20190889 Ver 1_USACE Permit_20190815

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW -2019-01254 County: Guilford U.S.G.S. Quad: NC -Lake Brandt
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: City of Greensboro
Attn: Butch Shumate
Address: PO Box 3136
Greensboro, NC 27402
Size (acres) —7.3 Nearest Town Greensboro
Nearest Waterway UT to Richland Creek River Basin Cape Fear
USGS HUC 03030002 Coordinates 36.13138 N, -79.835641 W
Location description: The proiect areas is located in the southeastern quadrant of the intersection of Nathanael Green Drive
and Orman Road, at 4301 Lawndale Drive, in Greensboro, Guilford County, North Carolina.
Description of projects area and activity: This verification authorizes the permanent discharge of dredged or fill material into
0.009 acre of wetlands (considered a permanent loss of waters) and 0.22 acre of open water impoundment (not a loss of
waters), necessary for the repair/reconstruction of an existing breached dam and removal of accumulated sediment within the
existing impoundment, included as part of the expansion of the existing Greensboro Science Center.
Applicable Law(s): ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: NWP 39. Commercial and Institutional Developments
SEE ATTACHED NWP GENERAL, REGIONAL, AND/OR SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the enclosed
Conditions, your application signed and dated 7/2/2019, and revised information sent via email on 8/8/2019, and the enclosed
plans sheets C0.1, C2.01, C2.1, and Dam Profiles. Any violation of the attached conditions or deviation from your submitted
plans may subject the permittee to a stop work order, a restoration order, a Class I administrative penalty, 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 Resources (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 David E. Bailey at [phone], Ext. 30or David.E.Bailey2Ausace.army.mil.
Date: 2019.08.1514:22:41
Corps Regulatory Official: -04'00' Date: 08/15/2019
Expiration Date of Verification: 03/18/2022

SAW -2019-01254
SPECIAL CONDITIONS
1. Dredged material from the authorized pond excavation area must be disposed of in an upland area
(i.e. not within waters of the US) in such a way as to prevent return water and runoff from entering
waters of the US.
2. Please note that future impacts and/or phases of The Greensboro Science Center, and related
activities associated with Corps Action ID: SAW -2019-01254 will be considered part of a single and
complete project; these impacts will be considered cumulative with impacts permitted during
earlier phases regarding compensatory mitigation and Nationwide Permit thresholds. Current
cumulative impacts to aquatic resources for this single and complete project include permanent
impacts (loss of waters) to 0.009 acre of riparian, non-riverine wetlands. This amounts to a total loss
of waters of the US of 0.009 acre.
�6'5�� Date: 2019.08.15
Corps Regulatory Official: 14:22:22 -04'00' Date: 08/15/2019
Expiration Date of Verification: 03/18/2022
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we continue to do so,
please complete the Customer Satisfaction Survey located at http://corpsmapu.usace.army.mil/cm apex/Pp=136:4:0
Copy furnished:
Tori Small, Wescott, Small, and Associates, PLC, 125 S. Elm St., Greensboro, NC 27401
Sue Homewood, NCDEQ-DWR, 450 W. Hanes Mill Rd., Suite 300, Winston Salem NC 27105

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VICINITY MAP (1"=2000')
P-0578
SITE INFORMATION
EX. ZONING
PNR
CURRENT LANDUSE
SCIENCE CENTER
PROP. LANDUSE
SCIENCE CENTER
TAX MAP NUMBER
00-06-0350-0-0767-SE005
DEED REFERENCE
D.B. 002421 PG. 00650
PLAT REFERENCE
TOTAL AREA
343.57 AC
WATERSHED
WS -III
AVERAGE SLOPE
2.15 % (OF DEVELOPED AREA)
DISTANCE TO
NEAREST FEMA
200' WEST OF NW CORNER
FLOOD PLAIN
SOILS
CeB2, CcC, CcB, MaE
EX. GROSS
FLOOR AREA
108,356 SF
5
\
PROP. GROSS
FLOOR AREA
15,979 SF (123,200 SF TOTAL)
ACREAGE
PERCENTAGE
4.43 AC
1.29%
ZDISTURBED
r4mA
339.14 AC
98.71%
UNDISTURBED
o'er
10.44 AC
3.03 %
EX. BUA
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PROP. BUA
1.43 AC
0.42%
TOTAL BUA
11.87 AC
3.45%
EX. PERVIOUS
333.46 AC
96.96 %
-1.43 AC
-0.42%
PROP. PERVIOUS
O y
TOTAL PERVIOUS
331.70 AC
96.55%
Z
!4-3
CuO
i
PARKING INFORMATIONiz
o
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TOTAL
SPACES
1 SPACE PER 400 SF (INTERIOR PUBLIC SPACE) _
65,300 SF *(1/400 SF) = 164 SPACES REQUIRED
Z
11 H.C. SPACES REQUIRED, 15 H.C. SPACES PROVIDED
512
2 VAN SPACES REQUIRED
C
OWNER INFORMATION
V
OWNER: DEVELOPER:
CITY OF GREENSBORO GREENSBORO SCIENCE CENTER
PO BOX 3136 4301 LAWNDALE DR.
