20081459 Ver 1_401 Application_20080908

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William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
'-1459
June 19, 2008
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
Land Management Group
Attn: Adam Carter
PO Box 2522
Wilmington, North Carolina 28402
Subject Property: Club Pond Crossing
® RETURN OF CORRESPONDENCE AND USACE PERMIT
Dear W. Carter:
Coleen H. Sullins, Director
Division of Water Quality
DWQ# Not Assigned
Hoke County
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s E P 4 2008
7EN? -±tiF,i ??;
V&TL. DS AHO 37 ORt1',IATER FsR/aKII
On June 19, 2008, the Division of Water Quality (DWQ) received your correspondence relating to the
above referenced project. The DWQ has determined that a 401 Water Quality Approval is necessary and
will require submission of five (5) PCN application sets along with the appropriate fee to impact protected
wetlands and/or streams on the subject property.
Additional Information Requested:
® For written concurrence to occur, DWQ requires five (5) complete application sets along with the
appropriate fee. Please visit the following site and print off the correct application for lake
residence work: http://h2o.enr.state.nc.us/ncwetiands/ Select `Applying for a 401 Water Quality
Certification' heading on the left side; review Frequently Asked Questions and complete the
required PCN form for submission.
® The fee for applications is $240 for projects impacting less than an acre of wetland and less than
150 linear feet of streams (whether intermittent or perennial). For projects impacting one or more
acres of wetland or 150 or more fett of streams (whether intermittent or perennial) the fee is
$570. Please remit $240 made payable to DWQ to initiate the review and approval process.
This letter only addresses the application review and does not authorize any impacts to wetlands, waters
or protected buffers. Please be aware that any impacts requested within your application are not
authorized (at this time) by the DWQ. Please call Ian McMillan or me at 919-733-1786 if you have any
questions regarding or would like to set up a meeting to discuss this matter.
401 Oversight/Express Review Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: http://h2o.enr.state.nc.us/ncwetlands
r o Caro 'na
t fray
An Equal Opportunity/Aftirmitive Action Employer - 50% Recycled/ 10% Post Consumer Paper
Army Corps of Engineers/ Division of Water Quality
Wetland Data Package
Club Pond Road Tract
Hoke County
Property Owner: William Wright Jr., James Wright, Jeffery Wright
P.O Box 218, 52 East Second Street
Parkton NC 28371
[phone]
Applicant: Harvey Allen
Allen- Allen & Associates of N.C., 2606 Raeford Road,
Suite 31
Fayetteville NC 28303
Site address: Club Pond Road McLaughlin Township, Hoke County NC
Subdivision name: Club Pond Crossing
Lot number:
Parcel ID: pin 694450001094
Directions From Fayetteville take Highway 401 South towards Raeford. Go 14 miles and
Club pond road will be on your left. Go 3/a of a mile an property will be on the right.
Nearest water body: Beaver Creek
Name of watershed: Cape Fear 03030005
Coordinates of Site: Latitude: 79.1680 N
Longitude: 35.00588 W
USGS Quad: Raeford Quadrangle 7.5 minute topographic 1990
Total Size: -40.797 acres
Total Size of Wetlands: -1.131 acres (see preliminary wetland map for details)
With construction of roads, home site and driveways the impervious surface is calculated
at 14.24 percent.
,o IF a
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D
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
June 19, 2008
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
Land Management Group
Attn: Adam Carter
PO Box 2522
Wilmington, North Carolina 28402
Subject Property: Club Pond Crossing
® RETURN OF CORRESPONDENCE AND USACE PERMIT
Dear Mr. Carter:
Coleen H. Sullins, Director
Division of Water Quality
DWQ# Not Assigned
Hoke County
On June 19, 2008, the Division of Water Quality (DWQ) received your correspondence relating to the
above referenced project. The DWQ has determined that a 401 Water Quality Approval is necessary and
will require submission of five (5) PCN application sets along with the appropriate fee to impact protected
wetlands and/or streams on the subject property.
Additional Information Requested:
® For written concurrence to occur, DWQ requires five (5) complete application sets along with the
appropriate fee. Please visit the following site and print off the correct application for lake
residence work: http://h2o.enr.state.nc.us/ncwetlands/ Select `Applying for a 401 Water Quality
Certification' heading on the left side; review Frequently Asked Questions and complete the
required PCN form for submission.
® The fee for applications is $240 for projects impacting less than an acre of wetland and less than
150 linear feet of streams (whether intermittent or perennial). For projects impacting one or more
acres of wetland or 150 or more feet of streams (whether intermittent or perennial) the fee is
$570. Please remit $240 made payable to DWQ to initiate the review and approval process.
