the C day of MCA
Tim Kemper
Authorized Representative Authorized kepresentalive
(Print Name) (Signature)

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PRELIMINARY JURISDICTIONAL
REQUEST

SAW-2022-00915
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2022-00915 County: Mecklenburg U.S.G.S. Quad: NC-Derita
NOTIFICATION OF JURISDICTIONAL DETERNIINATION
Requestor:
NVR - Ryan Homes
John Eskridge
Address:
10710 Sikes Place, #250
Charlotte, NC 28277
Telephone Number:
704.512.1262
E-mail:
ieskrid6a,nvrinc.com
Size (acres) 150 Nearest Town Charlotte
Nearest Waterway Toby Creek River Basin Upper Pee Dee
USGS HUC 03040105 Coordinates Latitude: 35.265006
Longitude:-80.753903
Location description: The review area is defined as an 150-acre area in the City of Charlotte in Mecklenburg County, North
Carolina consisting of tax narcels 04907101. 04913101. 04906101 and 04903208 and is located at 6607 Old Concord Road.
Charlotte NC, 28213.
Indicate Which of the Following Apply:
A. Preliminary Determination
❑ There appear to be waters, including wetlands on the above described project area/property, that may be subject to Section 404
of the Clean Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). The
waters, including wetlands have been delineated, and the delineation has been verified by the Corps to be sufficiently accurate
and reliable. The approximate boundaries of these waters are shown on the enclosed delineation map dated DATE. Therefore
this preliminary jurisdiction determination may be used in the permit evaluation process, including determining compensatory
mitigation. For purposes of computation of impacts, compensatory mitigation requirements, and other resource protection
measures, a permit decision made on the basis of a preliminary JD will treat all waters and wetlands that would be affected in any
way by the permitted activity on the site as if they are jurisdictional waters of the U.S. This preliminary determination is not an
appealable action under the Regulatory Program Administrative Appeal Process (Reference 33 CFR Part 331). However, you may
request an approved JD, which is an appealable action, by contacting the Corps district for further instruction.
❑ There appear to be waters, including wetlands on the above described project area/property, that may be subject to Section 404
of the Clean Water Act (CWA)(33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403).
However, since the waters, including wetlands have not been properly delineated, this preliminary jurisdiction determination
may not be used in the permit evaluation process. Without a verified wetland delineation, this preliminary determination is
merely an effective presumption of CWA/RHA jurisdiction over all of the waters, including wetlands at the project area, which
is not sufficiently accurate and reliable to support an enforceable permit decision. We recommend that you have the waters,
including wetlands on your project area/property delineated. As the Corps may not be able to accomplish this wetland
delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that can be verified by the Corps.
B. Approved Determination
❑ There are Navigable Waters of the United States within the above described project area/property subject to the permit
requirements of Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403) and Section 404 of the Clean Water Act
(CWA)(33 USC § 1344). Unless there is a change in 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 waters, including wetlandson the above described project area/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 recommend you have the waters, including wetlands on your project area/property delineated. As the Corps may not be
able to accomplish this wetland delineation in a timely manner, you may wish to obtain a consultant to conduct a delineation that
can be verified by the Corps.

SAW-2022-00915
❑X The waters, including wetlands on your project area/property have been delineated and the delineation has been verified by
the Corps. The approximate boundaries of these waters are shown on the enclosed delineation map dated 6/1/2022. 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.
❑ The waters, including wetlands have been delineated and surveyed and are accurately depicted on the plat signed by the
Corps Regulatory Official identified below onDATE. 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 project area/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 Morehead City, NC, at [phone] to determine their
requirements.
Placement of dredged or fill material within waters of the US, including wetlands, without a Department of the Army permit may
constitute a violation of Section 301 of the Clean Water Act (33 USC § 1311). Placement of dredged or fill material, construction or
placement of structures, or work within navigable waters of the United States without a Department of the Army permit may
constitute a violation of Sections 9 and/or 10 of the Rivers and Harbors Act (33 USC § 401 and/or 403). If you have any questions
regarding this determination and/or the Corps regulatory program, please contact M. Scott Jones at 828.271.7980, ext. 4222 or
scoff. i ones(&usace.armv.mil.
C. Basis For Determination: Basis For Determination: See the approved iurisdictional determination
form dated 7/15/2022.
D. Remarks: Stream features labeled AC, CA, CAI, CB, CB2, CB3, CD, CF, CG, GA, GAB, GBA, GC,
GD, GG, GGA, GGB, GH, and GI were determined to be ephemeral and/or erosional features and not
subject to Clean Water Act Jurisdiction.
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.
above)
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: Mr. Philip A. Shannin
Administrative Appeal Review Officer
60 Forsyth Street SW, Floor M9
Atlanta, Georgia 30303-8803
AND
PHILIP.A. SHANNINgUSACE.ARMY.MIL

SAW-2022-00915
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 09/11/2022.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
Corps Regulatory Official:
Date of JD: 7/15/2022 Expiration Date of JD: 7/15/2027
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
http://corpsmapu.usace.army.mil/cm_apex/f?p=136:4:0
Copy furnished:
Agent:
LaBella Associates, DPC
Eric Prunchak
Address:
400 South Tryon Street, Suite 1300
Charlotte, NC 28285
Telephone Number:
704.376.6423
E-mail:
eprunchak(&1abe11apc.com

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: NVR - Rvan Homes, John Eskridge File Number: SAW-2022-00915
Date: 7/15/2022
Attached is:
See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter of permission)
A
PROFFERED PERMIT (Standard Permit or Letter of permission)
B
PERMIT DENIAL
C
❑X
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.
Additional information may be found at or hllp://www.usace.army.miUMissions/CivilWorks/ReaulatoryProgramandPermits.aspx
or ft Corps 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 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 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 APPEAMoCTIONS TO AN INITIAL PROFFERED PERMIT Er
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
MR. PHILIP A. SHANNIN
Attn: M. Scott Jones
ADMINISTRATIVE APPEAL REVIEW OFFICER
Asheville Regulatory Office
CESAD-PDS-O
U.S Army Corps of Engineers
60 FORSYTH STREET SOUTHWEST, FLOOR M9
151 Patton Avenue, Room 208
ATLANTA, GEORGIA 30303-8803
Asheville, North Carolina 28801
PHONE: [phone]; FAX [phone]
EMAIL: PHILIP.A.SHANNIN(a USACE.ARMY.MIL
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 opportum to participate in all site investi ations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: M. Scott Jones, 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. Philip Shannin, Administrative
Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]