GREENSBORO, NC 27402 GREENSBORO, NC 27455
336-373-2489 CONTACT: GLENN DOBROGOSZ
PHONE: [phone]
EMAIL: [e-mail]
LEGEND
X NAIL SET/FOUND
Line Legend
IRON PIPE FOUND
Mk Date Description
0 IRON PIPE SET SANITARY SEWER LINE — —
(SIZE &TYPE AS NOTED)
® NC DOT RIGHT-OF-WAY DISC
OVERHEAD UTILITY HWOHW
�
Revisions
UTILITY POLE
TREE PROTECTION FENCE —TCA—TCA—
UTILITY POLE
TCA TCaGUY
TREELINE
GUYWIRE
WATERLINE W
OS SANITARY SEWER MANHOLE
SIGN DMUE LINE
Ow WATER METER TREE PROTECTION LINE —
V FIRE HYDRANT PERM. EARTH BERM PEB PEB
Zt
© GAS VALVE
X123.4 SPOT ELEVATION
N/F NOW OR FORMERLY
E/P EDGE OF PAVEMENT
DIP DUCTILE IRON PIPE
WCR WHEELCHAIR RAMP
0
.a
CY
WESTCOTT, SMALL & ASSOCIATES, PLLC
Date 08-23-2018
125 SOUTH ELM STREET, SUITE 606
Drawn
By mbw
GREENSBORO, NC 27401
WWW.WSAAENG.COM
Check
By vws
PHONE: [phone]
Job No.
17-093
Sheet
DESIGNED BY: MICHAEL WESTCOTT MWESTCOTTQWSAAENG.COM
coil
REVIEWED BY: TORI SMALL TSMALLQWSAAENG.COM

CMNF / a
NPS
AA4R
UNDERGROUND
ELECTRICAL VAULT
KEYPAD
ON A�POST
�W
18"RCP
81
NV.: 817.66'
BO\ARD WITH
E\ECTRICAL SWITCH N
YPAD C�f.\ A POST �
\ POST WILLH
\ ELEC NAL PAD
TREE PRESERVATION AREA
TABLE
MAX. REQUIRED AREA = 4.43 AC
x 10% = 0.44 AC
PREV. REQUIRED AREA = 5.30 AC
x 10% = 0.53 AC
TOTAL REQ'D TREE PRESERVATION
AREA = 0.97 AC
EX. TREE PRESERVATION AREA =
2.00 AC
**SEE SHEET C4.0 FOR LOCATION OF TREE CONSERVATION AREA
TREE PRESERVATION NOTES:
NO DISTURBANCE IS ALLOWED WITH IN THE TREE CONSERVATION AREA
EXCEPT AS NOTED ON THE APPROVED PLAN OR WITH PRIOR
APPROVAL FROM URBAN FORESTER. THE TREE CONSERVATION AREA
INCLUDES THE CRITICAL ROOT ZONE AREA.
ALL PROPOSED IMPROVEMENTS ARE LOCATED ACROSS THE CREEK
FROM THE PROPOSED TREE CONSERVATION AREA. THEREFORE NO
TREE PROTECTION FENCE SHALL BE INSTALLED. HOWEVER, IF
PROPOSED GRADING, CLEARING OR DEVELOPMENT ENCROACHES
TOWARD THE CREEK AND BEYOND THE LIMITS OF DISTURBANCE
INDICATED ON THE PLAN, OR AT THE DIRECTION OF THE URBAN
FORESTER, THE CONTRACTOR SHALL PROVIDE TREE PROTECTION FENCE
OUTSIDE OF THE REQUIRED UNDISTURBED CRITICAL ROOT ZONE.
PENALTIES FOR DISTURBANCE OF THE CRITICAL ROOT ZONE AND/OR
TCA SHALL APPLY.
TREE PROTECTION FENCING SHALL REMAIN IN PLACE UNTIL
CONSTRUCTION IS COMPLETE AND OTHER LANDSCAPING HAS BEEN
INSTALLED, AND THE CITY URBAN FORESTER OR ENFORCEMENT OFFICER
HAS APPROVED ITS REMOVAL.
NO PARKING, STORAGE, DIRT STOCKPILING, CONCRETE WASHOUT OR
ANY OTHER ACTIVITIES IS PERMITTED IN THE TREE CONSERVATION
AREAS.
CONTACT THE URBAN FORESTER AT 373-2150 TO SET UP
A PRE -CONSTRUCTION MEETING PRIOR TO LAND
DISTURBANCE.
ALL TREE PROTECTION DEVICES MUST BE INSTALLED PRIOR TO LAND
DISTURBANCE, INCLUDING THE CUTTING OF ANY TREES. A PENALTY OF
$500.00 PER DAY FOR FAILURE TO INSTALL APPROVED TREE
PROTECTION MEASURES MAY APPLY
THE CONTRACTOR SHALL FAMILIARIZE HIMSELF WITH ALL TREE
PRESERVATION REGULATIONS AND INSPECTION REQUIREMENTS.
NPOES Stam Lw DWpe Pi-il for C -M -U n AGMdles INCGOII
HGDENFVD'ls4n .1 MI., 0_xy
NEW STABILIZATION TIMEFRAMES
t Erl kc Aug 3. 10111
SiTE AREA DESCRIPTION
STA131LIZA71DM
TIMEFRAME Ex[EPTIDNS
I ] Perimeter dikes: swages, d1[ahes: slopes
7 days
None
High Quality Water {HQW] Zones
7 days
None
~ y slopes 'tee per than 3:1
7 �
If slopes are 10' ar less In length and are
not steeper Nan 2:1, 14 days are allowed.