This letter only addresses the application review and does not authorize any impacts to wetlands, waters
or protected buffers. Please be aware that any impacts requested within your application are not
authorized (at this time) by the DWQ. Please call Ian McMillan or me at 919-733-1786 if you have any
questions regarding or would like to set up a meeting to discuss this matter.
401 Oversight/Express Review Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: http://h2o.enr. state. nc. us/ncwed ands
NorthCarolina
JVa&MAY
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID. SAW-2008-00269 County: Hoke USGS Quad: Raeford
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner / Authorized Agent: Mr. William Wright Jr., Mr. James Wright, and Mr. Jeffrey Wright
Address: PO Box 218
Parkton, NC 28371
Telephone No.: 919-858-3701
Size and location of property (water body, road name/number, town, etc.): The property is approximately 40 acres and
is located at the northwest corner of Club Pond Road and Rockfish Road, east of Raeford Hoke County North
Carolina.
Description of projects area and activity: This permit authorizes the discharge of fill material into 0.024 acres of
wetlands for the construction of a road associated with the development of the Club Pond Crossing residential
subdivision.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
? Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number:
Nationwide Permit Number: 29
SEE ATTACHED GENERAL, REGIONAL AND SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted plans. Any violation of the attached conditions or deviation from your submitted plans may
subject the permittee to a stop work order, a restoration order and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and/or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide permit. If the nationwide permit authorization expires or is suspended, revoked, or is modified, such that the
activity would no longer comply with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify, suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you must contact the N.C. Division of Coastal Management.
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program, please contact Ronnie Smith at 910-251-4829
Corps Regulatory Official Ronnie Smith Date: Mav 21, 2008
Expiration Date of Verification: May 21, 2010
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-g-my.miYWETLANDS/index.htnil to
complete the survey online.
Page 1 of 2
Determination of Jurisdiction:
? Based on preliminary information, there appear to be waters of the US including wetlands within the above described project area.
This preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
( Reference 33 CFR Part 331).
? There are Navigable Waters of the United States within the above described project area 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.
® There are waters of the US and/or wetlands within the above described project area 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.
? The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued. Action ID
Basis of Jurisdictional Determination: This site exhibits wetlands criteria as described in the 1987 Corns Wetland Delineation
Manual and is adjacent to an unnamed tributary of Beaver Creek, a tributary of Rockfish Creek, which is a traditional
naviLyable water of the U.S.
Appeals Information (This information applies only to approved jurisdictional determinations.)
Attached to this verification is an approved jurisdictional determination. If you are not in agreement with that approved jurisdictional
determination, you can make an administrative appeal under 33 CFR 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: Ronnie Smith, Project Manager,
Wilmington Regulatory Field Office
PO Box 1890
Wilmington, North Carolina 28402
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 33 1.5, and that it has been received by the District Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by July 21, 2008.
**It is not necessary to submit an RFA form to the Dis ffice if you do not object to the determination in this correspondence.**
Corps Regulatory Official: Ronnie Smith
Date May 21, 2008 Expiration Date May 21, 2013
SURVEY PLATS, FIELD SKETCH, WETLAND DELINEATION FORMS, PROJECT PLANS, ETC., MUST BE
ATTACHED TO THE FILE COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
Copy Furnished:
Mr. Adam Carter
Land Management Group, inc.
PO Box 880
Lillington, NC 27546
Page 2 of 2
Action ID Number: SAW-2008-00269 County: Hoke
Permittee: Mr. William Wright, James Wright, Jeffrey Wright
Date Verification Issued: May 21, 2008
Project Manager:. Ronnie Smith
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
WILMINGTON REGULATORY FIELD OFFICE
POST OFFICE BOX 1890
WILMINGTON, NORTH CAROLINA 28402-1890
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. If you fail to comply with this permit you are subject to permit suspension,
modification, or revocation.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance 'with the permit conditions.
Signature of Permittee
Date