APPROVED JURISDICTIONAL DETERMINATION FORM
U.S. Army Corps of Engineers
This form should be completed by following the instructions provided in Section IV of the JD Form Instructional Guidebook.
SECTION L• BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD): 7/15/2022
B. DISTRICT OFFICE, FILE NAME, AND NUMBER: Wilmington District, Blankenship Family Trust / Ryan Homes, SAW-2022-00915
C. PROJECT LOCATION AND BACKGROUND INFORMATION: The review area is defined as an 150-acre area in the City of Charlotte in
Mecklenburg County, North Carolina consisting of tax parcels 04907101, 04913101, 04906101 and 04903208 and is located at 6607 Old Concord
Road, Charlotte NC, 28213.
State: NC County/parish/borough: Mecklenburg City: Charlotte
Center coordinates of site (lat/long in degree decimal format): Lat. 35.265006 , Long.-80.753903
Universal Transverse Mercator:
Name of nearest waterbody: Toby Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Rocky River
Name of watershed or Hydrologic Unit Code (HUC): 03040105
® Check if map/diagram of review area and/or potential jurisdictional areas is/are available upon request.
❑ Check if other sites (e.g., offsite mitigation sites, disposal sites, etc...) are associated with this action and are recorded on a different JD form:
D. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY):
® Office (Desk) Determination. Date: 27 MAY 2022
® Field Determination. Date(s): 02 JUN 2022
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There are no "navigable waters of the U.S." within Rivers and Harbors Act (RHA) jurisdiction (as defined by 33 CFR part 329) in the review area.
[Required]
❑ Waters subject to the ebb and flow of the tide.
❑ Waters are presently used, or have been used in the past, or may be susceptible for use to transport interstate or foreign commerce. Explain:
B. CWA SECTION 404 DETERMINATION OF JURISDICTION.
There are "waters of the U.S." within Clean Water Act (CWA) jurisdiction (as defined by 33 CFR part 328) in the review area. [Required]
1. Waters of the U.S.
a. Indicate presence of waters of U.S. in review area (check all that apply):'
❑TNW s, including territorial seas
❑ Wetlands adjacent to TNWs
❑X Relatively permanent watersz (RPWs) that flow directly or indirectly into TNWs (Streams A, B, C, CE, G, and GB)
❑Non-RPWs that flow directly or indirectly into TNWs
❑X Wetlands directly abutting RPWs that flow directly or indirectly into TNWs (Wetlands AB and F)
❑X Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs (Wetlands, D, E, and H)
❑ Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
❑ Impoundments of jurisdictional waters
❑ Isolated (interstate or intrastate) waters, including isolated wetlands
b. Identify (estimate) size of waters of the U.S. in the review area:
Non -wetland waters: 3,665 linear feet, 2-10 wide, and/or 0.552 acres.
Wetlands: 0.304 acres.
c. Limits (boundaries) of jurisdiction based on: Established OHWM
1 Boxes checked below shall be supported by completing the appropriate sections in Section III below.
2 For purposes of this form, an RPW is defined as a tributary that is not a TNW and that typically flows year-round or has continuous flow at least "seasonally" (e.g.,
typically 3 months).
Pagel of 8 Form Version 10 June 2020

Elevation of established OHWM (if known):
2. Non -regulated waters/wetlands (check if applicable):'
❑ Potentially jurisdictional waters and/or wetlands were assessed within the review area and determined to be not jurisdictional. Explain:
SECTION III: CWA ANALYSIS
A. TNWs AND WETLANDS ADJACENT TO TNWs
The agencies will assert jurisdiction over TNWs and wetlands adjacent to TNWs. If the aquatic resource is a TNW, complete Section
IILA.1 and Section IILD.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections I LAA and 2 and Section
I LDA.; otherwise, see Section I LB below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetlandadjacent to TNW
Summarize rationale supporting conclusion that wetland is "adjacent":
B. CHARACTERISTICS OF TRIBUTARY (THAT IS NOT A TNW) AND ITS ADJACENT WETLANDS (IF ANY):
This section summarizes information regarding characteristics of the tributary and its adjacent wetlands, if any, and it helps determine
whether or not the standards for jurisdiction established under Rapanos have been met.
The agencies will assert jurisdiction over non -navigable tributaries of TNWs where the tributaries are "relatively permanent waters"
(RPWs), i.e. tributaries that typically flow year-round or have continuous flow at least seasonally (e.g., typically 3 months). A wetland
that directly abuts an RPW is also jurisdictional. If the aquatic resource is not a TNW, but has year-round (perennial) flow, skip to
Section IILD.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow, skip to Section I LDA.
A wetland that is adjacent to but that does not directly abut an RPW requires a significant nexus evaluation. Corps districts and EPA
regions will include in the record any available information that documents the existence of a significant nexus between a relatively
permanent tributary that is not perennial (and its adjacent wetlands if any) and a traditional navigable water, even though a significant
nexus finding is not required as a matter of law.
If the waterbody4 is not an RPW, or a wetland directly abutting an RPW, a JD will require additional data to determine if the
waterbody has a significant nexus with a TNW. If the tributary has adjacent wetlands, the significant nexus evaluation must consider
the tributary in combination with all of its adjacent wetlands. This significant nexus evaluation that combines, for analytical purposes,
the tributary and all of its adjacent wetlands is used whether the review area identified in the JD request is the tributary, or its adjacent
wetlands, or both. If the JD covers a tributary with adjacent wetlands, complete Section I LBA for the tributary, Section I LB.2 for any
onsite wetlands, and Section III.B.3 for all wetlands adjacent to that tributary, both onsite and offsite. The determination whether a
significant nexus exists is determined in Section I LC below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: 3,274 acres
Drainage area: 3274 acres
Average annual rainfall: 43 inches
Average annual snowfall: 2 inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
❑ Tributary flows directly into TNW.
❑X Tributary flows through 2 tributaries before entering TNW.
Project waters are 10-15 river miles from TNW.
Project waters are 1 (or less) river miles from RPW.
Project waters are 5-10 aerial (straight) miles from TNW.
Project waters are 1 (or less) aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain: No
' Supporting documentation is presented in Section III.F.
4Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and West.
Page 2 of 8 Form Version 10 June 2020