.�
Installation of perimeter erosion and sediment control measures
Oslopas a;1 or natter
14 days
7 days for slopes greater than 50' in lengtri.
I� Ail other areas With slopes [latter than 4:1
14 days
None. except (or perimeters and HOW Zones.
EROSION CONTROL SEEDING SPECIFICATION
APPLY 4,000Ibs. AGRICULTURAL LIMESTONE PER ACRE.
APPLY 1,000Ibs. 10-10-10 FERTILIZER PER ACRE FOR GRASS SEEDING.
LIME AND FERTILIZER ARE TO BE DISKED INTO THE SOIL SURFACE TO A MINIMUM DEPTH OF 4 INCHES.
LATER WINTER - EARLY SPRING
A. GRASS:
(1) TALL FESCUE-1501bs. PER ACRE.
B. GRASS -LEGUME MIXTURE
(1) TALL FESCUE-1001bs. PER ACRE PLUS SERECIA LESPEDEZA(SCARFIED)- 601bs. PER ACRE.
(2) TALL FESCUE-1001bs. PER ACRE PLUS CROWNVETCH- 251bs. PER ACRE.
EARLY SPRING - LATE SPRING
A. GRASS:
(1) TALL FESCUE-1501bs. PER ACRE.
B. GRASS -LEGUME MIXTURE
(1) TALL FESCUE-1001bs. PER ACRE PLUS SERECIA LESPEDEZA(SCARIFIED)-601bs. PER ACRE.
LATE SUMMER - EARLY WINTER
A. GRASS:
(1) TALL FESCUE-1501bs. PER ACRE.
(2) TALL FESCUE-1001bs. PER ACRE PLUS ANNUAL RYEGRAIN-251bs. PER ACRE.
B. GRASS -LEGUME MIXTURE:
(1) TALL FESCUE-1001bs. PER ACRE PLUS SERECIA LESPEDEZA(UNSCARIFIED)-601bs. PER ACRE.
(2) TALL FESCUE-1001bs. PER ACRE PLUS CROWNVETCH-2511bs. PER ACRE
(3) TALL FESCUE-751bs. PER ACRE PLUS ANNUALRYEGRAIN-251bs. PER ACRE PLUS SERECIA LESPEDEZA
(UNSCARIFIED)-601bs. PER ACRE.
AFTER SEEDING, THE AREA IS TO BE ROLLED OR CULTIPACKED TO INSURE THAT THE SEED IS PRESSED INTO CONTACT WITH
SOIL SURFACE. ALL SEEDED AREAS ARE TO BE MULCHED WITH STRAW MULCH AT THE RATE OF 3,000LBS. PER ACRE. (APPX.
100 BALES PER ACRE.)
APPLY ASPHALT EMULSION TO THE STRAW MULCH AT THE RATE OF 150 GALLONS PER ACRE.
THE ABOVE SEEDING RECOMMENDATIONS AND RATES HAVE BEEN PREPARED FOR SELECTION OF A VEGETATIVE COVER SUITABLE
FOR SOIL EROSION CONTROL IN THE GREENSBORO AREA.
AREA SOIL TYPES, CLIMATIC CONDITIONS, SEED AVAILIBILITY AND INDIVIDUAL PLANT CHARACTERISTICS ARE ALL TAKEN INTO
ACCOUNT IN THE ABOVE RECOMMENDATIONS. DUE TO DENSITY, UNIFORMITY AND TEXTURAL QUALITY REASONS, THE ABOVE
SELECTIONS ARE NOT RECOMMENDED FOR LAWN AREA USE.
SELF -INSPECTION REPORT FOR LAND DISTURBING ACTIVITY AS REQUIRED BY NCGS 113A-54.1
W
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Phase of A roved Erosion and Sedimentation Control Plan:
----�Pp _ _... _...__- _...._. Date
ORMAN
Q ROAD
i
Responsible onsible Part�orAFentncialfy
P Y )
Installation of perimeter erosion and sediment control measures
Clearing and grubbing of existing round cover
��wwV I -
`�J titit
Completion of any phase of grading or sio es for fills
W `
o��Ca
Installation of storm drainage facilities
rT
OLd
E to M M
Completion of construction or development
z z
J�w°'n`�=
C6to
Establishment of permanent ground cover sufficient to restrain erosion
2
ME
CURB INLET
TOP: 866.61'
NIA/ INI(F)- RFF nl'
CONSTRUCTION SEQUENCE
1. OBTAIN GRADING PERMIT.
2. INSTALL ALL TREE PROTECTION MEASURES PRIOR TO ANY LAND DISTURBANCE.
3. INSTALL CONSTRUCTION ENTRANCES.
4. CLEAR SITE ONLY AS NECESSARY TO CONSTRUCT SEDIMENT TRAPS, EARTH BERMS, SILT FENCE
AND ROCK OUTLETS.
5. INSTALL SEDIMENT TRAPS 1, 2 AND 3. INSTALL OUTLET PROTECTION FOR THE SKIMMER OUTLETS.
6. SEED ALL AREAS DISTURBED BY CONSTRUCTION OF SEDIMENT TRAPS.
7. CONSTRUCT EARTH BERMS. ENSURE POSITIVE FLOW TO THE SEDIMENT TRAPS. SEED ALL AREAS
DISTURBED BY EARTH BERM CONSTRUCTION.
