20190614 Ver 1_USACE Permit_20191028

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2018-01939 County: Guilford U.S.G.S. Quad: NC -Guilford
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Permittee: Cameron General Contractors
Attn: Bob Lewis
Address: 7101 South 82nd Street
Lincoln, NE 68516
Size (acres) —11.79 Nearest Town Greensboro
Nearest Waterway UT to Reddicks Creek River Basin Cape Fear
USGS HUC 03030003 Coordinates 36.020358 N,-79.883246 W
Location description: The proiect area is located between High Point Road and West Gate City Boulevard, lust west of
Alamance Road, at 5300 High Point Road, in Greensboro, Guilford County, North Carolina.
Description of projects area and activity: This verification authorizes the permanent discharge of fill material (loss of waters of
the US) into 0.07 acre of riparian non-riverine wetlands, necessary to install access and infrastructure for a senior resort
lifestyle residential facility at The Pilot at Sedgefield development.
Applicable Law(s): ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: NWP 29. Residential 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 5/7/2019, and additional information sent via email on 6/11/2019, and the enclosed
plans Sheets 2, 3, and 4. 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 (LAMA), 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.Baile 2 sace.arm .mil.
Corps Regulatory Official: Date: 10/28/2019
Expiration Date of Verification: 03/18/2022

SPECIAL CONDITIONS
1. The Permittee shall fully implement the Memorandum of Agreement between the Permittee, the
North Carolina State Historic Preservation Officer and the U.S. Army Corps of Engineers,
Wilmington District, dated October 24, 2019, which is incorporated herein by reference.
2. Please note that this project is considered cumulative with all current and future phases of The
Pilot at Sedgefield development with respect to compensatory mitigation and Nationwide Permit
thresholds. As such, impacts permitted for this project (SAW-2018-01939) are considered
cumulative with impacts permitted during phases authorized and documented under Action ID:
SAW-2019-00781. Current cumulative impacts to waters of the US for The Pilot at Sedgefield
single and complete project include permanent impacts (loss of waters) to 0.07 acre of wetlands,
and temporary impacts to 91 linear feet (0.01 acre) of stream channel. This amounts to a total loss
of waters of the US of 0.07 acre.
Corps Regulatory Official: Date: 10/28/2019
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:Hcorpsmapu.usace.q=.mil/cm apex/f?p=136A:0.
Copy furnished:
Patrick Korn, Terracon Consultants, 2701 Wesport Road Charlotte, NC 28216
Craig Taylor, KSL Sedgefield Pilot, LLC, 5790 Fleet Street, Suite 300, Carlsbad, CA 92008
Sue Homewood, NCDEQ-DWR, 450 W. Hanes Mill Rd, Suite 300, Winston-Salem, NC 27105

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DATE : 05-31-2019
SHEET 2

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JOB No. 100192-01-001
DATE : 05-31-2019
SHEET 4