Identify flow route to TNW': RPW to Toby Creek, Mallard, Creek, and into the Rocky River.
Tributary stream order, if known:
(b) General Tributary Characteristics (check all that apply):
Tributary is: ❑X Natural
❑ Artificial (man-made). Explain:
❑ Manipulated (man -altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: 3 feet
Average depth: 1 feet
Average side slopes: 2:1.
Primary tributary substrate composition (check all that apply):
❑X Silts ❑X Sands ❑ Concrete
❑ Cobbles ❑X Gravel ❑ Muck
❑X Bedrock ❑ Vegetation. Type/% cover -
El Other. Explain:
Tributarycondition/stability [e.g., highly eroding, sloughing banks]. Explain: Stable with localized erosional areas.
Presence of run/riffle/pool complexes. Explain: N/A
Tributary geometry: Meandering
Tributary gradient (approximate average slope): 1 %
(c) Flow:
Tributary provides for. Seasonal flow
Estimate average number of flow events in review area/year: 20 (or greater)
Describe flow regime:
Other information on duration and volume:
Surface flow is: Discrete. Characteristics:
Subsurface flow: Unknown. Explain findings:
❑ Dye (or other) test performed:
Tributary has (check all that apply):
❑X Bed and banks
❑X OHWM'(check all indicators that apply):
❑X clear, natural line impressed on the bank ❑X the presence of litter and debris
❑X changes in the character of soil ❑ destruction of terrestrial vegetation
❑X shelving ❑ the presence of wrack line
❑ vegetation matted down, bent, or absent ❑X sediment sorting
❑ leaf litter disturbed or washed away
❑X sediment deposition
❑ water staining
❑ other (list):
❑ Discontinuous OHWM.' Explain:
❑X scour
❑ multiple observed or predicted flow events
❑X abrupt change in plant community
If factors other than the OHWM were used to determine lateral extent of CWA jurisdiction (check all that apply):
❑ High Tide Line indicated by: ❑ Mean High Water Mark indicated by:
❑ oil or scum line along shore objects ❑ survey to available datum;
'Flow route can be described by identifying, e.g., tributary a, which flows through the review area, to flow into tributary b, which then flows into TNW.
'A natural or man-made discontinuity in the OHWM does not necessarily sever jurisdiction (e.g., where the stream temporarily flows underground, or where the
OHWM has been removed by development or agricultural practices). Where there is a break in the OHWM that is unrelated to the waterbody's flow regime (e.g., flow
over a rock outcrop or through a culvert), the agencies will look for indicators of flow above and below the break.
'Ibid.
Page 3 of 8 Form Version 10 June 2020

❑ fine shell or debris deposits (foreshore) ❑ physical markings;
❑ physical markings/characteristics ❑ vegetation lines/changes in vegetation types.
❑ tidal gauges
❑ other (list):
(iii) Chemical Characteristics:
Characterize tributary (e.g., water color is clear, discolored, oily film; water quality; general watershed characteristics, etc.). Explain:
Water color is generally clear.
Identify specific pollutants, if known:
(iv) Biological Characteristics. Channel supports (check all that apply):
❑X Riparian corridor. Characteristics (type, average width): >50 ft. average width
❑ Wetland fringe. Characteristics:
❑X Habitat for.
❑Federally Listed species. Explain findings:
❑X Fish/spawn areas. Explain findings: Fish observed in streams during stire visit.
❑ Other environmentally -sensitive species. Explain findings:
❑ Aquatic/wildlife diversity. Explain findings:
2. Characteristics of wetlands adjacent to non-TNW that flow directly or indirectly into TNW
(i) Physical Characteristics:
(a) General Wetland Characteristics:
Properties:
Wetland size: 0.044 acres
Wetland type. Explain: PEM and PFO
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain: No
(b) General Flow Relationship with Non-TNW:
Flow is: Intermittent flow Explain:
Surface flow is: Discrete
Characteristics: Adjacent wetlands D, E, and H discharge / flow into discrete ephemeral channels and into seasonal RPWs.
Subsurface flow: Unknown. Explain fmdings:
❑ Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
❑ Directly abutting
❑X Not directly abutting
❑X Discrete wetland hydrologic connection. Explain: Reference responses in 2.(b) above.
El Ecological connection. Explain:
❑X Separated by berm/barrier. Explain: Natural berm separates Wetland D from perrennial RPW (stream C)
(d) Proximity (Relationship) to TNW
Project wetlands are 10-15 river miles from TNW.
Project waters are 5-10 aerial (straight) miles from TNW.
Flow is from: Wetland to navigable waters.
Estimate approximate location of wetland as within the 5-10 year floodplain.
(ii) Chemical Characteristics:
Characterize wetland system (e.g., water color is clear, brown, oil film on surface; water quality; general watershed characteristics;
etc.). Explain: water is generally clear
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
0 Riparian buffer. Characteristics (type, average width): forested, typically 5o ft. or greater in width.
0 Vegetation type/percent cover. Explain: forested, generally 80% coverage
Page 4 of 8 Form Version 10 June 2020

❑X Habitat for -
El Federally Listed species. Explain fmdings:
❑Fish/spawn areas. Explain fmdings:
❑ Other environmentally -sensitive species. Explain findings:
❑X Aquatic/wildlife diversity. Explain findings: adjacent wetlands provide unique habitat for amphibians and reptiles within a
larger forested, upland complex.
3. Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: 3
Approximately 0.44 acres in total are being considered in the cumulative analysis.
For each wetland, specify the following:
Directly abuts? (Y/N) Size (in acres) Directly abuts? (Y/N) Size (in acres)
D — N 0.03
E — N 0.004
H - N 0.01
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERDIINATION
A significant nexus analysis will assess the flow characteristics and functions of the tributary itself and the functions performed by any
wetlands adjacent to the tributary to determine if they significantly affect the chemical, physical, and biological integrity of a TNW.
For each of the following situations, a significant nexus exists if the tributary, in combination with all of its adjacent wetlands, has more
than a speculative or insubstantial effect on the chemical, physical and/or biological integrity of a TNW. Considerations when
evaluating significant nexus include, but are not limited to the volume, duration, and frequency of the flow of water in the tributary and
its proximity to a TNW, and the functions performed by the tributary and all its adjacent wetlands. It is not appropriate to determine
significant nexus based solely on any specific threshold of distance (e.g. between a tributary and its adjacent wetland or between a
tributary and the TNW). Similarly, the fact an adjacent wetland lies within or outside of a floodplain is not solely determinative of
significant nexus.
Draw connections between the features documented and the effects on the TNW, as identified in the Rapanos Guidance and discussed in
the Instructional Guidebook. Factors to consider include, for example:
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to carry pollutants or flood waters to TNWs, or to
reduce the amount of pollutants or flood waters reaching a TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), provide habitat and lifecycle support functions for fish and other
species, such as feeding, nesting, spawning, or rearing young for species that are present in the TNW?
• Does the tributary, in combination with its adjacent wetlands (if any), have the capacity to transfer nutrients and organic carbon that
support downstream food webs?
• Does the tributary, in combination with its adjacent wetlands (if any), have other relationships to the physical, chemical, or biological
integrity of the TNW?
Note: the above list of considerations is not inclusive and other functions observed or known to occur should be documented below:
Significant nexus findings for non-RPW that has no adjacent wetlands and flows directly or indirectly into TNWs. Explain fmdings
of presence or absence of significant nexus below, based on the tributary itself, then go to Section IILD:
Significant nexus findings for non-RPW and its adjacent wetlands, where the non-RPW flows directly or indirectly into TNWs.
Explain findings of presence or absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands,
then go to Section IILD:
3. Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. Explain fmdings of presence or
absence of significant nexus below, based on the tributary in combination with all of its adjacent wetlands, then go to Section IILD:
Adjacent wetlands D, E, and H discharge / flow into discrete ephemeral channels and into seasonal RPWs.
D. DETERDIINATIONS OF JURISDICTIONAL FINDINGS. THE SUBJECT WATERS/WETLANDS ARE (CHECK ALL THAT
APPLY):
1. TNWs and Adjacent Wetlands. Check all that apply and provide size estimates in review area:
❑ TNWs: linear feet, wide, Or acres.
Page 5 of 8 Form Version 10 June 2020