8. INSTALL SILT FENCE AND ROCK OUTLETS.
9. CONTACT THE CITY URBAN FORRESTER TO CONDUCT AN INTERMEDIATE INSPECTION OF THE TREE
PRESERVATION REQUIREMENTS.
10. ONCE ALL EROSION CONTROL MEASURES ARE INSTALLED AND SEEDED, BEGIN CLEARING AND
GRUBBING.
11. ROUGH GRADING.
12. INSTALL UTILITIES AND INSTALL INLET PROTECTION AROUND ALL STORM INLETS.
13. FINE GRADING.
14. CONSTRUCT THE BUILDINGS
15. CONSTRUCT THE CONCRETE SIDEWALKS.
16. EROSION CONTROL DEVICES SHALL BE INSTALLED AND DILIGENTLY MAINTAINED THROUGHOUT
CONSTRUCTION. DEVICES SHALL BE INSPECTED AND REPAIRED AFTER EACH SIGNIFICANT RAINFALL.
17. FINAL ADJUSTMENT OF ALL MANHOLES, VALVES AND CLEANOUTS WITH CHECKOUT.
18. SEED OR OTHERWISE STABILIZE ALL DENUDED AREAS AS REQUIRED ON THE ATTACHED NEW
STABILIZATION TIME FRAMES SCHEDULE.
19. INSTALL PUMP AROUND AND SILT SACK FOR POND.
20. DEWATER POND USING PUMP AROUND AND SILT SACK.
21. EXCAVATE POND INTERIOR AND CONSTRUCT DAM.
22. CONSTRUCT CONCRETE SPILLWAY.
23. STABILIZE POND INTERIOR AND DAM
24. REMOVE PUMP AROUND AND ALLOW FLOW BACK INTO POND ONLY AFTER INSPECTION BY THE
ENGINEER.
25. ALL EROSION CONTROL DEVICES ARE TO REMAIN IN PLACE UNTIL SITE IS PROPERLY STABILIZED
WITH GROUND COVER AND EROSION CONTROL OFFICE HAS ISSUED APPROVAL TO REMOVE. ALL
UPSTREAM AREAS MUST BE STABILIZED PRIOR TO REMOVAL OF EROSION CONTROL DEVICES. ONCE
THIS OCCURS, REMOVE SEDIMENT, GRADE TO FINAL ELEVATIONS AND STABILIZE.
26. SEDIMENT TRAP 2 SHALL BE CONVERTED INTO A LEVEL SPREADER PER THE LEVEL SPREADER
DETAIL. THE LEVEL SPREADER SHALL RUN THE FULL WIDTH OF THE SEDIMENT TRAP.
27. THE CONTRACTOR SHALL BE RESPONSIBLE FOR ALL SITE EROSION CONTROL MAINTENANCE DURING
CONSTRUCTION. IN ADDITION, THE CONTRACTOR SHALL BE RESPONSIBLE FOR KEEPING ALL
ITEMS/RECORDS REQUIRED BY THE NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
PERMIT.
28. THE CONTRACTOR SHALL HAVE ON SITE THE MEANS TO REMOVE ANY SEDIMENT TRACKED ONTO
THE STREET. IF CONDITIONS REQUIRE, EQUIPMENT MUST BE ON SITE TO WASH TIRES OF VEHICLES
PRIOR TO ENTERING STREET.
29. FINAL CLEAN UP.
30. CHECKOUT BY DEVELOPER AND THEIR ENGINEER.
EROSION CONTROL LEGEND
TEMPORARY SILT FENCE SF SF -
WIRE & STONE INLET PROTECTION
TREE PROTECTION FENCE TCA TCA
LIMIT OF DISTURBANCE
BLOCK & GRAVEL INLET PROTECTION
CONSTRUCTION ENTRANCE
COG STD 436-A
WIRE & STONE INLET PROTECTION I
GRAPHIC SCALE
50 0 25 50 100
1 inch = 50 ft.
W
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P-0576
VICINITY MAP (1"=2000')
SITE INFORMATION
EX. ZONING
PNR
CURRENT LANDUSE
SCIENCE CENTER
PROP. LANDUSE
SCIENCE CENTER
TAX MAP NUMBER
00-06-0350-0-0767-SE005
DEED REFERENCE
D.B. 002421 PG. 00650
PLAT REFERENCE
TOTAL AREA
343.57 AC
WATERSHED
WS- III
AVERAGE SLOPE
2.15 % (OF DEVELOPED AREA)
DISTANCE TO
NEAREST FEMA
200' WEST OF NW CORNER
FLOOD PLAIN
SOILS
CeB2, CcC, CcB, MaE
EX. GROSS
FLOOR AREA
108,356 SF
\
, �
V
zit
PROP. GROSS
FLOOR AREA
15,979 SF (123,200 SF TOTAL)
ACREAGE
PERCENTAGE
DISTURBED
4.43 AC
1.29%
14MA
44,
O
O '
•E
O
O =
y
44
N
OOH
O
UNDISTURBED
339.14 AC
98.71%
EX. BUA
10.44 AC
3.03 %
PROP. BUA
1.43 AC
0.42%
TOTAL BUA
11.87 AC
3.45%Z
EX. PERVIOUS
333.46 AC
96.96 %
AC
PROP. PERVIOUS
-1.43
-0.42%
3
-O
TOTAL PERVIOUS
331.70 AC
96.55%
CZ
~
PARKING INFORMATION
0
W4 W
r*4%
TOTAL
SPACES
1 SPACE PER 400 SF (INTERIOR PUBLIC SPACE) _!4
65,300 SF *(1/400 SF) = 164 SPACES REQUIRED
512
W
oc
11 H.C. SPACES REQUIRED, 15 H.C. SPACES PROVIDED
2 VAN SPACES REQUIREDIts�
Q
C
OWNER INFORMATION
V
OWNER: DEVELOPER:
CITY OF GREENSBORO GREENSBORO SCIENCE CENTER
PO BOX 3136 4301 LAWNDALE DR.
