20081045 Ver 1_401 Application_20080708

0Ir ."C) 45
Soutkern Environmcntal Group, Inc.
5315 `jouth College }load, `juite E- • Wilmington, Nortk Carolina 28412
910.452.271 1 - rax. 910.452.2899 - [e-mail]
www.segws
June 30, 2008
United States Postal Service
Mr. Ian McMillan
401 Oversite/Express Review Permitting Unit
2321 Crabtree Boulevard
Suite 250
Raleigh, NC 27604
Re: Brunswick Community Hospital Site
Supply, North Carolina
USACE AID: SAW-2008-1690
DWQ Courtesy Copy
Dear Mr. McMillan:
Pr= c??oe[NQ
JUL 2 2008
DENR - WATER QUALITY
WETUms AND STORMWATER BRANCH
jSEGi Project #07-004.01]
Southern Environmental Group, Inc. (SEGi) has been retained by Brunswick Community
Hospital, LLC to pursue approval from the Department of the Army to utilize the Nationwide
Permit 39 to impact 0.13 acre (5,226.8 SF) of jurisdictional wetlands. The fill is necessary to
establish infrastructure, as well as provide a stable building foundation for the proposed
Brunswick Community Hospital, to be located at 555 Highway 17, near Supply, in Brunswick
County, North Carolina. It is SEGi's understanding that DWQ written concurrence is not
required for this project.
The site is an approximately 101.25 acre parcel, which is bordered by NC-17 to the east and by
Beaverdam Swamp to the west. Beaverdam Swamp is a tributary to the Lockwood Folly River.
The site is comprised of an open water stream system and several associated drainage patterns.
Historically, the site was utilized for silviculture and agriculture. There is an existing soil road
which bisects the property. The road begins at the southern property boundary and runs
northwest, where it connects to other soil roads within and outside the project boundaries. The
roads ware implemented to provide access to the land during the forestry period. Today the site
has been cleared and graded in preparation of the proposed medical facility and attendant
features.
SE-6i
Brunswick County Community Hospital, LLC, is in the process of obtaining all required permits
for the much needed medical facility, which will replace the existing hospital located just south
of this site. This new facility will be much more technologically advanced and has also been
designed for future expansion, unlike the existing facility, which was not planned to
accommodate future expansion without major disruption to existing services within the hospital.
The new campus will have an initial facility which will house 68 beds, with expansion
capabilities of 200 beds total.
The proposed facility was designed for vertical expansion to minimize a sprawling footprint and
impervious surface area, which, in turn, minimizes impacts to wetlands. In addition, the existing
soil road will be utilized to construct the access road. The fill material will be stabilized using
traditional methods (i.e. 3:1 side slopes, seeding and mulching).
A combination of mitigation mechanisms will be utilized to satisfy the Corps' mitigation
requirements:
1. Minimization and avoidance of impacts to 404 jurisdictional wetlands has been
incorporated into the design plan;
2. All remaining wetlands, outside any utility easements and within the project boundaries,
will be placed into preservation; and
3. Applicant shall make payment to the North Carolina Ecosystem Enhancement Program
(NC EEP) in an attempt to off-set impacts associated with the development.
For clarification and verification of the statements made above, please refer to the following
documentation attached to this correspondence:
Attachment 1. Pre-Construction Notification
Attachment 2. Overall Impact Map
Attachment 3. Zoom Shots of Impact Areas
Attachment 4. Cross-sections
Attachment 5. Aerial Photograph
Attachment 6. Vicinity Maps (2 scales)
Attachment 7. Tear Sheet and Signed Map
Attachment 8. NC EEP In-Lieu Fee Acceptance Letter
Attachment 9. Draft Declaration of Preservation
Attachment 10. Draft Exhibit A - Preservation Map
Attachment 11. General Warranty Deed
Attachment 12. Letter of Agency
Should have any questions/comments about the project, please feel free to contact me at
910.452.2711. Thank you in advance for your assistance.

SE-Gi
Sincerely,
Dana A. Lutheran
Project Manager
Enclosures (12)
0.
/? h? hmer)- /
Office Use Only:
08-1045
Revised Version December '06
USACE Action ID No. DWQ No.