❑ Wetlands adjacent to TNWs: acres.
2. RPWs that flow directly or indirectly into TNWs.
❑X Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that tributary is
perennial: Streams B and C — NCDWQ Stream Identification Form provided documenting perennial assessment. Field observations
support year-round flow determination.
❑X Tributaries of TNW where tributaries have continuous flow "seasonally" (e.g., typically three months each year)are jurisdictional. Data
supporting this conclusion is provided at Section III.B. Provide rationale indicating that tributary flows seasonally: Streams A, CE,
G, and GB - NCDWQ Stream Identification Form provided documenting intermittent assessment. Field observations support
seasonal flow determination.
Provide estimates for jurisdictional waters in the review area (check all that apply):
❑X Tributary waters: 3,665 linear feet, 2-10 feet wide.
❑ Other non -wetland waters: acres.
Identify type(s) of waters:
3. Non-RPWs1 that flow directly or indirectly into TNWs.
❑ Waterbody that is not a TNW or an RPW, but flows directly or indirectly into a TNW, and it has a significant nexus with a TNW is
jurisdictional. Data supporting this conclusion is provided at Section IILC.
Provide estimates for jurisdictional waters within the review area (check all that apply):
❑ Tributary waters: linear feet, wide.
❑ Other non -wetland waters: acres.
Identify type(s) of waters:
4. Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
❑X Wetlands directly abut RPW and thus are jurisdictional as adjacent wetlands.
❑ Wetlands directly abutting an RPW where tributaries typically flow year-round. Provide data and rationale indicating that tributary
is perennial in Section III.D.2, above. Provide rationale indicating that wetland is directly abutting an RPW:
❑X Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is seasonal
in Section IILB and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly abutting an RPW:
Wetland AB directly abuts and flows into Stream A. Wetland F directly abuts and flows into Stream G.
Provide acreage estimates for jurisdictional wetlands in the review area: 0.26 acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
❑X Wetlands that do not directly abut an RPW, but when considered in combination with the tributary to which they are adjacent and with
similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisidictional. Data supporting this conclusion is
provided at Section IILC. Adjacent wetlands D, E, and H discharge / flow into discrete ephemeral channels and into seasonal RPWs
Provide acreage estimates for jurisdictional wetlands in the review area: 0.044 acres.
6. Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs.
❑ Wetlands adjacent to such waters, and have when considered in combination with the tributary to which they are adjacent and with
similarly situated adjacent wetlands, have a significant nexus with a TNW are jurisdictional. Data supporting this conclusion is
provided at Section IILC.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.'
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
El Demonstrate that impoundment was created from "waters of the U.S.," or
❑ Demonstrate that water meets the criteria for one of the categories presented above (1-6), or
❑ Demonstrate that water is isolated with a nexus to commerce (see E below).
'See Footnote # 3.
'To complete the analysis refer to the key in Section 111.13.6 of the Instructional Guidebook.
Page 6 of 8 Form Version 10 June 2020

E. ISOLATED [INTERSTATE OR INTRA-STATE] WATERS, INCLUDING ISOLATED WETLANDS, THE USE, DEGRADATION
OR DESTRUCTION OF WHICH COULD AFFECT INTERSTATE COMMERCE, INCLUDING ANY SUCH WATERS (CHECK
ALL THAT APPLY):'"
❑ which are or could be used by interstate or foreign travelers for recreational or other purposes.
❑ from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
❑ which are or could be used for industrial purposes by industries in interstate commerce.
❑ Interstate isolated waters. Explain:
❑ Other factors. Explain:
Identify water body and summarize rationale supporting determination:
Provide estimates for jurisdictional waters in the review area (check all that apply):
❑ Tributary waters: linear feet, wide.
❑ Other non -wetland waters: acres.
Identify type(s) of waters:
❑ Wetlands: acres.
F. NON -JURISDICTIONAL WATERS, INCLUDING WETLANDS (CHECK ALL THAT APPLY):
❑ If potential wetlands were assessed within the review area, these areas did not meet the criteria in the 1987 Corps of Engineers Wetland
Delineation Manual and/or appropriate Regional Supplements.
❑ Review area included isolated waters with no substantial nexus to interstate (or foreign) commerce.
❑ Prior to the Jan 2001 Supreme Court decision in "SWANCC," the review area would have been regulated based solely on the "Migratory
Bird Rule" (MBR).
❑ Waters do not meet the "Significant Nexus" standard, where such a finding is required for jurisdiction. Explain:
❑ Other. (explain, if not covered above):
Provide acreage estimates for non -jurisdictional waters in the review area, where the sole potential basis of jurisdiction is the MBR factors (i.e.,
presence of migratory birds, presence of endangered species, use of water for irrigated agriculture), using best professional judgment (check all
that apply):
❑Non -wetland waters (i.e., rivers, streams):linear feet, wide.
❑Lakes/ponds: acres.
❑ Other non -wetland waters: acres. List type of aquatic resource:
❑ Wetlands: acres.
Provide acreage estimates for non -jurisdictional waters in the review area that do not meet the "Significant Nexus" standard, where such a
fmding is required for jurisdiction (check all that apply):
❑Non -wetland waters (i.e., rivers, streams):linear feet, wide.
❑Lakes/ponds: acres.
❑ Other non -wetland waters: acres. List type of aquatic resource:
❑ Wetlands: acres.
SECTION IV: DATA SOURCES.
A. SUPPORTING DATA. Data reviewed for JD (check all that apply - checked items shall be included in case file and, where checked and
requested, appropriately reference sources below):
❑X Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
0 Data sheets prepared/submitted by or on behalf of the applicant/consultant.
D Office concurs with data sheets/delineation report.
❑ Office does not concur with data sheets/delineation report.
❑ Data sheets prepared by the Corps:
❑ Corps navigable waters' study:
1OPrior to asserting or declining CWA jurisdiction based solely on this category, Corps Districts will elevate the action to Corps and EPA HQ for review
consistent with the process described in the Corps/EPA Memorandum Regarding CWA Act Jurisdiction Following Rapanos.
Page 7 of 8 Form Version 10 June 2020