GREENSBORO, INC 27402 GREENSBORO, INC 27455
336-373-2489 CONTACT: GLENN DOBROGOSZ
PHONE: [phone]
EMAIL: GDOBROGOSZOGREENSBOROSCIENCE.ORG
LEGEND
iR NAIL SET/FOUND
Line Legend
IRON PIPE FOUND
Mk Date Description
O IRON PIPE SET SANITARY SEWER LINE _ -
(SIZE & TYPE AS NOTED)
® NC DOT RIGHT-OF-WAY DISC
OVERHEAD UTILITY OHW OHW
Revisions
UTILITY POLE
UTILITY POLE TREE PROTECTION FENCE TCA TCA
TREELINE
GUY WIRE
O SANITARY SEWER MANHOLE WATERLINE W
SIGN DMUE LINE
O
OO WATER METER TREE PROTECTION LINE -
V FIRE HYDRANT PERM. EARTH BERM PEB PEB
y
I] GAS VALVE
O
X123.4 SPOT ELEVATION
N/F NOW OR FORMERLY
W
E/P EDGE OF PAVEMENT
DIP DUCTILE IRON PIPE
WCR WHEELCHAIR RAMP
O
O
WESTCOTT, SMALL & ASSOCIATES, PLLC
Date 08-23-2018
125 SOUTH ELM STREET, SUITE 606
Drawn
By mbw
GREENSBORO, NC 27401
WWW.WSAAENG.COM
Check
By vws
PHONE: [phone]
Job No. 17-093
Sheet
DESIGNED BY: MICHAEL WESTCOTT [e-mail]
C2s0
REVIEWED BY: TORI SMALL [e-mail]

TREE PRESERVATION AREA
TABLE
MAX. REQUIRED AREA = 4.43 AC
x 10% = 0.44 AC
PREY. REQUIRED AREA = 5.30 AC
x 10% = 0.53 AC
TOTAL REQ'D TREE PRESERVATION
AREA = 0.97 AC
EX. TREE PRESERVATION AREA =
2.00 AC
TRAFFIC ARM
UNDERGROUND
ELECTRICAL VAULT
L I'lvonr
10
0
0
0
0
0
0
0
o
0
0
0
0
NOTES:
1. ANY STRUCTURE TO BE REMOVED SHALL REQUIRE A SEPARATE DEMOLITION PERMIT FROM THE BUILDING INSPECTIONS DEPARTMENT.
2. MEANS OF EGRESS ILLUMINATION SHALL BE PROVIDED THROUGHOUT EXIT DISCHARGES IN ACCORDANCE WITH NCBC.
3. ALL EXISTING AND PROPOSED POWER LINES ARE INDICATED ON THE SITE PLAN. IF NO OVERHEAD POWER LINES ARE INDICATED THERE SHALL BE NONE.
4. LANDINGS OUTSIDE ALL DOORS SHALL BE SIZED PER THE NORTH CAROLINA BUILDING CODE (NCBC), BE AT THE SAME ELEVATION AS THE FFE AND SHALL HAVE
A MAXIMUM SLOPE OF . 2% (1:48) IN ANY DIRECTION INCLUDING THE DIAGONAL.
5. SLOPES IN ACCESSIBLE PARKING SPACES, PASSENGER LOADING ZONES AND ACCESS AISLES SHALL NOT EXCEED 2% (1:48) IN ANY DIRECTION INCLUDING THE
DIAGONAL.
6. THERE SHALL BE LEVEL TURNING AREAS WITH A MAXIMUM SLOPE OF 2% (1:48) IN ANY DIRECTION INCLUDING IN THE DIAGONAL ON ALL SIDEWALKS WHERE AND
INTERSECTING SIDEWALK NEXT WITH IT. THERE SHALL BE NO DESIGNATED PEDESTRIAN ROOTS/SIDEWALKS WITH IN THE SITE, EXCEPT WERE LABELED AS A RAMP,
WHICH EXCEED 5% (1:20) SLOPE IN THE DIRECTION OF TRAVEL AND 2% (1:48) PRICE LOW.
7. ALL EXTERIOR PEDESTRIAN ROUTES SHALL HAVE A MINIMUM CLEAR WIDTH OF 48", INCLUDING CLEARANCE BETWEEN RAILINGS WHERE PROVIDED, AND SHALL
COMPLY WITH NCBC.
8. THERE SHALL BE NO DESIGNATED PEDESTRIAN ROUTES/SIDEWALKS WITH IN THIS SITE, EXCEPT WHERE LABELED AS A RAMP, WHICH EXCEED 5% (1:20) SLOPE IN
THE DIRECTION OF TRAVEL AND A 2% (1:48) CROSS SLOPE.