(1f any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
Processing
1. Check all of the approval(s) requested for this project:
?X Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
? 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: 39
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: FZ
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: N
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page 4),
and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information: Brunswick Community Hospital, LLC
Name: Dave MacMillan
Mailing Address: PO Box 33549
Charlotte, NC 28233
Telephone Number: NA Fax Number: NA
E-mail Address: NA
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: Ms. Dana Lutheran
Company Affiliation: Southern Environmental Group, Inc.
Mailing Address: 5315 S. College Rd. Suite E
Wilmington, North Carolina 28412
Telephone Number: 910.452.2711 Fax Number: 910.452.2899
E-mail Address: dlutheranksegims
QP= c?R odr= P
JUL 2 2008
Page 1 of 10 DENR - WATER QLWM
WETLANDS AND STDRMWATER BRANCH

III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction drawings
rather than a sequential sheet version of the full-size plans. If full-size plans are reduced to a
small scale such that the final version is illegible, the applicant will be informed that the project
has been placed on hold until decipherable maps are provided.
1. Name of project: Brunswick Communi Hospital
2. T.I.P. Project Number or State Project Number (NCDOT Only): NA
3. Property Identification Number (Tax PIN): 15200042
4. Location
County: Brunswick Nearest Town: Supply
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers, landmarks, etc.): Site is located on the right side
of Hwy 17, just past Galloway Road NE, near supply, in Brunswick County.
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody)
Decimal Degrees (6 digits minimum): 34.0377°N -78.2577°W
6. Property size (acres): 101.25 ac.
7. Nearest body of water (stream/river/sound/ocean/lake): Beaverdam Swamp
8. River Basin: Cape Fear River Basin
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project at
the time of this application:
The site is an approximately 101.25 acre parcel that is bordered by NC-17 to the east and
by Beaverdam Swamp to the west Beaverdam Swamp is a tributary to the Lockwood
Folly River. The site is comprised of an open water stream system and several associated
drainage patterns Historically, the site was utilized for silviculture and agriculture.
Page 2 of 10
There is an existing soil road which bisects the property. The road begins at the southern
property boundary and runs northwest where it connects to other soil roads within and
outside the project boundaries The road was implemented to provide access to the land
during the forestry period Today the site has been cleared and graded in preparation of
the proposed medical facility and attendant features.
10. Describe the overall project in detail, including the type of equipment to be used:
In order to prepare the site for the proposed medical facility and attendant features,
heavy equipment such as backhoes, dump trucks, graders, and paving machinery will be
utilized during the construction of the facility. The proposed development requires 0.13
acre of 404 jurisdictional wetland impact.
11. Explain the purpose of the proposed work:
Brunswick County Communi Hospital has began to construct a much needed
replacement facility for the existing hospital that is located just south of this site. This
new facility will be much more technologically advanced and has been designed for
future expansion The existing facility was not planned to accommodate future
expansion without major disruption to existing services within the hospital. The new
campus will have an initial facility which will house 68 beds, with expansion capabilities
of 200 beds total This is a much needed facility in the county and one that Novant
Health is planning for long term commitment to the community.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
USACE Jurisdictional Determination has been issued under AID # SAW-2008-1690.
At this time, Site Solutions (Engineer) is in the process of applying for a NC Phase II
Stormwater Permit.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
At some time in the future, expansion of the proposed facility is anticipated. With that
expansion will come the need for additional parking Impacts to 404 wetlands are not
Page 3 of 10
anticipated with the expansion of the facility or parking areas (see attached Overall Site
Plan for details of expansion areas).
It is anticipated that specialty medical offices will be needed in close proximity to the
proposed facility. Therefore, the Applicant has incorporated future medical offices and
associated parking areas into this site plan Again, wetland impacts associated with the
proposed future development are not anticipated.
In accordance with the Brunswick Counly Technical Review Committee, two stub-outs are
proposed They will provide access to the remaining undeveloped portion of the tract. At
this time, a design plan for the remainder of the parcel has not been formulated. The
Applicant does not anticipate this area to be developed within the next two years, and feels
it would be premature to include any future requests in this permit. Please note, should
additional impacts be required with the future development of this area, they will be
treated as cumulative and mitigated for appropriately.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description of the proposed impacts:
Impact Area 1: Fill required to provide a stable building footprint
Impact Area 2• Fill associated with the proposed access road.