-pi
J, Ux

81
ION _t,XP AD1ITNTLSTRATIVE APPEAL OPTIONS A'-I) PROCESS AND_
ESRA?'PE?L __

Applicant: Mr. William Wright Jr., Mr File Number: SAW-2008- Date: May 21, 2008
James Wright, Mr. Jeffrey Wright 00269
At tached is: singed survey See Section below
IlvITIAL PROFFERED PERMIT (Standard Permit or Letter of A
permission)
PROFFERED PERMIT Standard Permit or Letter of permission) B
PERMIT DENIAL C
APPROVED JURISDICTIONAL DETERMINATION D
PRELIMINARY JURISDICTIONAL DETERMINATION E
SECT U N , I'- -fll ` ?'olloZt?11 lclentihes otir iiglus allci bons re«aidiil? an adnurlistrative appeal of tliz above
de-cIS"bn. Adaiti('_) al a f-6im mon ill a_ be fot'ld at llttp: 'i«???-.usacc,.arrify: iLinCt%f?ilcti iiLS, c? 'cc c%v6l/ eu or
Go . s Legulatigils at 33 CFRPart X31:
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 Comps 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.

?.SZ('TION lI PEE?? UEST 1`0
.._.. ,
? I?I'PEt1I:. ??r OBJE('TIOItiS TO r1N INITI?IL PR(3?FEIZED PERMIT-
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 O.CONTACTOR QUESTIONS _OR INF ORN?QN
If you have questions regarding this decision If you only have questions regarding the appeal process you
and/or the appeal process you may contact: may also contact:
Ronnie Smith
USAED-RG Mr. Mike Bell, Administrative Appeal Review Officer
CESAD-ET-CO-R
PO Box 1890
Wilmington
NC 28402 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
investigations.
Telephone number:
Signature of appellant or agent.
L
For appeals on Initial Proffered Permits and approved Jurisdictional Determinations send this form to:
District Engineer, Wilmington Regulatory Division, Attn: Ronnie Smith, Project Manager, Wilmington
Regulatory Field Office, PO Box 1890, Wilmington, North Carolina 28402
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, 60 Forsyth Street, Room 9M15, Atlanta, Georgia
30303-8801
NATIONWIDE PERMIT 29
DEPARTMENT OF THE ARMY
CORPS OF ENGINEERS
FINAL NOTICE OF ISSUANCE AND MODIFICATION OF NATIONWIDE PERMITS
FEDERAL REGISTER
AUTHORIZED MARCH 19, 2007
Residential Developments. Discharges of dredged or fill material into non-tidal waters
of the United States for the construction or expansion of a single residence, a multiple unit
residential development, or a residential subdivision. This NWP authorizes the construction of
building foundations and building pads and attendant features that are necessary for the use of
the residence or residential development. Attendant features may include but are not limited to
roads, parking lots, garages, yards, utility lines, storm water management facilities, septic fields,
and recreation facilities such as playgrounds, playing fields, and golf courses (provided the golf
course is an integral part of the residential development).
The discharge must not cause the loss of greater than 1/2-acre of non-tidal waters of the
United States, including the loss of no more than 300 linear feet of stream bed, unless for
intermittent and ephemeral stream beds this 300 linear foot limit is waived in writing by the
district engineer. This NWP does not authorize discharges into non-tidal wetlands adjacent to
tidal waters.
Subdivisions: For residential subdivisions, the aggregate total loss of waters of United
States authorized by this NWP cannot exceed 1/2 acre. This includes any loss of waters of the
United States associated with development of individual subdivision lots.
Notification: The permittee must submit a pre-construction notification to the district
engineer prior to commencing the activity. (See general condition 27.) (Sections 10 and 404)

RO

_ ?,'?'r er ?FA•n
.4?
*Boundaries are approximate and are
not meant to be absolute.
Map Source: North Carolina Atlas & Gazetteer. Pg 73.2003
Harvey Allen
Club Pond Road LMG
Hoke County, NC LAND MANAGEMENT GROUP

SCALE 1" = 1 Mile
Figure 1
Vicinity Man

*Boundaries are approximate and are
not meant to be absolute.
Map Source: Raeford Quadrangle 7.5 minute (topographic) 1990.
Harvey Allen
Club Pond Road LMG
Hoke County, NC LnvD MANnGEMEYE GROUP
SCALE 1 1200'
Figure 2
USGS Tooaraghic Map

AuA: Autryville loamy sand
BaD: Blaney loamy sand
CaB: Candor sand
",Boundaries are approximate and are LaB: Lakeland sand
not meant to be absolute. WaB: Wagram loamy sand
Map Source: NRCS Soil Survey.
Harvey Allen
Club Pond Road LMG
Hoke County, NC in M MANAGEM.E.r GROUP
SCALE 1" = 300'
Figure 3
Soils Man

*Boundaries are approximate and are
not meant to be absolute.
Map Source: 2006 NAPP aerial photography
Harvey Allen
Club Pond Road LMG
Hoke COUntV, NC LAND MANAGEMENT CROUP i,c
SCALE 1" = 300'
Figure 4
Aerial Photograph
rs __

k? n

?Y.

NOTE: All boundaries and distances are considered approximate.
This represents a preliminary map prepared from field sketches.
A survey of delineated areas and review and approval by the US
Army Corps of Engineers is recommended prior to specific site planning.
Map Source: 2006 NAPP aerial photography
Harvey Allen
Club Pond Road AI?LMG
Hoke Countv, NC Lnarn Mn ?ncc seer GROUP
SCALE 1" = 300'
Figure 5
Aerial Photograph with
SOILS
Map Unit Name
(Series and Phase): ? D z) 0 A

Taxonomy (Subgroup): 112A
lP.y LQ,M(i Drainage Class: 10C2
Field Observations Confirm Mapped Type?
? Yes ? No
Profile Description
Depth Matrix Colors
(inches) Horizon (Munsell Moist)
Mottle Colors Mottle Texture, Concretions,
(Munsell Moist) -Abundance/Conttast Structum etc.

?,W" CJY 1 Y

Hydric Soil Indicators:
? Histosol
? Histic Epipedon
? Sulfidic Odor
? Aquic Moisture Regime
? Reducing Conditions
? Gleyed or Low-Chroma Colors
? Concretions
? High Organic Content in Surface Layer in Sandy Soil
? Organic Streaking in Sandy Soils w
? Listed on Local Hydric Soils List
? Listed on National Hydric Soils List
? Other (Explain in Remarks)
[Remarks:
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ? Yes No
Wetland Hydrology
Present? ? Yes ?,??No Is this Sampling Point within a Wetland?.
Hydric Soils Present? : ? Yes [No ? Yees . t.ld4o
Remarks: This observation point is. located approximately. . (,t? S ? p& 'Fromm
w Dataform Standard
,t.
SOILS
Map Unit Name } -
(Series and Phase): > L a QQjj ' n ?al ld Drainage Class-
-
"
f
Field Observations ConfirriLMapped Type?
Taxonomy (Subgroup): ? Yes Rgo
-Profile Description:
Depth Matrix Colors
(inches) Horizon (
Mu
nsselll Moist) Motte Colors Mottle Texture, Concretions,
(Munsell Moist) Abundance/Contrast Structure, etc.
t
i