9. ALL PEDESTRIAN ROUTES WITH SLOPES EXCEEDING 5% (1:20) OR LABELED `RAMPS QUOTE, SHOWING SLOPES, AND SHELL HAVE LANDINGS DESIGNATED TO
PREVENT THE ACCUMULATION OF WATER ON WALKING SURFACES AND WITH A MAXIMUM SLOPE OF 2% (1:48) IN ANY DIRECTION INCLUDING THE DIAGONAL, AND
COMPLY WITH NCBC. RAMP RUNS WITH A RISE OF GREATER THAN 6 INCHES SHALL BE PROVIDED WITH HANDRAILS ON BOTH SIDES.
10. ALL EXTERIOR STAIRS AND LANDINGS SHALL BE DESIGNED TO PREVENT ACCUMULATION OF WATER ON WALKING SURFACES, HAVE A MAXIMUM SLOPE OF 2%
(1:48) IN ANY DIRECTION INCLUDING THE DIAGONAL AND SHALL COMPLY WITH NCBC.
11. CHANGES OF ELEVATION OF LESS THAN 12 INCHES SHALL COMPLY WITH NCBC SECTION 1003.5.
12. ALL RETAINING SYSTEMS WITH A CUMULATIVE VERTICAL RELIEF GREATER THAN 5 FEET WITHIN 50 FEET, AND ALL RETAINING SYSTEMS WITH A CUMULATIVE
VERTICAL RELIEVE LESS THAN 5 FEET AND LOCATED CLOSER TO A BUILDING THEN THE VERTICAL RELIEF, SHALL BE DESIGNED BY A REGISTERED DESIGN
PROFESSIONAL, AND REQUIRE A SEPARATE BUILDING PERMIT AND SPECIAL INSPECTIONS.
3000 PSI CONCRETE
2.5' DEEP
CLASS -1 RIPRAP
STRIP
LEVEL SPREADER DETAIL
LANDSCAPE BUFFER AND TREE PROTECTION NOTES:
1. CONTRACTOR SHALL INSTALL TREE PROTECTION FENCE BETWEEN ALL AREAS OF
GRADING/DISTURBANCE AND THE STREET LANDSCAPE YARD ALONG ORMAN ROAD.
TREE PRESERVATION NOTES:
NO DISTURBANCE IS ALLOWED WITH IN THE TREE CONSERVATION AREA
EXCEPT AS NOTED ON THE APPROVED PLAN OR WITH PRIOR
APPROVAL FROM URBAN FORESTER. THE TREE CONSERVATION AREA
INCLUDES THE CRITICAL ROOT ZONE AREA.
ALL PROPOSED IMPROVEMENTS ARE LOCATED ACROSS THE CREEK
FROM THE PROPOSED TREE CONSERVATION AREA. THEREFORE NO
TREE PROTECTION FENCE SHALL BE INSTALLED. HOWEVER, IF
PROPOSED GRADING, CLEARING OR DEVELOPMENT ENCROACHES
TOWARD THE CREEK AND BEYOND THE LIMITS OF DISTURBANCE
INDICATED ON THE PLAN, OR AT THE DIRECTION OF THE URBAN
FORESTER, THE CONTRACTOR SHALL PROVIDE TREE PROTECTION FENCE
OUTSIDE OF THE REQUIRED UNDISTURBED CRITICAL ROOT ZONE.
PENALTIES FOR DISTURBANCE OF THE CRITICAL ROOT ZONE AND/OR
TCA SHALL APPLY.
TREE PROTECTION FENCING SHALL REMAIN IN PLACE UNTIL
CONSTRUCTION IS COMPLETE AND OTHER LANDSCAPING HAS BEEN
INSTALLED, AND THE CITY URBAN FORESTER OR ENFORCEMENT OFFICER
HAS APPROVED ITS REMOVAL.
NO PARKING, STORAGE, DIRT STOCKPILING, CONCRETE WASHOUT OR
ANY OTHER ACTIVITIES IS PERMITTED IN THE TREE CONSERVATION
AREAS.
CONTACT THE URBAN FORESTER AT 373-2150 TO SET UP
A PRE -CONSTRUCTION MEETING PRIOR TO LAND
DISTURBANCE.
ALL TREE PROTECTION DEVICES MUST BE INSTALLED PRIOR TO LAND
DISTURBANCE, INCLUDING THE CUTTING OF ANY TREES. A PENALTY OF
$500.00 PER DAY FOR FAILURE TO INSTALL APPROVED TREE
PROTECTION MEASURES MAY APPLY
THE CONTRACTOR SHALL FAMILIARIZE HIMSELF WITH ALL TREE
PRESERVATION REGULATIONS AND INSPECTION REQUIREMENTS.
EROSION CONTROL LEGEND
TEMPORARY SILT FENCE
WIRE & STONE INLET PROTECTION
TREE PROTECTION FENCE
LIMIT OF DISTURBANCE
- SF SF
- TCA TCA
�LOCK & GRAVEL INLET PROTECTION
CONSTRUCTION ENTRANCE
COG STID 436-A WHEM
WIRE & STONE INLET PROTECTION 13
GRAPHIC SCALE
30 0 15 30 60
1 inch = 30 ft.