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For
A- CPI1AYAfPIV lief imnn1-te rlne fn lNnfll ctrnetnre an(i flooding_
Wetland Impact Type of Wetland Located within Distance to Area of
Site Number
(indicate on Type of Impact (e.g., forested, marsh, 100-year
Floodplain (yes/ Nearest
Stream Impact
(acres)
map) herbaceous, bog, etc.) no) (linear feet)
1 Fill Bottomland Hardwood No 800 0.09
2 Fill Bottom land Hardwood No 600 0.04
Total Wetland Impact (acres) 0.13
Page 4 of 10
3. List the total acreage (estimated) of all existing wetlands on the property: 4.75 acre of
wetlands exist within the project boundaries, as verified by Kim Garvey on 1/30/08.
4. Individually list all intermittent and perennial stream impacts. Be sure to identify
temporary impacts. Stream impacts include, but are not limited to placement of fill or
culverts, dam construction, flooding, relocation, stabilization activities (e.g., cement
walls, rip-rap, crib walls, gabions, etc.), excavation, ditching/straightening, etc. If stream
relocation is proposed, plans and profiles showing the linear footprint for both the
original and relocated streams must be included. To calculate acreage, multiply length X
width then divine by 41 Shin
Stream Impact Average Impact Area of
Number Stream Type of Impact Perennial or Stream Width Length Impact
(indicate on Name Intermittent. Before Impact (linear feet) (acres)
map)

NA
Total Stream Impact (by length and acreage) NA
5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds,
Atlantic Ocean and any other water of the U.S.). Open water impacts include, but are not
limited to fill, excavation, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact Name of Waterbody Type of Type of Waterbody Area of
Site Number (if applicable) Impact (lake, pond, estuary, sound, Impact
(indicate on map) bay, ocean, etc.) (acres)

NA
Total Open Water Impact (acres) NA
6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres : 0.0
Wetland Impact (acres): 0.13
Open Water Impact (acres): 0.0
Total Impact to Waters of the U.S. (acres) 0.13
Total Stream Impact (linear feet): 0.0
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ?X No
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
Page 5 of 10
8. Pond Creation: Yes
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ?X uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): Excavation
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): Stormwater
Current land use in the vicinity of the pond: Undeveloped
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
As previously noted, Brunswick County is in desperate need of a larger, more advanced
medical facility, as the existing hospital was not designed for expansion and has outgrown
its skin The new facility, as proposed has been designed for vertical expansion. This
design minimizes a sprawling footprint and impervious surface area which, in turn,
minimizes impacts to wetlands In an effort to minimize wetland impacts even further, an
existing soil road will be utilized to construct the attendant road.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15, 2002, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland and/
or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
Page 6 of 10
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at http://h2 o.enr.state.nc.us/
newetlands/stnngide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
In order to offset the 0.13 acre of impacts to 404 jurisdictional wetlands associated with
the development of the property the Applicant is proposing to make payment to the NC
EEP In-Lieu Fee Program for 0.25 acre of riparian mitigation credit, in addition to
preserving almost all of the remaining riparian wetlands located within the project
boundaries Those wetlands not placed into preservation are associated with four (4)
utility easements located within the project boundaries. In total, 3.47 acres of riparian
wetlands will be placed into strict preservation (see attached NC EEP Acceptance
Letter Draft Preservation Language and accompanying Exhibit Map).
Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h2o.enr.state.nc.us/wr2/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet): 0.0 .
Amount of buffer mitigation requested (square feet): 0.0 .
Amount of Riparian wetland mitigation requested (acres): 0.25 (1.9:1 or 0.25 ac / 0.13 ac)
Amount of Non-riparian wetland mitigation requested (acres): 0.0 .
Amount of Coastal wetland mitigation requested (acres): 0.0 .
1. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes ? No FX1
Page 7 of 10
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ?
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
IX. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify)?
Yes ? No 0 If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Impact Multiplier Required
- ware feet - -Mitigation
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
X. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
Page 8 of 10
downstream from the property. If percent impervious surface exceeds 20%, please provide
calculations demonstrating total proposed impervious level.
At this time the Applicant has not submitted their application for a Phase Il State
Stormwater Permit It is SEGFs understanding that this will take place within the next 2
weeks.
Existing Impervious Surface Area: 0%
Total Project Area: 101.25 ac. (4,410,450.0 SF)
Total Impervious Area within Project Limits: 22.91 ac. (997,959.6 SF)
Percent Impervious Surface Area within Project Limits: 22.6 %
XI. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
Municipal or septic.
II. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No M
Is this an after-the-fact permit application?
Yes O No ?X
XII. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes D No 0
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.ne.us/ncwetlands. If no, please provide a short narrative description:
The proposed development will open up previously unaccessible portions of this parcel for
development. While minor future impacts may be anticipated, they will require
appropriate stormwater and erosion control measures, which are shown to reduce
potential impacts to downstream receiving waters.
Page 9 of 10
XIIL Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may choose
to list constraints associated with construction or sequencing that may impose limits on work
schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 10 of 10

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U.S. ARMY CORPS OF ENGINEERS
WMNUNGTON DISTRICT
Action Id- SAW-2008-1690 County: Brunswick U.S.G.S. Quad: &pply
NOTIFICATION OF JURISDICTIONAL DETERMINATION
Property Owner Tunston Partn r LLC 63arcel #s 1520064411-&'1520 04201.
Y?. .:. ....... ,?.,..
Address: c/oBicace Cameron
?n 4 .
PQ.oX 3 49
Wilmington: N.C 2840ti
Property Owner- Brunswick Community Hospital LLC !parcel # 15200042)
Address: do Dave Macmillan
PO Box 33549
Charlotte, NC 28233
Property description:
Size (acres) 385.35 Nearest Town Supply
Nearest Waterway )Beaverdam Swamp River Basin Lumber
USGS HUC 030_ 40208 Coordinates N 34.0377 W 78.2577
Location description The parcel is located along H 17 and Landfill Road near SuDDly. Brunswick Coun North
Carolina. Parcel ffs15200042 1520004411 & 1520004201.
Indicate Which of the Following Apply:
A. Preliminary Determination
Based on preliminary information, there may be wetlands on the above described property. We strongly suggest you have
--this property inspected to determine the extent of Department of the Army (DA) jurisdiret?-To be considered final, a
jurisdictional determination must be verified by the Corps. This preliminary determination is not an appealable action
under the Regulatory Program Administrative Appeal Process ( Reference 33 CFR Part 331),
R. Approved Determination _
_ There are Navigable Waters of the United States within the above described property subject to the permit requirements of '
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law or
our published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
?C There are waters of the U.S. including wetlands on the above described property subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published
regulations, this determination may be relied upon for a period not to exceed five years from the date of this notification.
_ We strongly suggest you have the wetlands on your property delineated. Due to the size of your property and/or our
present workload, the Corps may not be able to accomplish this wetland delineation in a timely manner. For a more timely
delineation, you may wish to obtain a consultant. To be considered final, any delineation must be verified by the Corps.
The wetland on your property have been delineated and the delineation has been verified by the Corps. We strongly
suggest you have this delineation surveyed. Upon completion, this survey should be reviewed and verified by the Corps.
OncEverified, this survey will provide an accurate depiction of all areas subject to CWA jurisdiction on your property
which, provided there is no change in the law or our published regulations, may be relied upon for a period not to exceed
five years.
X The waters of the U.S. including wetlands have been delineated and surveyed and are accurately depicted on the plat
signed by the Corps Regulatory Official identified below on Ma 24, 2008. 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-

Action 1D: SAW-2008-1690
There are no waters of the U.S., to include wetlands, present on the above described property which are subject to the
permit requirements of Section 404 of the Clean Water Act (33 USC 1344). Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
X 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 Wilmington, NC, at [phone] to determine
their requirements.
Placement of dredged or fill material within waters of the US and/or wetlands without a Department of the Army permit may
constltute a violation of Section 301 of the Clean Water Act (33 USC § 1311). If you have any questions regarding this
determination and/or the Corps regulatory program, please contact Ms. Kimberly Garvey. Regulatory Specialist at 9? 101
251-4482 or kmberly 1 garv"@usace army mil.
C. Basis For Determination
The site exhibits wetland criteria as described in he 1987 Corps Wetland Delineation Manual and water bodies with
ordina high water marks that drain to Beaverdam Swam and to the Lockwoods Foll River a Traditionall
Navigable Water. Thi determination is ased on information submitted b The Clark Group and a site visit b
Kimberly Garvey, of this office, on I130108
D. Remarks
E. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in
B. above)
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this
determination you must submit a completed RFA form to the following address:
District Engineer, Wilmington Regulatory Division
Attn: Kimberly Garvey, Project Manager,
Wilmington Regulatory Field Office
PO Box 1890
Wilmington, North Carolina 28403
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 District Office within 60 days of the date of the NAP.