❑X U.S. Geological Survey Hydrologic Atlas:
❑X USGS NHD data. USACE — NC Regualtory Viewer
❑USGS 8 and 12 digit HUC maps.
❑X U.S. Geological Survey map(s). Cite scale & quad name: NC-Derita, 1:24,000
❑X USDA Natural Resources Conservation Service Soil Survey. Citation: USDA-NRCS Web Soil Survey
❑X National wetlands inventory map(s). Cite name:. USACE — NC Regualtory Viewer
❑ State/Local wetland inventory map(s):
❑X FEMA/FIRM maps:. USACE — NC Regualtory Viewer
❑ 100-year Floodplain Elevation is: (National Geodetic Vertical Datum of 1929)
❑X Photographs: ❑ Aerial (Name & Date):
Or ❑X Other (Name & Date): Photo Log 25-27 AUG 2021
❑ Previous determination(s). File no. and date of response letter -
El Applicable/supporting case law:
❑ Applicable/supporting scientific literature:
❑ Other information (please specify):
B. ADDITIONAL COMMENTS TO SUPPORT JD: Stream features labeled AC, CA, CA1, CB, CB2, CB3,
CD, CF, CG, GA, GAB, GBA, GC, GD, GG, GGA, GGB, GH, and GI were determined to be ephemeral
and/or erosional features and not subject to Clean Water Act Jurisdiction. NCDWQ Stream Identification
forms completed for these features and support erosional and/or ephemeral finding.
Page 8 of 8 Form Version 10 June 2020

Page 9 of 1 Form Version 10 June 2020

AGENCY CORRESPONDENCE

Kimley>»Horn
May 8, 2024
Ms. Renee Gledhill -Earley
Environmental Review Coordinator
North Carolina State Historic Preservation Office
4617 Mail Service Center
Raleigh, North Carolina 27699-4617
Re: Blankenship Site
Charlotte, Mecklenburg County, North Carolina
Dear Ms. Gledhill -Earley,
Kimley-Horn is writing this letter on behalf of our client, Exeter Development Company, to request a review and
comment on any possible issues that might emerge with respect to cultural resource issues associated with the
proposed project in Mecklenburg County, North Carolina.
The project area is an approximately 153-acre tract located northeast of the North Tryon Street and Old Concord
Road intersection in Charlotte, Mecklenburg County, NC. (Figures 1-3). The proposed project seeks to construct
a residential development on the subject property.
We request that you review the site based on the attached information to determine the presence of any
architectural, cultural, or historic resources. If a response has not been received within 30 days we will assume
that you have reviewed the project area and that there are no issues to address at the present time.
Thank you in advance for your timely response and cooperation. Please email ([e-mail])
a copy of your reply and/or send an original copy by mail. If you have any questions regarding this request, please
feel free to contact me at [phone].
Sincerely,
KIMLEY-HORN AND ASSOCIATES, INC.
Taylor Kiker, PWS
Environmental Scientist

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LaBeLLa
Powered by partnership.
4/26/2021
Janet Mizzi
Unite States Fish and Wildlife Service
Asheville Field Office
160 Zillicoa St.
Asheville, NC 28801
Re: Online Project Review Request, Ryan Homes: Blankenship Family assemblage,
Mecklenburg County, North Carolina, IPaC Consultation Code: 2022-0037403
We have reviewed the referenced project using the Asheville Field Office's online project review
process and have followed all guidance and instructions in completing the review. We
completed our review on August 251, 2021 and are submitting our project review package in
accordance with the instructions for further review.
Our proposed action consists of: A 150-acre single family residential development. This
development includes single family homes, along with the associated roadways and electrical,
stormwater, sewer, and water utilities.
The location of the project and the action area are identified on the enclosed map.
The enclosed project review package provides the information about the species, critical habitat,
and bald eagles considered in our review, and the species conclusions table included in the
package identifies our determinations for the resources that may be affected by the project.
For additional information, please contact Eric Prunchak at (703) 975-9 718 or
[e-mail].
Sincerely,
Eric Prunchak, Environmental Manager
Enclosures:
1) ENTIRE PROJECT REVIEW PACKAGE
400 S. Tyron St, Suite 1300 . Charlotte, NC 28285 1 p 704-376-6423
www.labellapc.com

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United States Department of the Interior
x
FISH AND WILDLIFE SERVICE
Asheville Ecological Services Field Office
160 Zillicoa Street
Asheville, NC 28801-1082
Phone: [phone] Fax: [phone]
http://www.fws.p,ov/nc-es/es/cougiyfr.html
In Reply Refer To: April 29, 2022
Project Code: 2022-0037403
Project Name: Blankenship Family Assemblage
Subject: List of threatened and endangered species that may occur in your proposed project
location or may be affected by your proposed project
To Whom It May Concern:
The enclosed species list identifies threatened, endangered, proposed and candidate species, as
well as proposed and designated critical habitat, that may occur within the boundary of your
proposed project and/or may be affected by your proposed project. The enclosed species list
fulfills the requirements of the U.S. Fish and Wildlife Service (Service) under section 7(c) of the
Endangered Species Act (Act) of 1973, as amended (16 U.S.C. 1531 et seq.).
Please note that new species information can change your official species list. Under 50 CFR
402.12(e) of the regulations implementing section 7 of the Act, the accuracy of this species list
should be verified after 90 days. The Service recommends you visit the ECOS-IPaC website at
regular intervals during project planning and implementation to ensure your species list is
accurate or obtain an updated species list.
The purpose of the Act is to provide a means whereby threatened and endangered species and the
ecosystems upon which they depend may be conserved. Under sections 7(a)(1) and 7(a)(2) of the
Act and its implementing regulations (50 CFR 402 et seq.), Federal agencies are required to
utilize their authorities to carry out programs for the conservation of threatened and endangered
species and to determine whether projects may affect threatened and endangered species and/or
designated critical habitat.
A biological assessment (BA) or biological evaluation (BE) should be completed for your
project. A BA is required for major construction activities (or other undertakings having similar
physical impacts) considered to be Federal actions significantly affecting the quality of the
human environment as defined in the National Environmental Policy Act (42 U.S.C. 4332(2) (c))
(NEPA). For projects other than major construction activities, the Service suggests that a BE be
prepared to determine effects of the action and whether those effects may affect listed species
and/or designated critical habitat. E?ects of the action are all consequences to listed species or