W
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VICINITY MAP (1"=2000')
P-0578
SITE INFORMATION
EX. ZONING
PNR
CURRENT LANDUSE
SCIENCE CENTER
PROP. LANDUSE
SCIENCE CENTER
TAX MAP NUMBER
00-06-0350-0-0767-SE005
DEED REFERENCE
D.B. 002421 PG. 00650
PLAT REFERENCE
TOTAL AREA
343.57 AC
WATERSHED
WS- III
AVERAGE SLOPE
2.15 % (OF DEVELOPED AREA)
DISTANCE TO
NEAREST FEMA
200' WEST OF NW CORNER
FLOOD PLAIN
SOILS
CeB2, CcC, CcB, M°E
EX. GROSS
FLOOR AREA
108,356 SF
- lq
y
PROP. GROSS
FLOOR AREA
15,979 SF (123,200 SF TOTAL)
ACREAGE
PERCENTAGE
DISTURBED
4.43 AC
1.29%
�
G
ClIc CIL)
UNDISTURBED
339.14 AC
98.71%
EX. BUA
10.44 AC
3.03 %
- 0
nl
1.43 AC
0.42%
PROP. BUA
OTOTAL
BUA
11.87 AC
3.45%
O
10
_
O O
~ 44t:t
Ow
�
EX. PERVIOUS
333.46 AC
96.96 %
PROP. PERVIOUS
-1.43 AC
-0.42%
TOTAL PERVIOUS
331.70 AC
96.55%
PARKING INFORMATION
D
L
t;
TOTAL
SPACES
1 SPACE PER 400 SF (INTERIOR PUBLIC SPACE) _
65,300 SF *(1/400 SF) = 164 SPACES REQUIRED
512
ct
11 H.C. SPACES REQUIRED, 15 H.C. SPACES PROVIDED
2 VAN SPACES REQUIRED
0
OWNER INFORMATION
v
OWNER: DEVELOPER:
CITY OF GREENSBORO GREENSBORO SCIENCE CENTER
PO BOX 3136 4301 LAWNDALE DR.
GREENSBORO, NC 27402 GREENSBORO, NC 27455
336-373-2489 CONTACT: GLENN DOBROGOSZ
PHONE: [phone]
EMAIL: [e-mail]
LEGEND
iR NAIL SET/FOUND
Line Legend
IRON PIPE FOUND
Mk
Date Description
0 IRON PIPE SET SANITARY SEWER LINE --
(SIZE &TYPE AS NOTED)
® NC DOT RIGHT-OF-WAY DISC
OVERHEAD UTILITY -OHW OHW
Revisions
8 UTILITY POLE
UTILITY POLE TREE PROTECTION FENCE TCA TCA
GUY WIRE TREELINE
�S SANITARY SEWER MANHOLE WATERLINE W
SIGN DMUE LINE
OO WATER METER TREE PROTECTION LINE - • • - • •
FIRE HYDRANT PERM. EARTH BERM PEB PEB
5�i
© GAS VALVE
x123.4 SPOT ELEVATION
N/F NOW OR FORMERLY
E/P EDGE OF PAVEMENT
DIP DUCTILE IRON PIPE
WCR WHEELCHAIR RAMP
o
WESTCOTT, SMALL & ASSOCIATES, PLLC
Date 09-13-2018
125 SOUTH ELM STREET, SUITE 606
Drawn
By mbw
GREENSBORO, NC 27401
WWW.WSAAENG.COM
Check
By vws
PHONE: [phone]
Job No.
17-093
Sheet
DESIGNED BY: MICHAEL WESTCOTT MWESTCOTTQWSAAENG.COM
C2.
REVIEWED BY: TORI SMALL TSMALLQWSAAENG.COM

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----,,,,,,,,,,��
P-0678
SITE INFORMATION
EX. ZONING
PNR
CURRENT LANDUSE
SCIENCE CENTER
PROP. LANDUSE
SCIENCE CENTER
TAX MAP NUMBER
00- 06- 0350- 0- 0 76 7-SE005
DEED REFERENCE
D.B. 002421 PG. 00650
PLAT REFERENCE
TOTAL AREA
343.5 7 A C
WATERSHED
WS -III
AVERAGE SLOPE
2.15 % (OF DEVELOPED AREA)
DISTANCE TO
NEAREST FEMA
200' WEST OF NW CORNER
FLOOD PLAIN
SOILS
CeB2, CcC, CcB, MoE
EX. GROSS
FLOOR AREA
108,356 SF
O
\I Q1
PROP. GROSS
FLOOR AREA
15,979 SF (123,200 SF TOTAL)
ACREAGE
PERCENTAGE
DISTURBED
4.43 AC
1.29%
OTOTAL
OPROP.
O
L Q
� �
O = xz
ycu
N
Z
iw
UNDISTURBED
339.14 AC
98.71%
EX. BUA
10.44 AC
3.03 %
PROP. BUA
1.43 AC
0.42%
BUA
11.87 AC
3.45%
EX. PERVIOUS
333.46 AC
96.96 %
PERVIOUS
-1.43 AC
-0.42%
It
w
~
D
W
Q
TOTAL PERVIOUS
331.70 AC
96.55%
PARKING INFORMATION
TOTAL
SPACES
1 SPACE PER 400 SF (INTERIOR PUBLIC SPACE) _
65,300 SF *(1/400 SF) = 164 SPACES REQUIRED
512
W
11 H.C. SPACES REQUIRED, 15 H.C. SPACES PROVIDED
2 VAN SPACES REQUIRED
C
OWNER INFORMATION
V
OWNER: DEVELOPER:
CITY OF GREENSBORO GREENSBORO SCIENCE CENTER
PO BOX 3136 4301 LAWNDALE DR.