Should you decide to submit an RFA form, it must be received at th ve address by Ju124.200g.
**It is not necessary to submit an fo o thct Offi if ou do not object to the determination in this
correspondence.**
Corps Regulatory
Date Mav 24, 2008
Date May 24, 2013
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 attached customer Satisfaction Survey or visit
http://www.saw.usace.ariny.miVWETLANDS/index.html to complete the survey online.
Copy furnished:
Chad Coburn, NCDENR-DWQ, 127 Cardinal Drive, Wilmington, NC 28405
Gary Mitchell, The Clark Group, PO Box 10136, Castle Hayne, NC 28429

Applicant: Funston Partners (c% Bruce Cameron for parcel
#s 1520004201 & 1520004411) and Brunswick Community
Hospital (c/o Dave Macmillan for parcel # 15200042)
Attached is:'
INITIAL PROFFERED PERMIT
PROFFERED PERMIT Standard
PERMIT DENIAL
File Number: SAW-2008-1690 Date: May 24,
2008
Peiuut or Letter of
Permit or Letter of nermissi
APPROVED JURISDICTIONAL DETERMINATION
PRELDAINARY JURISDICTIONAL DETERMINATION
A: E4ITUL PROFFERED PERIMT: You may accept or object to the permit.
See Section
below
A
B
C
D
E
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 H 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 11 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.
a
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.
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 arc addressed in the adiilinislra.live 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.
If you have questions regarding this decision T
and/or the appeal process you may contact:
District Engineer, Wilmington Regulatory Division,
Attn: Kimberly Garvey, Project Manager
Wilmington Regulatory Field Office
PO Box 1890
Wilmington, North Carolina 28402
If you only have questions regarding the appeal process you
may also contact:
Mr. Mike Bell, Administrative Appeal Review officer
CESAD-ET-CO-R
U.S. Army Corps of Engineers, South Atlantic Division
60 Forsyth Street, Room 9M15
Atlanta, Georgia 30303-8801.
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any
government consultants, to conduct investigations of the project site during the course of the appeal process. You
will be provided a 15 day notice of any site investigation, and will have the opportunity to participate in all site
i n?tPC?i `ra+i nr. n
Date: + Telephone number:
of appellant or
For appeals on Initial Proffered Permits and approved Jurisdictional Determinations send this
form to:
District Engineer, Wilmington Regulatory Division, Attn: Kimberly Garvey, Project Manager,
Wilmington Regulatory Field Office, PO Box 1890, Wilmington, North Carolina 28403
For Permit denials and Proffered Permits send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Mike Bell,
Administrative Appeal Officer, CESAD-ET-CO-R, 00.Forsyth Street, Room 9M15, Atlanta,
Georgia 30303-8801
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PROGRAM
June 27, 2008
Mr. Bruce Cameron
Funston Partners, LLC
P.O. Box 3649
Wilmington, NC 28406
Expiration of Acceptance: December 27, 2008
Project: New Brunswick Community Hospital Site County: Brunswick
The purpose of this letter is to notify you that the North Carolina Ecosystem Enhancement Program (NCEEP) is willing to accept
payment for impacts associated with the above referenced project. Please note that this decision does not assure that the payment will
be approved by the permit issuing agencies as mitigation for project impacts. It is the responsibility of the applicant to contact these
agencies to determine if payment to the NCEEP will be approved.
This acceptance is valid for six months from the date of this letter and is not transferable. If we have not received a copy of the
issued 404 Permit/401 Certification/CAMA permit within this time frame, this acceptance will expire. It is the applicant's
responsibility to send copies of the permits to NCEEP. Once NCEEP receives a copy of the permit(s) an invoice will be issued based
on the requked mitigation in that pefmit and payment must be made prior to conducting the autho. ized work. The uniowit uf thr, In
Lieu Fee to be paid to NCEEP by an applicant is calculated based upon the Fee Schedule and policies listed at www.necep.net.
Based on the information supplied by you the impacts that may require compensatory mitigation are summarized in the following
table.
River CU Stream (feet) Wetlands (acres) Buffer I Buffer II
Basin Location (Sq. Ft.) (Sq. Ft.)