MEMORANDUM OF AGREEMENT BETWEEN
U.S. ARMY CORPS OF ENGINEERS, WILMINGTON DISTRICT,
KSL SEDGEFIELD PILOT, LLC,
AND
NORTH CAROLINA STATE HISTORIC PRESERVATION OFFICER
FOR
THE CONSTRUCTION OF THE PILOT AT SEDGEFIELD
MIXED -USE DEVELOPMENT SEWER IMPROVEMENTS
GREENSBORO, GUILFORD COUNTY, NORTH CAROLINA
WHEREAS, the U.S. Army Corps of Engineers ("USACE") is considering the issuance of a permit for
the construction of sewer improvements at The Pilot at Sedgefield (the Development), a mixed -use
development located at the intersection of High Point Road and Alamance Road in Greensboro, North
Carolina (the "Undertaking"), pursuant to Section 404 of the Clean Water Act (33 U.S.0 1334); and
WHEREAS, the Pilot Life Insurance Headquarters campus (GF 1234) ("Historic Property"), is
individually eligible for listing in the National Register of Historic Places under Criterion C for
architecture and is located on the project site, specifically Tract 3 and 4 as shown in Appendix A. The
Historic Property is also a contributing resource within the National Register -eligible Sedgefield-Pilot Life
Historic District; and
WHEREAS, the proposed Sedgefield-Pilot Life Historic District (GF2993) ("Historic District"), is
eligible for listing in the National Register of Historic Places under Criterion A for planning and
development, Criterion B for its association with several of the area's leading industrialists and
businessmen including John Blackwell Cobb, and Criterion C for architecture and is partially located on
the project site; and
WHEREAS, the USACE has determined that the Undertaking will result in an adverse effect upon the
historic property and historic district; and
WHEREAS, the USACE has consulted with the North Carolina State Historic Preservation Officer
("SHPO") pursuant to 36 CFR Part 800, regulations implementing Section 106 of the National Historic
Preservation Act (as amended, 54 U.S.C. 300101, et seq.); and
WHEREAS, the USACE notified the Advisory Council on Historic Preservation ("ACHP") of the adverse
effect determination with specified documentation and the ACHP has chosen not to participate in the
consultation pursuant to 36 CFR 800.6(a)(1)(iii); and
WHEREAS, KSL Sedgefield Pilot, LLC ("Owner") is the owner of the Development; and
WHEREAS, the Owner has participated in the consultation regarding the Development, and the Owner
and its successors and assigns have been invited by USACE and the SHPO to be signatories to this
Memorandum of Agreement (MOA); and
NOW, THEREFORE, the signatories agree that should the USACE issue a permit for the Development,
the USACE will include the following stipulations to mitigate the adverse effect to the Historic Property
and the Historic District:
MOA — The Pilot at Sedgefield, Guilford County, North Carolina

STIPULATIONS
I. VIEWSHED EASEMENT
A. To ensure the preservation of the Historic Property's open campus landscape and setting, as
well as the visual and spatial relationship between the Historic Property and the Historic
District, the Owner will grant or reserve a viewshed easement that will incorporate the front
lawn of the Historic Property from the south facade of the Pilot Life Insurance Company
headquarters building located on Tract 3, and shown in Appendix A, south to High Point Road
(the "Viewshed Easement") when affected property is conveyed to a purchaser.
• The form of the Viewshed Easement estate is attached as Appendix B. The Viewshed
Easement will reserve or grant to the Owner the right to approve or disapprove all
construction within the easement area (the "Construction Approval Right"), among other
things.
• The Owner stipulates that it has reviewed and approved the construction of a biocell
stormwater retention area within the Viewshed Easement in accordance with plans prepared
by Cameron General Contractors, and shown in Appendix C.
B. The Owner or Holder (as defined below), as applicable, will review all proposed construction
within the Viewshed Easement area for potential impacts to the Historic Property and Historic
District with every effort made to assure that the National Register -eligible integrity of the
Historic Property will be retained.
C. The Owner will have the responsibility of controlling the nature of construction within the
Viewshed Easement, until such a time as the Construction Approval Right is transferred to a
Holder, as such term is defined in N.C.G.S. Section 121-35(2), as hereafter amended or
modified, such as Preservation Greensboro Development Fund, Inc. or another third -party
historic preservation entity with professional staff that meets the Secretary of the Interior's
Professional Qualification Standards for architectural history.
D. The Owner will transfer the Construction Approval Right to a Holder no later than the date of
the Historic Property's listing in the National Register of Historic Places, or the expiration of
the USACE permit, whichever comes first.
E. Once the Construction Approval Right has been transferred to the Holder, the Holder will be
added as a concurring party to this agreement, through the process outlined in Stipulation V.
F. Should the Owner sell all or part of the Historic Property to a Buyer, the Owner shall require
as a condition to the conveyance, that the Buyer will, after a reasonable opportunity to review
this MOA and the Viewshed Easement, become a concurring party to this MOA through the
process outlined in Stipulation V.
II. DURATION
This MOA will expire if its terms are not carried out prior to expiration of the Nationwide Permit
on March 18, 2022. Prior to such time, USACE may consult with the other signatories to reconsider
the terms of the MOA and amend it in accordance with Stipulation V below.
MOA — The Pilot at Sedgefield, Guilford County, North Carolina