Hydric Soil Indicators:
? Histosol ? Concretions
? Histic Epipedon ? High Organic Content in Surface-Layer m Sandy Soil
? Sulfidic odor ? Organic streaking in sandy Soils
? quid Moisture Regime
( ? Listed on Local Hydric Soils List
Reducing Conditions
' ? Listed on National Hydric Soils List
[?
Gleyed or Low-Chroma Colors - ? Other (Explain in Remarks)
Remarks:
WETLAND DE I - RMIINATION
Hydrophytic Vegetation Present? Fkf Yes ? No
Wetland Hydrology Present? Yes El No Is this Samp ' Point within a Wetland?.
Hydric Soils Present? Yes ? -No lid Y es ? No
Remarks: This observation point is located approximately . ;.a,P+ au•N S 6pe d- . G
Oataform Standard
t
soILs
Map Unit Name
(Series and Phase): D rC t
6C / 4d S0, J Drainage Class: ?)ill , y
1l 1-o" krs?

Taxonomy (Subgroup): T Field Observations Confirm-Mapped Type?
? Yes Vl?o
Profile Description
Depth Matrix Colors
Cinches) Horizm (?M?u1 sseell moist)
S LL 1LL cy ?? Mottle Colors Mottle Texture, Concretions,
(Mansell Moist) Abundance/Contrast Structur etc.
_ -

Hydric Soil Indicators:
? Histosol ? Concretions
? Histic Epipedon ? High Organic Content in Surface Layer in Sandy Soil
? Sulfidic Odor d
? Organic Streaking in Sandy Soils
? Aquic Moisture Regime ? Listed on Local Hydric Soils List
rEr Reducing Conditions
uGleyed or Low-Chroma Colors ? Listed on National Hydric Soils List
El Other (
Explain in Remarks)
'
Remarks: J of k pal.l+ n 15 rjeif l t w?n t7 Tp? ?.IC'?"lux i µ i
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Yes ? No
Wetland Hydrology. Present? FdYes ? No Is this Sampligg Point within a Wetland?.
Hydric Soils Present? .. [Yes ? No
Yes ? No
T
Remarks: This observation point is located approximately . p . J4 Dolu j b[aoe 461-, A
Dataform Standard
` ms
SOILS
Map Unit Name
(Series and Phase): nn .47!),.D ZI0-??, .? Drainage Class:

Taxonomy (Subgroup): Field Observations Confirm Mapped Type?
? Yes ? No
Profile Description:
Depth Matrix Colors
(inches) Horizon unsell Moist Moide Colors Mottle Texture, Concretions,
(M?msell Moist) Abundanee/Conttact S etc.
o_-_ tv S z
/i
_
3-11 C)G - -- S G.
G
/
1???? - sL

Hydric Soil Indicators:
? Histosol ? Concretions
? Histic Epipedon
? Sulfidic Odor ? High Organic Content in Surface Layer in Sandy Soil
? Organic Streaking in Sandy Soils
? Aquic Moisture Regime ? Listed on Local Hydric Soils List
? Reducing Conditions ? Listed on National Hydric Soils List
? Gleyed or Low-Chroma Colors ? Other (Explain in Remarks)
Remarks:
WETLAND DETERABNATION
Hydrophytic Vegetation Present? ? . Yes ? No
Wetland Hydrology Present? ? Yes No Is this Sampling Point within a Wetland?
Hydric Soils Present? ? Yes 0 No ? Yes 2<o
Remarks: This observation point is located approximately.
.
/ i
?? ?(GYt' ? ?Er
K Dataform Standard
' t'
DATA FORM
ROUTINE WETLAND DETERMINATION
!t 9R7 rOF. W, l..A- Teta..e.,w,... nT......-.,
t/Site: ?l0 20r ,,4 9.( .
Date: a
aut/Owner.
gator. a?arrr nr?2r
F ?
County
State: North C
li
aro
na
Do
rmal Circumstances ex ist on the site? ®Yes [--]No
Is the site significantly disturbed (Atypical Situation)? E]Yes ®No
Is the area a potential Problem Area? ElYes ®No
(Ifneeded, explain on reverse.) Community ID:JZPL.. d
Transit ID:
Plot ID:-/--
VEGETATION
Dominant Plant Species tinn° Iridicat° r D9miaPlant Species
'
?Sh
t

1. L;rloclea\1dro?l /?
T
P&Iv- die
a
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9.1-yoai4 Lu,60(A. Kig" S F,4??
2.1 ij 14 daAtbw, s'y,o,-6P f I-Ac i lO.Vi 4-t.S .65p, V FweVwJ
3-qqe eUb Skcllq T AGit 11.
4 ?uc.^cu5 Yi,- r- C, L r T F 12.
5. Co, KV.S 5 -- 13.
6.Qu.p-Cu5 vir9iNCaaaP,111"U S' Fi1Ctt 14.
?•t?iNusoct?[s` I- 1' FAC 15.

Percent of dominant species that are OBL, FACW or FAC(excluding FAC-). X 100 =
HYDROLOGY
FFEINo orded Data (Describe in Remarks)
? Stream, Lake or Tide Gauge
? Aerial Photographs
? Other
record ed Data Available
Field Observations:
Depth of Surface Water, -(2L-(in.)
Depth to Free Water in Pit: (in.)
Depth to Saturated Soih (in.)
Remarks:
Wetland Hydrology Indicators:
Primary Indicators:
? Inundated
? Saturated in Upper 12 Inches
fl Water Marks
Q Drift Lines
? Sediment Deposits
? Drainage Patterns in Wetlands
Secondary Indicators. (2 or more required)
? Oxidized Root Channels in Upper 12 Inches
? Water-Stained Leaves
? Local Soil Survey Data
? FAC Neutral Test
? Other (explain in remarks)
K Dataform Standard
DATA FORM
ROUTINE WETLAND DETERMINATION
h987 COE Wetlands Delinentinn Mnnnnn
Date: 4 7- 0
Applicant/Owner. .dke
Investigator. C State: . North Carolina .