Cold Cool Warm Riparian Non-Riparian Coastal Marsh
Impacts Cape 03030007 0 0 0 0.13 0 0 0 0
Fear
Credits Cape 03030007 0 0 0 0.26 0 0 0 0
Fear
Upon receipt of payment, EEP will take responsibility for providing the compensatory mitigation. If the regulatory agencies require
mitigation credits greater than indicated above, and the applicant wants NCEEP to be responsible for the additional mitigation, the
applicant will need to submit a mitigation request to NCEEP for approval prior to permit issuance. The mitigation will be performed
in accordance with the Memorandum of Understanding between the N. C. Department of Environment and Natural Resources and the
U. S. Army Corps of Engineers dated November 4, 1998.
If you have any questions or need additional information, please contact Valerie Mitchener at [phone].
Sincerely,
William D. Gilmore, PE
Director
cc: Cyndi Karoly, NCDWQ Wetlands/401 Unit
Kim Garvey, USACE-Wilmington
Chad Coburn, NCDWQ-Wilmington
Dana Lutheran, agent
File ©
k"toruiG9... ... Prot-P.Gtl l? ow Stag RUM-
North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699-16521919-715-0476 /wvvw.nceep.net
/4+_? ch M&O _- ?
MODEL DECLARATION OF RESTRICTIONS
August, 2003
STATE OF NORTH CAROLINA
3yJU_ -Q-> D i C_V_ COUNTY
CONSERVATION DECLARATION
This DECLARATION of CONSERVATION COVENANTS, CONDITIONS, and
RESTRICTIONS (" ") is made on this day of cJicne ,
2008, by ?3t-urt,i elc-C?mmu? Na?,p??a? "Declarant").
RECITALS & CONSERVATION PURPOSES
A. Declarant is the sole owner in fee simple of the certain Conservation
Property (Property) being approximately _ <3. M acres, more particularly described in
Exhibit A attached hereto and by this reference incorporated herein [reference to a
recorded map showing a survey of the preserved area may be required]; and
B. The purpose of this Conservation Declaration is to maintain wetland and/or
riparian resources and other natural values of the Property, and prevent the use or
development of the Property for any purpose or in any manner that would conflict with
the maintenance of the Property in its natural condition. The preservation of the Property
in its natural condition is a condition of Department of the Army permit Action 1D
t?OW-Zaog- lAc)issued by the Wilmington District Corps of Engineers (Corps), required
to mitigate for unavoidable impacts to waters of the United States authorized by that
permit, and this Conservation Declaration may therefore be enforced by the United States
of America.
NOW, THEREFORE the Declarant hereby unconditionally and irrevocably declares that
the Property shall be held and subject to the following restrictions, covenants and
conditions as set out herein, to run with the subject real property and be binding on all
parties that have or shall have any right, title, or interest in said property.
ARTICLE I. PROHIBITED AND RESTRICTED ACTIVITIES
Any activity on, or use of, the Property inconsistent with the purposes of this
Conservation Declaration is prohibited. The Property shall be maintained in its natural,
scenic, and open condition and restricted from any development or use that would impair
or interfere with the conservation purposes of this Conservation Declaration set forth
above.
Without limiting the generality of the foregoing, the following activities and uses are
expressly prohibited or restricted.
A. Disturbance of Natural Features. Any change disturbance, alteration or
impairment of the natural features of the Property or any introduction of non-native
plants and/or animal species is prohibited.
B. Construction. There shall be no constructing or placing of any building,
mobile home, asphalt or concrete pavement, billboard or other advertising display,
antenna, utility pole, tower, conduit, line, pier, landing, dock or any other temporary or
permanent structure or facility on or above the Property.
C. Industrial, Commercial and Residential Use. Industrial, residential and/or
commercial activities, including any right of passage for such purposes are prohibited.
D. Agricultural, Grazing and Horticultural Use. Agricultural, grazing, animal
husbandry, and horticultural use of the Property are prohibited.
E. Vegetation. There shall be no removal, burning, destruction, harming, cutting
or mowing of trees, shrubs, or other vegetation on the Property.
F. Roads and Trails. There shall be no construction of roads, trails or walkways
on the property.
G. Sig_nage. No signs shall be permitted on or over the Property, except the
posting of no trespassing signs, signs identifying the conservation values of the Property,
signs giving directions or proscribing rules and regulations for the use of the Property
and/or signs identifying the Grantor as owner of the property.