GREENSBORO, NC 27402 GREENSBORO, INC 27455
CONTACT: GLENN DOBROGOSZ
336-373-2489
PHONE: [phone]
EMAIL: GDOBROGOSZOGREENSBOROSCIENCE.ORG
LEGEND
NAIL SET/FOUND
Line Legend
� IRON PIPE FOUND
Mk Date Description
O IRON PIPE SET SANITARY SEWER LINE — —
® NC DOT RIGHT—OF—WAY DISC �� TYPE AS NOTED)
Revisions
OVERHEAD UTILITY HWOHW
UTILITY POLE
UTILITY POLE TREE PROTECTION FENCE TCA TCA
TREELINE
GUY WIRE
WATERLINE W
OS SANITARY SEWER MANHOLE
SIGN DMUE LINE
OO WATER METER TREE PROTECTION LINE —
V FIRE HYDRANT PERM. EARTH BERM PEB PEB
© GAS VALVE
LQLQ
■123.4 SPOT ELEVATION
N/F NOW OR FORMERLY
E/P EDGE OF PAVEMENT
_
DIP DUCTILE IRON PIPE
O
WCR WHEELCHAIR RAMP
ME
WESTCOTT, SMALL & ASSOCIATES, PLLC
Date 08-23-2018
125 SOUTH ELM STREET, SUITE 606
Drawn
By mbw
GREENSBORO, NC 27401
WWW.WSAAENG.COM
Check
By vws
PHONE: [phone]
Job No.
17-093
Sheet
DESIGNED BY: MICHAEL WESTCOTT MWESTCOTTQWSAAENG.COM
REVIEWED BY: TORI SMALL TSMALLQWSAAENG.COM

SAW -2019-01254
Determination of Jurisdiction:
A. ® There are waters including wetlands, on the above described project area that may be subject to Section 404 of the
Clean Water Act (CWA) (33 USC § 1344) and/or Section 10 of the Rivers and Harbors Act (RHA) (33 USC § 403). This
preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
(Reference 33 CFR Part 331). However, you may request an approved JD, which is an appealable action, by contacting
the Corps district for further instruction. Please note, if work is authorized by either a general or nationwide permit, and
you wish to request an appeal of an approved JD, the appeal must be received by the Corps and the appeal process
concluded prior to the commencement of any work in waters of the United States and prior to any work that could alter
the hydrology of waters of the United States.
B. ❑ 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 (RHA) (33 USC § 403) and 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.
C. ❑ There are waters including wetlands, within the above described project area that are 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.
D. ❑ The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued DATE. Action ID: FILE NUMBER.
Basis For Determination: See the Preliminary Jurisdictional Determination form dated 08/15/2019.
Remarks: None.
E. Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdiction determinations as indicated in B and C
above).
This correspondence constitutes an approved jurisdiction 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:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room 10M 15
Atlanta, Georgia 30303-8801
Phone: [phone]
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by N/A.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.**
/i�'v Date: 2019.08.15
Corps Regulatory Official: 14:22:02 -04'00'
David E. Bailey
Date of JD: 08/15/2019 Expiration Date of JD: N/A

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL Ad
Applicant: City of Greensboro attn.: Butch ShumaLej File Number: SAW -2019-01254 Date: 08/15/2019
Attached is: See Section below
LAPPROVED
PROFFERED PERMIT Standard Permit or Letter of ermission A
RED PERMIT Standard Permit or Letter of ermission B
DENIAL C
JURISDICTIONAL DETERMINATION D
INARY JURISDICTIONAL DETERMINATION E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or hLtp://www.usace.qM.mil/Missions/CivilWorks/RegulatoEyProgramandPerinits.aspx
or the Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the fixture. 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 I1 of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.

SECTION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED 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 OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the
If you only have questions regarding the appeal process you may
appeal process you may contact:
also contact:
District Engineer, Wilmington Regulatory Division
Mr. Jason Steele, Administrative Appeal Review Officer
Attn: David E. Bailey
CESAD-PDO
Raleigh Regulatory Office
U.S. Army Corps of Engineers, South Atlantic Division
U.S Army Corps of Engineers
60 Forsyth Street, Room 1OM15
3331 Heritage Trade Drive, Suite 105
Atlanta, Georgia 30303-8801
Wake Forest, North Carolina 27587
Phone: [phone]
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 opportunit to participate in all site investigations.
Date:
Telephone number:
Signature of appellant oragent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division, Attn: David E. Bailey, 69 Darlington Avenue, Wilmington, North Carolina
28403
For Permit denials, Proffered Permits and Approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele, Administrative Appeal
Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]

Action ID Number: SAW -2019-01254
Permittee: City of Greensboro (attn.: Butch Shumate)
County: Guilford
Project Name: Greensboro Science Center expansion / City of Greensboro / Guilford / commercial
Date Verification Issued: 08/15/2019
Project Manager: David E. Bailey
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
Attn: David E. Bailey
Raleigh Regulatory Office
U.S Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
or
[e-mail]
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
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