Do Normal Circumstances exist on the site? NYes ?No Community ID: A
Is the site significantly disturbed (Atypical Situation)? ?Yes NNo Transit ID-.
Is the area a potential Problem Area? ?Yes NNo Plot ID:-.
(Ifneeded, explain on reverse.)
VEGETATION
pominantPlant Species 1 Stratum
1
?-, t`i c)deNAP&J 'iY+li Gr0.1^'
I ndicator

W Dominant Plant Species Stratum Indicato
r
.
2. L;$4 5
Yh
` 9.

0

3. A7e,,eilo, C r(4, ?/)G f 1
.

a14
4. 5M'IjgX glakad. ,/
V
12.

i
d
0.
.c
Ci
R
LC?
6.?a cuIWiu? w
! 13.
14.
7
r
y
-%
,
o
0
q,,
5
L,
7.1-i t<,domba, STyraa{ia L
1 S Few
15.
8. r-JK4 16.
Percent of dominant species that are OBL, FACW or FAC(excluding FAC-). X loo = %
Remarks:
HYDROLOGY
? Recorded Data (Describe in Remarks)
? Stream, Lake or Tide Gauge
? Aerial Photographs
? Other
? No recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
® Inundated
Saturated in Upper 12 Inches
® Water Marks

Field Observations: ? Drift Lines
? Sediment Deposits

h ? Drainage Patterns in Wetlands
Dept
of Surface Water, (in.) Secondary Indicators_(2 or more required)

Depth to Free Water in Pit: (in.) ? Oxidized Root Channels in Upper 12 Inches
® Water-Stained Leaves
? Local Soil Survey Data
Depth to Saturated Soil: (in.) ? FAC Neutral Test
? Other (explain in remarks)
Remarks:
z,
K Dataform Standard
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE. Wetlands Delineation Manual)
Project/Site: ??Ii? ?r rA X? Date.
Applicant/Owner.
Investigator. r!t I ps County C
State: 'North Carolina
.
Do Normal Circumstances 6dst on the site? ®Yes ?No
Is the site significantly disturbed (Atypical Situation)? ?Yes ONO
ttheis area a potential Problem Area? ?Yes ®No
(Ifneeded, explain on reverse.) Community ID:4Ld
Transit ID:
Plot ID:
VEGETATION
Uommant Plant Species Strawm dica ''AA/r Dominant Plant SPecies Strew Indicator
1.).??iodenidroa 1?IL i eirc
T F,46 V? ~
? 9.4ct„io. 11A(lid404m) glh&, S F/}W
2.L,%4dgmbwr .5+ faci-Flat T FAe-f 10 Vi+; Ss
'AW-fdu5 S?e1?a?q f F,4 ?u 11-t; tl5 ryiwt L_ V F)Cw _
4.Q(tercu5 oic5ra L. % Fk 12.
13.
16. QlAc ttlwS VIr?jMMAC ?0;11 S' 14.
7.17i,vu5 i'wedq 1., 'r FA-e- 15.
8. smi la"X GlatxCa U t At 16.
II Percent of dominant species that are OBL, FACW or FAC(excluding FAC-). X 100 =.% , II
Remarks:
F1YDROY.n(_V
? Recorded Data (Describe in Remarks)
? Stream, Lake or Tide Gauge
? Aerial Photographs
? Other
? No recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
? Inundated
? Saturated in Upper 12 Inches
? Water Marks

Field Observations: ? Drift Lines
? Sediment Deposits

Depth of Surface Water, (in.) ? Drainage Patterns in Wetlands
Secondary Indicators_(2 or more required)

Depth to Free Water in Pit: (in.) ? Oxidized Root Channels in Upper 12 Inches
? Water-Stained Leaves

Depth to Saturated Soil: (in.) ? Local Soil Survey Data
? FAC Neutral Test
? Other (explain in remarks)
Remarks:
< Dataform Standard
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE, Wetlands Delineation Manual)
Project/Site: _ Cluh Pi:wd Rd Date:
Applicant/Owner:
Investigator.ei, C(is p v- county:-& kL
State:
North Carolina
.
.
Do Normal Circumstances exist on the site? ®Yes ?No Community ID : bI e_4 . 6(
Is the site significantly disturbed (Atypical Situation)? ?Yes ®No
Is the area a potential Problem Area? ?Yes ®No Transit ID:
Plot ID-_a__
(If needed, explain on reverse.)
VEGETATION
Dominant Plant Species /? Stratum
1
Lil';o4w8rcwl tt?hPP, 7- ndica
FItC Dominant Plant Species Stratum Indicator
.
2.1-1gjA6+0- S
F 9.
10.
3./Ylorp Ida CC rie tw(L,) gw6i S
4
$iw?[ Cw
- 11.
.
Mc 51oatu. Wt 'u- V 12.
5•l-yc,Nj% 6.uejdd_0_anyK,4c1, 5 r!4,vj 13.
t
6 UotcCrdunt C,0rytmbos
A/ $ I=RGnI 14.
/!
??
7 L(d4iL?gnbdn ShrdeYTra r i=AGf 15.
8. Zak, Oj.neQ X4 7- F&- 16.
Percent of dominant species that are OBL, FACW or FAC(excluding FAC-). X100=
Remarks:
HYDROLOGY
? Recorded Data (Describe in Remarks)
? Stream, Lake or Tide Gauge
? Aerial Photographs
? Other
? No recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
© Inundated
® Saturated in Upper 12 Inches
O Water Marks