04/29/2022
critical habitat that are caused by the proposed action, including the consequences of other
activities that are caused by the proposed action. A consequence is caused by the proposed action
if it is reasonably certain to occur and would not occur "but for" the proposed action..
Recommended contents of a BA/BE are described at 50 CFR 402.12. More information and
resources about project review and preparing a BA/BE can be found at the following web link:
https://www.fws. gov/office/asheville-ecological-services/asheville-field-office-online-review-
process-overview.
If a Federal agency determines listed species and/or designated critical habitat may be affected
by the proposed project, the agency is required to consult with the Service pursuant to 50 CFR
402. The Service is not required to concur with "no effect" determinations from Federal action
agencies. If consultation is required, the Service recommends that candidate species, proposed
species, proposed critical habitat, and at -risk species be addressed within the consultation. More
information on the regulations and procedures for section 7 consultation, including the role of
permit or licensed applicants, can be found in the "Endangered Species Consultation Handbook"
at the following web link: https://www.fws.gov/media/endangered-species-consultation-
handbook.
Migratory Birds: In addition to responsibilities to protect threatened and endangered species
under the Act, there are additional responsibilities under the Migratory Bird Treaty Act (MBTA)
and the Bald and Golden Eagle Protection Act (BGEPA) to protect native birds from project -
related impacts. Any activity, intentional or unintentional, resulting in take of migratory birds,
including eagles, is prohibited unless otherwise permitted by the Service (50 C.F.R. Sec. 10.12
and 16 U.S.C. Sec. 668(a)). More information about MBTA and BGEPA can be found at the
following web link: https://www.fws.gov/program/migratory-birds.
We appreciate your consideration of Federally listed species. The Service encourages Federal
agencies to include conservation of threatened and endangered species in their project planning
to further the purposes of the Act. Please contact our staff at 828-258-3939, if you have any
questions. In any future correspondence concerning this project, please reference the
Consultation Code which can be found in the header of this letter.
Attachment(s):
• Official Species List
• USFWS National Wildlife Refuges and Fish Hatcheries
• Migratory Birds
• Wetlands

04/29/2022
Official Species List
This list is provided pursuant to Section 7 of the Endangered Species Act, and fulfills the
requirement for Federal agencies to "request of the Secretary of the Interior information whether
any species which is listed or proposed to be listed may be present in the area of a proposed
action".
This species list is provided by:
Asheville Ecological Services Field Office
160 Zillicoa Street
Asheville, NC 28801-1082
[phone]

04/29/2022
VA
Project Summary
Project Code: 2022-0037403
Event Code: None
Project Name: Blankenship Family Assemblage
Project Type: Residential Construction
Project Description: Residential Development
Project Location:
Approximate location of the project can be viewed in Google Maps: https:
www. google.com/maps/(a)35.2712723,-80.75340307312453,14z
S
wow
Counties: Mecklenburg County, North Carolina

04/29/2022 3
Endangered Species Act Species
There is a total of 6 threatened, endangered, or candidate species on this species list.
Species on this list should be considered in an effects analysis for your project and could include
species that exist in another geographic area. For example, certain fish may appear on the species
list because a project could affect downstream species.
IPaC does not display listed species or critical habitats under the sole jurisdiction of NOAA
Fisheriesi, as USFWS does not have the authority to speak on behalf of NOAA and the
Department of Commerce.
See the "Critical habitats" section below for those critical habitats that lie wholly or partially
within your project area under this office's jurisdiction. Please contact the designated FWS office
if you have questions.
1. NOAA Fisheries, also known as the National Marine Fisheries Service (NMFS), is an
office of the National Oceanic and Atmospheric Administration within the Department of
Commerce.
Mammals
NAME STATUS
Northern Long-eared Bat Myotis septentrionalis Threatened
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/9045
Clams
NAME STATUS
Carolina Heelsplitter Lasmigona decorata Endangered
There is final critical habitat for this species. The location of the critical habitat is not available.
Species profile: https:Hecos.fws.gov/ecp/species/3534
Insects
NAME
Monarch Butterfly Danaus plexippus
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/9743
STATUS
Candidate

04/29/2022
4
Flowering Plants
NAME
STATUS
Michaux's Sumac Rhus michauxii
Endangered
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/5217
Schweinitz's Sunflower Helianthus schweinitzii
Endangered
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/3849
Smooth Coneflower Echinacea laevigata
Endangered
No critical habitat has been designated for this species.
Species profile: https:Hecos.fws.gov/ecp/species/3473
Critical habitats
THERE ARE NO CRITICAL HABITATS WITHIN YOUR PROJECT AREA UNDER THIS OFFICE'S
JURISDICTION.

04/29/2022
USFWS National Wildlife Refuge Lands And Fish
Hatcheries
Any activity proposed on lands managed by the National Wildlife Refuge system must undergo a
'Compatibility Determination' conducted by the Refuge. Please contact the individual Refuges to
discuss any questions or concerns.
THERE ARE NO REFUGE LANDS OR FISH HATCHERIES WITHIN YOUR PROJECT AREA.

04/29/2022
Migratory Birds
Certain birds are protected under the Migratory Bird Treaty Act! and the Bald and Golden Eagle
Protection Actz.
Any person or organization who plans or conducts activities that may result in impacts to
migratory birds, eagles, and their habitats should follow appropriate regulations and consider
implementing appropriate conservation measures, as described below.
1. The Migratory Birds Treat. Act of 1918.
2. The Bald and Golden Eagle Protection Act of 1940.
3. 50 C.F.R. Sec. 10.12 and 16 U.S.C. Sec. 668(a)
The birds listed below are birds of particular concern either because they occur on the USFWS
Birds of Conservation Concern (BCC) list or warrant special attention in your project location.
To learn more about the levels of concern for birds on your list and how this list is generated, see
the FAQ below. This is not a list of every bird you may find in this location, nor a guarantee that
every bird on this list will be found in your project area. To see exact locations of where birders
and the general public have sighted birds in and around your project area, visit the E-bird data
mapping tool (Tip: enter your location, desired date range and a species on your list). For
projects that occur off the Atlantic Coast, additional maps and models detailing the relative
occurrence and abundance of bird species on your list are available. Links to additional
information about Atlantic Coast birds, and other important information about your migratory
bird list, including how to properly interpret and use your migratory bird report, can be found
below.
For guidance on when to schedule activities or implement avoidance and minimization measures
to reduce impacts to migratory birds on your list, click on the PROBABILITY OF PRESENCE
SUMMARY at the top of your list to see when these birds are most likely to be present and
breeding in your project area.
BREEDING
NAME SEASON
Bald Eagle Haliaeetus leucocephalus Breeds Sep 1 to
This is not a Bird of Conservation Concern (BCC) in this area, but warrants attention Jul 31
because of the Eagle Act or for potential susceptibilities in offshore areas from certain types
of development or activities.
Cerulean Warbler Dendroica cerulea Breeds Apr 28
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Jul 20
and Alaska.
https:Hecos.fws.gov/ecp/species/297