H. Dumping or Storage. Dumping or storage of soil, trash, ashes, garbage, waste,
abandoned vehicles, appliances, machinery or hazardous substances, or toxic or
hazardous waste, or any placement of underground or aboveground storage tanks or other
materials on the Property is prohibited.
1. Excavation, Dredging or Mineral Use. There shall be no grading, filling,
excavation, dredging, mining or drilling; no removal of topsoil, sand, gravel, rock, peat,
minerals or other materials, and no change in the topography of the land in any manner
on the Property, except to restore natural topography or drainage patterns.
J. Water Quality and Drainage Pattern. There shall be no diking, draining,
dredging, channeling, filling, leveling, pumping, impounding or related activities, or
altering or tampering with water control structures or devices, or disruption or alteration
of the restored, enhanced, or created drainage patterns. In addition, diverting or causing
2
or permitting the diversion of surface or underground water into, within or out of the
easement area by any means, removal of wetlands, polluting or discharging into waters,
springs, seeps, or wetlands, or use of pesticide or biocides is prohibited.
K. Development Rights. No development rights that have been encumbered or
extinguished by this Conservation Declaration shall be transferred pursuant to a
transferable development rights scheme or cluster development arrangement or
otherwise.
L. Vehicles. The operation of mechanized vehicles, including, but not limited to,
motorcycles, dirt bikes, all-terrain vehicles, cars and trucks is prohibited.
M. Other Prohibitions. Any other use of, or activity on, the Property which is or
may become inconsistent with the purposes of this grant, the preservation of the Property
substantially in its natural condition, or the protection of its environmental systems, is
prohibited.
ARTICLE II. ENFORCEMENT & REMEDIES
A. This Declaration is intended to ensure continued compliance with the
mitigation condition of authorizations issued by the United States of America, U.S. Army
Corps of Engineers, Wilmington District, and therefore may be enforced by the United
States of America. This covenant is to run with the land and shall be binding on all
parties and all persons claiming under the Declarant.
B. Corps, its employees and agents and its successors and assigns, have the
right, with reasonable notice, to enter the Property at reasonable times for the purpose of
inspecting the Property to determine whether the Declarant, Declarant's representatives,
or assigns are complying with the terms, conditions and restrictions of this Conservation
Declaration.
C. Nothing contained in this Conservation Declaration shall be construed to
entitle Corps to bring any action against Declarant for any injury or change in the
Conservation Property caused by third parties, resulting from causes beyond the
Declarant's control, including, without limitation, fire, flood, storm, and earth movement,
or from any prudent action taken in good faith by the Declarant under emergency
conditions to prevent, abate, or mitigate significant injury to life, damage to Property or
harm to the Property resulting from such causes.
ARTICLE III. PUBLIC ACCESS
A. This Conservation Declaration does not convey to the public the right to
enter the Property for any purpose whatsoever.
ARTICLE IV. DOCUMENTATION AND TITLE
A. Conservation Property Condition. The Declarant represents and
acknowledges that the Property is currently undeveloped land, with no improvements
other than any existing utility lines, Declarations and rights of way.
B. Title. The Declarant covenants and represents that the Declarant is the
sole owner and is seized of the Property in fee simple and has good right to make the
herein Declaration; that there is legal access to the Property, that the Property is free and
clear of any and all encumbrances, except Declarations of record.
ARTICLE V. MISCELLANEOUS
A. Conservation Purpose.
(1) Declarant, for itself, its successors and assigns, agrees that this
Conservation Property shall be held exclusively for conservation purposes.
B. Entire Agreement. This instrument sets forth the entire agreement of the
parties with respect to the Conservation Declaration and supersedes all prior discussions,
negotiations, understandings or agreements relating to the Conservation Declaration. If
any provision is found to be invalid, the remainder of the provisions of this Conservation
Declaration, and the application of such provision to persons or circumstances other than
those as to which it is found to be invalid, shall not be affected thereby.
C. Recording. Declarant shall record this instrument and any amendment
hereto in timely fashion in the official records of 5vunscoiclLCounty, North Carolina,
and may re-record it at any time as may be required to preserve its rights.