Field Observations: ? Drift Lines.,
? Sediment Deposits

Depth of Surface Water, (in.) ? Drainage Patterns in Wetlands
Secondary Indicators_(2 or more required)
`g
Depth to Free Water in Pit: -j k (in) ? Oxidiied Root Channels in Upper 12 Inches
Water-Stained Leaves
N

Depth to Saturated Soil: (in.) Local Soil Survey Data
? FAC Neutral Test
? Other (explain in remarks)
Remarks:
Dataform Standard
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 I: BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR APPROVED JURISDICTIONAL DETERMINATION (JD):
B. DISTRICT OFFICE, FILE NAME, AND NUMBER:
C. PROJECT LOCATION AND BACKGROUND INFORMATION:
State:NC County/parish/borough: Hoke City: Mclaughlin Township
Center coordinates of site (lat/long in degree decimal format): Lat. 79.16801° N, Long. 35.00588° W.
Universal Transverse Mercator:
Name of nearest waterbody: Beaver Creek
Name of nearest Traditional Navigable Water (TNW) into which the aquatic resource flows: Cape Fear River
Name of watershed or Hydrologic Unit Code (HUC): 03030004
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):
El Office (Desk) Determination. Date:
Field Determination. Date(s):
SECTION II: SUMMARY OF FINDINGS
A. RHA SECTION 10 DETERMINATION OF JURISDICTION.
There Pick List "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.
El 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 Pick List "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): i
TNWs, including territorial seas
El Wetlands adjacent to TNWs
Relatively permanent waters2 (RPWs) that flow directly or indirectly into TNWs
El Non-RPWs that flow directly or indirectly into TNWs
® Wetlands directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to but not directly abutting RPWs that flow directly or indirectly into TNWs
Wetlands adjacent to non-RPWs that flow directly or indirectly into TNWs
0 Impoundments of jurisdictional waters
E] 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: linear feet: width (ft) and/or acres.
Wetlands: 1.131 acres.
c. Limits (boundaries) of jurisdiction based on: 1987 Delineation Manual
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:
' 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).
' Supporting documentation is presented in Section HIT.
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 III.A.1 and Section III.D.1. only; if the aquatic resource is a wetland adjacent to a TNW, complete Sections III.A.1 and 2
and Section III.D.L; otherwise, see Section III.B below.
1. TNW
Identify TNW:
Summarize rationale supporting determination:
2. Wetland adjacent 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 III.D.2. If the aquatic resource is a wetland directly abutting a tributary with perennial flow,
skip to Section III.D.4.
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 III.B.1 for
the tributary, Section III.B.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 M.C below.
1. Characteristics of non-TNWs that flow directly or indirectly into TNW
(i) General Area Conditions:
Watershed size: Pick List
Drainage area: Pck List
Average annual rainfall: inches
Average annual snowfall: inches
(ii) Physical Characteristics:
(a) Relationship with TNW:
? Tributary flows directly into TNW.
? Tributary flows through Pick List tributaries before entering TNW.
Project waters are )4clz List river miles from TNW.
Project waters are Pick List river miles from RPW.
Project waters are Pick List aerial (straight) miles from TNW.
Project waters are Pick List aerial (straight) miles from RPW.
Project waters cross or serve as state boundaries. Explain:
Identify flow route to TNW5:
Tributary stream order, if known:
4 Note that the Instructional Guidebook contains additional information regarding swales, ditches, washes, and erosional features generally and in the and
West.
5 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.
(b) General Tributary Characteristics (check all that apply):
Tributary is: ? Natural
? Artificial (man-made). Explain:
? Manipulated (man-altered). Explain:
Tributary properties with respect to top of bank (estimate):
Average width: feet
Average depth: feet
Average side slopes: P kk Lsf.
Primary tributary substrate composition (check all that apply):
? Silts ? Sands ? Concrete
? Cobbles ? Gravel ? Muck
? Bedrock ? Vegetation. Type/%cover:
? Other. Explain:
Tributary condition/stability [e.g., highly eroding, sloughing banks]. Explain:
Presence of run/riffle/pool complexes. Explain:
Tributary geometry: Pi k List
Tributary gradient (approximate average slope): %
(c) Flow:
Tributary provides for Pik Lis
Estimate average number of flow events in review area/year: Pick_ List
Describe flow regime:
Other information on duration and volume:
Surface flow is: Pick Lisi. Characteristics:
Subsurface flow: Pick List. Explain findings:
El Dye (or other) test performed:
Tributary has (check all that apply):
? Bed and banks
? OHWM6 (check all indicators that apply):
? clear, natural line impressed on the bank ?
? changes in the character of soil ?
? shelving ?
? vegetation matted down, bent, or absent ?
? leaf litter disturbed or washed away ?
? sediment deposition ?
? water staining ?
? other (list):
? Discontinuous OHWM.7 Explain:
the presence of litter and debris
destruction of terrestrial vegetation
the presence of wrack line
sediment sorting
scour
multiple observed or predicted flow events
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;
? 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:
Identify specific pollutants, if known:
6A 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.
(iv) Biological Characteristics. Channel supports (check all that apply):
? Riparian corridor. Characteristics (type, average width):
? Wetland fringe. Characteristics:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? 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: acres
Wetland type. Explain:
Wetland quality. Explain:
Project wetlands cross or serve as state boundaries. Explain:
(b) General Flow Relationship with Non-TNW:
Flow is: Plck List. Explain:
Surface flow is: Pick List
Characteristics:
Subsurface flow: Pick List. Explain findings:
? Dye (or other) test performed:
(c) Wetland Adjacency Determination with Non-TNW:
? Directly abutting
? Not directly abutting
? Discrete wetland hydrologic connection. Explain:
? Ecological connection. Explain:
? Separated by berm/barrier. Explain:
(d) Proximity (Relationship) to TNW
Project wetlands are Pack List river miles from TNW.
Project waters are PickList aerial (straight) miles from TNW.
Flow is from: Pick List.
Estimate approximate location of wetland as within the Pick List 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:
Identify specific pollutants, if known:
(iii) Biological Characteristics. Wetland supports (check all that apply):
? Riparian buffer. Characteristics (type, average width):
? Vegetation type/percent cover. Explain:
? Habitat for:
? Federally Listed species. Explain findings:
? Fish/spawn areas. Explain findings:
? Other environmentally-sensitive species. Explain findings:
? Aquatic/wildlife diversity. Explain findings:
Characteristics of all wetlands adjacent to the tributary (if any)
All wetland(s) being considered in the cumulative analysis: Pick List
Approximately ( ) 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/l) Size (in acres)
Summarize overall biological, chemical and physical functions being performed:
C. SIGNIFICANT NEXUS DETERMINATION
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 foodwebs?
• 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
findings of presence or absence of significant nexus below, based on the tributary itself, then go to Section III.D:
2. 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 III.D:
Significant nexus findings for wetlands adjacent to an RPW but that do not directly abut the RPW. 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 III.D:
D. DETERMINATIONS 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 width (ft), Or, acres.
p Wetlands adjacent to TNWs: acres.
RPWs that flow directly or indirectly into TNWs.
Tributaries of TNWs where tributaries typically flow year-round are jurisdictional. Provide data and rationale indicating that
tributary is perennial:
[] 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:
Provide estimates for jurisdictional waters in the review area (check all that apply):
[] Tributary waters: linear feet width (ft).
0 Other non-wetland waters: 1.131acres.
Identify type(s) of waters: Wetland drain from hill side seep.
3. Non-RPWss that flow directly or indirectly into TNWs.
Q 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 III. C.
Provide estimates for jurisdictional waters within the review area (check all that apply):
Q Tributary waters: linear feet width (ft).
Q Other non-wetland waters: acres.
Identify type(s) of waters:
Wetlands directly abutting an RPW that flow directly or indirectly into TNWs.
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:
Wetlands directly abutting an RPW where tributaries typically flow "seasonally." Provide data indicating that tributary is
seasonal in Section III.B and rationale in Section III.D.2, above. Provide rationale indicating that wetland is directly
abutting an RPW:
Provide acreage estimates for jurisdictional wetlands in the review area: 1.131acres.
5. Wetlands adjacent to but not directly abutting an RPW that flow directly or indirectly into TNWs.
Q 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 III.C.
Provide acreage estimates for jurisdictional wetlands in the review area: 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 III.C.
Provide estimates for jurisdictional wetlands in the review area: acres.
7. Impoundments of jurisdictional waters.9
As a general rule, the impoundment of a jurisdictional tributary remains jurisdictional.
Q 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).
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): 10
which are or could be used by interstate or foreign travelers for recreational or other purposes.
El from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
El which are or could be used for industrial purposes by industries in interstate commerce.
Ell Interstate isolated waters. Explain:
Q Other factors. Explain:
Identify water body and summarize rationale supporting determination:
'See Footnote # 3.
9 To complete the analysis refer to the key in Section III.D.6 of the Instructional Guidebook.
10 Prior 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.
Provide estimates for jurisdictional waters in the review area (check all that apply):
C( Tributary waters: linear feet width (ft).
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 width (ft).
I[D 0 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 finding is required for jurisdiction (check all that apply):
El. Non-wetland waters (i.e., rivers, streams): linear feet, width (ft).
? Lakes/ponds: acres.
Other non-wetland waters: acres. List type of aquatic resource:
Ell 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):
Maps, plans, plots or plat submitted by or on behalf of the applicant/consultant:
® Data sheets prepared/submitted by or on behalf of the applicant/consultant.
? 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:
? U.S. Geological Survey Hydrologic Atlas:
? USGS NHD data.
® USGS 8 and 12 digit HUC maps.
® U.S. Geological Survey map(s). Cite scale & quad name:
® USDA Natural Resources Conservation Service Soil Survey. Citation:NRCS GIS Based Soil Survey.
National wetlands inventory map(s). Cite name:
? State/Local wetland inventory map(s):
FEMA/F1RM maps:
Q 100-year Floodplain Elevation is: (National Geodectic Vertical Datum of 1929)
Photographs: ® Aerial (Name & Date):
or ? Other (Name & Date):
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:

(,ENR `J'Fi ? t.?USI.CI
Office Use Only: ? oim ?ecsion?kVlaich OS
USACE Action ID No. DWQ No.
of anV Darticular item is not annlicable to this nrniect_ nlease enter "Nnt Annlicahla" nr "N/A" 1
I. Processing
1. Check all of the approval(s) requested for this project:
Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
Z] 401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: Al W act
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here:
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: ?
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
Name: o
Mailing Address:
Telephone Number: Cq[C? 94,q - 70 Fax Number:
E-mail Address:
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
authority for the o wner/applicant.)
must be attached if the Ag nt has siKZT-_
Name: d , ,- Company Affiliation: Lau !?!aA Yad v &_" A 6^'Jt, ?
Mailing Address: P,n 136m 9
Telephone Number: Cgty) $ Al ? 231 Fax Number: 4 0 114 =
E-mail Address: a ar- -... 460 /.,, ?-n,. n AL-4-
Updated 11/1/2005
Page 5 of 12
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: C I u k pot.-A R 60A
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 6 9.9 H A D00 10 9 q
4. Location
County: N oke, Nearest Town: a o,+
,C,rc'
Subdivision name (include phase/lot number):
Directions to site (include road numbers/names, landmarks, etc.):
e 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): -7 9.1 fa A G 1 °N A S. O O 5 $ 6 °W
6. Property size (acres):
7. Name of nearest receiving body of water: BeA#'r
8. River Basin: Ux„P tour
(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 icini?J?' of the oject
at the time of his application: L a4, r( i S Cu frnj? , .5F'??" 1t " r id'
n .,I I A
Updated 11/1/2005
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be
fRI- oN pace, its aae;(u il; es c, 1 ).a ?'u s?C+ [led r ti? f ? sz}a.
11. Explain the purpose of the proposed work: r7c wcQ a -9 -Ae, Pr,oa d w
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. N
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification r t the exclusion of this work from the current application.
bIOP97- ra,r(? AYE r&ir ro,^-m? ? rPn AnS?,????r??rJ? IL.?-
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 descri ption of the proposed impacts: Pr©p o se a pn 4- i S 1, K Jr,i
Updated 11/1/2005
Page 7 of 12
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
separately list impacts due to both structure and flooding.
Wetland Impact
Site Number

(indicate on map)
Type of Impact Type of Wetland
(e.g., forested, marsh,

herbaceous, bog, etc.) Located within
100-year

Floodplain (es/no Distance to
Nearest
Stream
linear feet) Area of
Impact
(acres)
Roca r,. NO 1006a ©.0

Total Wetland Impact (acres)
3. List the total acreage (estimated) of all existing wetlands on the property:
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, multi 1 length X width, then divide b 43,560.
Stream Impact
Number
(indicate on ma)
Stream Name
Type of Impact
Perennial or Intermittent? Average
Stream Width
Before Impact Impact
Length
(linear feet Area of
Impact
(acres)
4

Total Stream Impact (by length and acreage)
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, dredains, floodine. drainaee. bulkheads. etc.
Open Water Impact
Site Number
(indicate on ma Name of Waterbody

(if applicable)
Type of Impact Type of Waterbody
(lake, pond, estuary, sound, bay,
ocean, etc. Area of
Impact
(acres)

Total Open Water Impact (acres)
Updated 11/1/2005
Page 8 of 12
6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres : ;
Wetland Impact (acres):
Open Water Impact (acres): AJ 14
Total Impact to Waters of the U.S. (acres) O)A
Total Stream Impact (linear feet): [AIA
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ZJ 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.
8. Pond Creation
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): ? uplands ? stream ? wetlands
Describe the method of construction (e.., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): --_.o
Proposed use or purpose of pond(e.g., I" e'stock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): W
Current land use in the vicinity of the pond:
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, discuLA. co struction
techniques to be followed during construction to reduce impacts. :A t Q?.1)ka ? -k ,(
1NCL1?1iGt ?&
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.
Updated 11/1/2005
Page 9 of 12
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.
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 (see DWQ website for most current
version.).
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.
2. 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://www.nceep.net/pages/inlieureplace.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):
Amount of buffer mitigation requested (square feet): AiL+
Amount of Riparian wetland mitigation requested (acres):----?
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Updated 11/1/2005
Page 0 of 12
IX. Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ? No 91
2. 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 ?
3. 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 ?
X. 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 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify V Yes ? No
2. If "yes", 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.
* I Impact I I Required
Zone f--- f s+% Multiplier
3 (2 for Catawba)
1.5
Total
* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach alj ropriate information as identified
within 15A NCAC 213.0242 or.0244, or.0260.
Updated 11/l/2005
Page 11 of 12
XI. s Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface excpecjs 20%, please provide calculations
demonstrating total proposed impervious level. l
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater,geyelated from the proposed project, or available capacity of the subject facility.
XM. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application? Yes ? No N?
XIV. 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 ? No ?
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.nc.us/ncwetlands. If no, please provide a short narrative description:
XV. 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
ThreatenA 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.)
Updated 11/1/2005
Page 12 of 12
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