04/29/2022
BREEDING
NAME SEASON
Kentucky Warbler Oporornis formosus Breeds Apr 20
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Aug 20
and Alaska.
Prairie Warbler Dendroica discolor Breeds May 1
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Jul 31
and Alaska.
Prothonotary Warbler Protonotaria citrea Breeds Apr 1 to
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA Jul 31
and Alaska.
Red-headed Woodpecker Melanerpes erythrocephalus Breeds May 10
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Sep 10
and Alaska.
Rusty Blackbird Euphagus carolinus Breeds
This is a Bird of Conservation Concern (BCC) only in particular Bird Conservation Regions elsewhere
(BCRs) in the continental USA
Wood Thrush Hylocichla mustelina Breeds May 10
This is a Bird of Conservation Concern (BCC) throughout its range in the continental USA to Aug 31
and Alaska.
Probability Of Presence Summary
The graphs below provide our best understanding of when birds of concern are most likely to be
present in your project area. This information can be used to tailor and schedule your project
activities to avoid or minimize impacts to birds. Please make sure you read and understand the
FAQ "Proper Interpretation and Use of Your Migratory Bird Report" before using or attempting
to interpret this report.
Probability of Presence (■)
Each green bar represents the bird's relative probability of presence in the 10km grid cell(s) your
project overlaps during a particular week of the year. (A year is represented as 12 4-week
months.) A taller bar indicates a higher probability of species presence. The survey effort (see
below) can be used to establish a level of confidence in the presence score. One can have higher
confidence in the presence score if the corresponding survey effort is also high.
How is the probability of presence score calculated? The calculation is done in three steps:
The probability of presence for each week is calculated as the number of survey events in
the week where the species was detected divided by the total number of survey events for
that week. For example, if in week 12 there were 20 survey events and the Spotted Towhee
was found in 5 of them, the probability of presence of the Spotted Towhee in week 12 is
0.25.

04/29/2022
3
2. To properly present the pattern of presence across the year, the relative probability of
presence is calculated. This is the probability of presence divided by the maximum
probability of presence across all weeks. For example, imagine the probability of presence
in week 20 for the Spotted Towhee is 0.05, and that the probability of presence at week 12
(0.25) is the maximum of any week of the year. The relative probability of presence on
week 12 is 0.25/0.25 = 1; at week 20 it is 0.05/0.25 = 0.2.
3. The relative probability of presence calculated in the previous step undergoes a statistical
conversion so that all possible values fall between 0 and 10, inclusive. This is the
probability of presence score.
Breeding Season( )
Yellow bars denote a very liberal estimate of the time -frame inside which the bird breeds across
its entire range. If there are no yellow bars shown for a bird, it does not breed in your project
area.
Survey Effort (1)
Vertical black lines superimposed on probability of presence bars indicate the number of surveys
performed for that species in the 10km grid cell(s) your project area overlaps. The number of
surveys is expressed as a range, for example, 33 to 64 surveys.
No Data (—)
A week is marked as having no data if there were no survey events for that week.
Survey Timeframe
Surveys from only the last 10 years are used in order to ensure delivery of currently relevant
information. The exception to this is areas off the Atlantic coast, where bird returns are based on
all years of available data, since data in these areas is currently much more sparse.
probability of presence breeding season I survey effort — no data
SPECIES JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Bald Non -BCC ++++ + �ji boom ���� Jill IN IIII ++++ III iV±± "++_
Vulnerable
Cerulean Warbler III Jill III
BCC Rangewide +� I I IIII I I ++ + � � I� + ++++ ++++ ++++ ++-+ +++-
(CON)
Kentucky WarblRangewide
++++++++++++++II Jill 1111 + ++ ++++
BCC Rangewide +++ + + ++—+ +++—
(CON)
Prairie warbler II IIU
BCC Rangewide ++++ ++++ ++++ ++,+ ++++ +++++—
(CON)

04/29/2022 4
Prothonotary ++++ ++++ ++++ —+ ++++ ++++ ++++ ++—+ +++—
Warbler
BCC Rangewide
(CON)
Red-headed
Woodpecker ++++ ++++ ++++ ++$++++—
BCC Rangewide
(CON)
Rusty Blackbird ++++ ++-- ---+ ++++ ++++ ++++ ++—' +++—
BCC-BCR
Wood Thrush �� ���� N� NEF
BCC Rangewide ++++ ++++ ++++ +„1 I f i ++—' -- ++++ +,'+ +++++++—
(CON)
Additional information can be found using the following links:
• Birds of Conservation Concern https://www.fws.gov/program/migratory-birds/species
• Measures for avoiding and minimizing impacts to birds https://www.fws.gov/library
collections/avoidinp--and-minimizinv--incidental-take-mip-ratorv-birds
• Nationwide conservation measures for birds https://www.fws.gov/sites/default/files/
documents/nationwide-standard-conservation-measures.pdf
Migratory Birds FAQ
Tell me more about conservation measures I can implement to avoid or minimize impacts
to migratory birds.
Nationwide Conservation Measures describes measures that can help avoid and minimize
impacts to all birds at any location year round. Implementation of these measures is particularly
important when birds are most likely to occur in the project area. When birds may be breeding in
the area, identifying the locations of any active nests and avoiding their destruction is a very
helpful impact minimization measure. To see when birds are most likely to occur and be breeding
in your project area, view the Probability of Presence Summary. Additional measures or permits
may be advisable depending on the type of activity you are conducting and the type of
infrastructure or bird species present on your project site.
What does IPaC use to generate the migratory birds potentially occurring in my specified
location?
The Migratory Bird Resource List is comprised of USFWS Birds of Conservation Concern
(BCQ and other species that may warrant special attention in your project location.
The migratory bird list generated for your project is derived from data provided by the Avian
Knowledge Network (AKN). The AKN data is based on a growing collection of survey, banding,
and citizen science datasets and is queried and filtered to return a list of those birds reported as
occurring in the 10km grid cell(s) which your project intersects, and that have been identified as
warranting special attention because they are a BCC species in that area, an eagle (Eagle Act

04/29/2022
5
requirements may apply), or a species that has a particular vulnerability to offshore activities or
development.
Again, the Migratory Bird Resource list includes only a subset of birds that may occur in your
project area. It is not representative of all birds that may occur in your project area. To get a list
of all birds potentially present in your project area, please visit the AKN Phenology Tool.
What does IPaC use to generate the probability of presence graphs for the migratory birds
potentially occurring in my specified location?
The probability of presence graphs associated with your migratory bird list are based on data
provided by the Avian Knowledge Network (AKN). This data is derived from a growing
collection of survey, banding, and citizen science datasets .
Probability of presence data is continuously being updated as new and better information
becomes available. To learn more about how the probability of presence graphs are produced and
how to interpret them, go the Probability of Presence Summary and then click on the "Tell me
about these graphs" link.
How do I know if a bird is breeding, wintering, migrating or present year-round in my
project area?
To see what part of a particular bird's range your project area falls within (i.e. breeding,
wintering, migrating or year-round), you may refer to the following resources: The Cornell Lab
of Ornithology All About Birds Bird Guide, or (if you are unsuccessful in locating the bird of
interest there), the Cornell Lab of Ornithology Neotropical Birds guide. If a bird on your
migratory bird species list has a breeding season associated with it, if that bird does occur in your
project area, there may be nests present at some point within the timeframe specified. If "Breeds
elsewhere" is indicated, then the bird likely does not breed in your project area.
What are the levels of concern for migratory birds?
Migratory birds delivered through IPaC fall into the following distinct categories of concern:
1. "BCC Rangewide" birds are Birds of Conservation Concern (BCC) that are of concern
throughout their range anywhere within the USA (including Hawaii, the Pacific Islands,
Puerto Rico, and the Virgin Islands);
2. "BCC - BCR" birds are BCCs that are of concern only in particular Bird Conservation
Regions (BCRs) in the continental USA; and
3. "Non -BCC - Vulnerable" birds are not BCC species in your project area, but appear on
your list either because of the Eagle Act requirements (for eagles) or (for non -eagles)
potential susceptibilities in offshore areas from certain types of development or activities
(e.g. offshore energy development or longline fishing).
Although it is important to try to avoid and minimize impacts to all birds, efforts should be made,
in particular, to avoid and minimize impacts to the birds on this list, especially eagles and BCC
species of rangewide concern. For more information on conservation measures you can
implement to help avoid and minimize migratory bird impacts and requirements for eagles,
please see the FAQs for these topics.
Details about birds that are potentially affected by offshore projects