D. Environmental Condition of Conservation Property. The Declarant
warrants and represents that to the best of its knowledge after appropriate inquiry and
investigation: (a) the Property described herein is and at all times hereafter will continue
to be in full compliance with all federal, state and local environmental laws and
regulations, and (b) as of the date hereof there are no hazardous materials, substances,
wastes, or environmentally regulated substances (including, without limitation, any
materials containing asbestos) located on, in or under the Property or used in connection
therewith, and that there is no environmental condition existing on the Property that may
prohibit or impede use of the Property for the purposes set forth in the Recitals.
IN WITNESS WHEREOF, Declarant has hereunto set his hand and seal, the day and
year first above written.
[Signature of Declarant in proper form]
4
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50utkern Environmental 6roup, Inc.
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represent 2?/YkH1-41aA ,; g
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consulting services on real property owned 6,9 at !V/ l (PwFcrty Owner)
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(Address) (City)
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Land Owner/ Agent
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5515 South College Road, Juite F- • Wilmington, North Carolina 28412
.910.+12-2711 • Fax: 910.+52.2899 • of{[e-mail]
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275Deeds 1 11709
of page
Robinson Register of Deeds
03-03-2006 11:43:24.002 Brunswick County, NC
NC REVENUE STAMP: $10025.00 (#106326)
ash 5
1 - ' Ck 811??- l`
'? .) Refeir _ Finance
pp?l ttts of tocumec; a , dltlDn
? IJocvnianl txmtalns 5^ =.'
irtslttaaetdCMitar,:; copled.
Tax: S I
Parse) Identifier No. Verified by+K - ` Obu'ory on the _ day of , 20
By: L ,..,_, .
MaiLBox to: Johnston, Allison & Hord, P.A., P.O. Box 36469, C}i? 28236
This instrument was prepared by: Johnston, Allison & Hord, P.A. (JWA)
Briefdescription for the Index: Tract A, Plat Book 48, Page 33
THIS DEED made this 2 9 day of
NORTH CAROLINA GENERAL WARRANTY DEED
S x
5.00 „.g.. - J' I - I. -
by and between l
GRANTOR I '1' GRANTEE
Bruce B. Cameron, IV (unmarried), Allee -Jfr,rson E1.4, :iDAV141WICK COMMUNITY HOSPITAL, LLC
Scott C. Sullivan, Jabe V. Hardee and Cameron Properties Affri:''Fijtrty Management
Limited Partnership P. O. Box 33549
Charlotte, Nc 28233
Enter in avoropnate block for each party: name, address, and, if appropriate, character of entity, e.g. corporation or
The designation Grantor and Grantec as used hehall include said par;iC , ifieirCits, successors, and assigns, and shall include
singular, plural, masculine, feminine or neuter as 'C 'Y-co
WITNESSETH, that the Grantor, for a valuable c eiafidn paid by tbs-"P tt?ef xltc receipt of which is hereby acknowledged, has
?'
and by these presents does grant, bargain, sell ud rivey unioS* Gra!?te@in fee simple, all that certain lot or parcel of land situated
in Lockwood Folly Township, Brunswick County, North Carolina "and' or 'jgrticularly described as follows (the "Property'l:
BEING all of Tract A, containing approximately 101.25 acres, as shown on that certain Map for
Cameron Properties Limited Partnership, recorded in Plat Book 48 at Page 33, in the Office of the
Register of Deeds for Brunswick County, North Carolina.
TOGETHER WITH all rights ben" 1 the Property snVhdotvxer thereof and SUBJECT TO
obligations of the owner of the Property tp• :.? 6a?th'ri t iitiri Master Declaration of Covenants,
Conditions, Restrictions and Easle n" f B pnat?iek ViHsZr,s,tec?}rded in Book 5 at Page
1r , in the Office of the Regi .7 eas (gt,$s>}u?wtck County, North Carolina.
TOGETHER WITII all rights benefiting the Property and the oivner thereof and SUBJECT TO any
obligations of the owner of the Pro rty contained to that certain Declaration of Restrictions of
Brunswick Village recorded in BooiT' at Page , in the Office of the Register of Deeds for
Brunswick County, North Carolina.
Al .
The Property hereinabove described was acqutred?X Grantor by instrumer)t+pcgtde?l in Book 2614 at Page 989 and in Book 2698 at
r>:
Page 808 of the Brunswick County Public Registry. ? •.E.
438992 ..4 I

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