04/29/2022 6
For additional details about the relative occurrence and abundance of both individual bird species
and groups of bird species within your project area off the Atlantic Coast, please visit the
Northeast Ocean Data Portal. The Portal also offers data and information about other taxa besides
birds that may be helpful to you in your project review. Alternately, you may download the bird
model results files underlying the portal maps through the NOAA NCCOS Integrative Statistical
Modeling and Predictive Mapping of Marine Bird Distributions and Abundance on the Atlantic
Outer Continental Shelf project webpage.
Bird tracking data can also provide additional details about occurrence and habitat use
throughout the year, including migration. Models relying on survey data may not include this
information. For additional information on marine bird tracking data, see the Diving Bird Study
and the nanotag studies or contact Caleb Spiegel or Pam Loring.
What if I have eagles on my list?
If your project has the potential to disturb or kill eagles, you may need to obtain a permit to avoid
violating the Eagle Act should such impacts occur.
Proper Interpretation and Use of Your Migratory Bird Report
The migratory bird list generated is not a list of all birds in your project area, only a subset of
birds of priority concern. To learn more about how your list is generated, and see options for
identifying what other birds may be in your project area, please see the FAQ "What does IPaC
use to generate the migratory birds potentially occurring in my specified location". Please be
aware this report provides the "probability of presence" of birds within the 10 km grid cell(s) that
overlap your project; not your exact project footprint. On the graphs provided, please also look
carefully at the survey effort (indicated by the black vertical bar) and for the existence of the "no
data" indicator (a red horizontal bar). A high survey effort is the key component. If the survey
effort is high, then the probability of presence score can be viewed as more dependable. In
contrast, a low survey effort bar or no data bar means a lack of data and, therefore, a lack of
certainty about presence of the species. This list is not perfect; it is simply a starting point for
identifying what birds of concern have the potential to be in your project area, when they might
be there, and if they might be breeding (which means nests might be present). The list helps you
know what to look for to confirm presence, and helps guide you in knowing when to implement
conservation measures to avoid or minimize potential impacts from your project activities,
should presence be confirmed. To learn more about conservation measures, visit the FAQ "Tell
me about conservation measures I can implement to avoid or minimize impacts to migratory
birds" at the bottom of your migratory bird trust resources page.

04/29/2022
Wetlands
Impacts to NWI wetlands and other aquatic habitats may be subject to regulation under Section
404 of the Clean Water Act, or other State/Federal statutes.
For more information please contact the Regulatory Program of the local U.S. Army Corps of
Engineers District.
Please note that the NWI data being shown may be out of date. We are currently working to
update our NWI data set. We recommend you verify these results with a site visit to determine
the actual extent of wetlands on site.
WETLAND INFORMATION WAS NOT AVAILABLE WHEN THIS SPECIES LIST WAS GENERATED.
PLEASE VISIT HTTPS://WWW.FWS.GOV/WETLANDS/DATA/MAPPER.HTML OR CONTACT THE FIELD
OFFICE FOR FURTHER INFORMATION.

04/29/2022
IPaC User Contact Information
Agency:
LaBella Associates PC
Name:
Eric Prunchak
Address:
400 S Tryon St
Address Line 2:
#1300
City:
Charlotte
State:
NC
Zip:
28285
Email
[e-mail]
Phone:
7043766423

Roy Cooper, Governor
■*■19 NC DEPARTMENT OF
■■r�■� NATURAL AND CULTURAL RESOURCES
■ ■■■
April 29, 2022
Eric Prunchak
La Bella Associates PC
400 S Tryon St
Charlotte, NC 28285
RE: Blankenship Family Assemblage; 2220227
Dear Eric Prunchak:
D. Reid Wilson, Secretary
Misty Buchanan
0,LWV Director, Natural Heritage Program
The North Carolina Natural Heritage Program (NCNHP) appreciates the opportunity to provide
information about natural heritage resources for the project referenced above.
A query of the NCNHP database indicates that there are records for rare species, important natural
communities, natural areas, and/or conservation/managed areas within the proposed project
boundary. These results are presented in the attached `Documented Occurrences' tables and map.
The attached `Potential Occurrences' table summarizes rare species and natural communities that
have been documented within a one -mile radius of the property boundary. The proximity of these
records suggests that these natural heritage elements may potentially be present in the project area
if suitable habitat exists. Tables of natural areas and conservation/managed areas within a one -mile
radius of the project area, if any, are also included in this report.
If a Federally -listed species is documented within the project area or indicated within a one -mile
radius of the project area, the NCNHP recommends contacting the US Fish and Wildlife Service
(USFWS) for guidance. Contact information for USFWS offices in North Carolina is found here:
httr)s://www.fws.gov/offices/Directory/ListOffices.cfm?statecode=37.
Please note that natural heritage element data are maintained for the purposes of conservation
planning, project review, and scientific research, and are not intended for use as the primary criteria
for regulatory decisions. Information provided by the NCNHP database may not be published
without prior written notification to the NCNHP, and the NCNHP must be credited as an information
source in these publications. Maps of NCNHP data may not be redistributed without permission.
Also please note that the NC Natural Heritage Program may follow this letter with additional
correspondence if a Dedicated Nature Preserve, Registered Heritage Area, Land and Water Fund
easement, or an occurrence of a Federally -listed species is documented near the project area.
If you have questions regarding the information provided in this letter or need additional assistance,
please contact Rodney A. Butler at rod ney.butler�ncdcr.gov or 919-707-8603.
Sincerely,
NC Natural Heritage Program
0EPARTHENT OF NATVRAt AND CULTURAL RESOVRCES
{4 l21 W..1ONEI, STPrCT RALMGH r-iC 2?A;,c3 • 1651 MAIL SI"RviCE CENTPR, RALEIGH_ WC 276"
OFC KW0791120 • FAX919.707,13131

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