III. UNANTICIPATED DISCOVERIES
The Owner will notify SHPO and USACE as soon as practicable if it appears that the Undertaking
will affect a previously unidentified historic property, including human remains, or affect aknown
historic resource in an unanticipated manner. The Owner will take all reasonable measures to avoid,
minimize harm, and protect any such new discoveries until further consultation with SHPO and any
other consulting parties has concluded. Inadvertent or accidental discovery of human remains will
be handled in accordance with North Carolina General Statutes Chapters 65 and 70.
IV. DISPUTE RESOLUTION
Should any signatory or concurring parry to this MOA object within 30 days to any plans or
documentation provided for review pursuant to this MOA, the USACE shall consult with the
objecting party(ies) to resolve the objection. If the USACE or the objecting party(ies) determines
that the objection cannot be resolved, the USACE will forward all documentation relevant to the
dispute to the ACHP.
Within thirty (30) days after receipt of all pertinent documentation, the ACHP will either:
Provide the USACE with recommendations, which the USACE will take into account in
reaching a final decision regarding the dispute, or
2. Notify the USACE that it will comment pursuant to 36 CFR Section 800.7(c) and proceed to
comment. Any ACHP comment provided in response to such a request will be taken into
account by the USACE in accordance with 36 CFR Section 800.7 (c) (4) with reference to the
subject of the dispute.
Any recommendation or comment provided by the ACHP will be understood to pertain only to the
subject of the dispute. The Owner's responsibility to carry out all of the actions under this MOA
that are not the subject of the dispute will remain unchanged.
V. AMENDMENTS
If any signatory to this MOA believes that its terms cannot be carried out or that an amendment to
the terms must be made, that party(ies) shall immediately consult with the other party(ies) to amend
this MOA in accordance with 36 CFR 800.6(c)(7). If an amendment cannot be agreed upon, the
dispute resolution process set forth in Stipulation IV will be followed.
VI. TERMINATION
A. Any signatory to this MOA may terminate the MOA by providing notice to the other
parties, provided that the signatories and concurring parties will consult during the period
prior to termination to seek agreement on amendments or other actions that would avoid
termination.
B. Termination of this MOA will require compliance with 36 CFR 800. This MOA may be
terminated by the execution of a subsequent MOA that explicitly terminates or supersedes
the terms of this MOA.
Execution of this Memorandum of Agreement by USAGE, Owner and SHPO, its subsequent filing
with the ACHP, and implementation of its terms shall evidence that USACE has afforded the
MOA — The Pilot at Sedgefield, Guilford County, North Carolina

ACHP an opportunity to comment on the Undertaking and that USACE has taken into account the
effects of the Undertaking on the Historic Property and proposed Historic District.
MOA — The Pilot at Sedgefield, Guilford County, North Carolina

MEMORANDUM OF AGREEMENT BETWEEN
U.S. ARMY CORPS OF ENGINEERS, WILMINGTON DISTRICT
KSL SEDGEFIELD PILOT, LLC
AND
NORTH CAROLINA STATE HISTORIC PRESERVATION OFFICER
FOR
THE CONSTRUCTION OF THE PILOT AT SEDGEFIELD
.............. ____ .........MIXED....USE DEVELOPMENT. SEWER IMPROVEMENTS
GREENSBORO, GUILFORD COUNTY, NORTH CAROLINA
SIGNATORIES:
United States Army Corps of Engineers
FOR THE COMMANDER
Scott McLendon
Chief, Regulatory Division
Wilmington District
2 j
Date
MOA — The Pilot at Sedgefeld, Guilford County, North Carolina

MEMORANDUM OF AGREEMENT BETWEEN
U.S. ARMY CORPS OF ENGINEERS, WILMINGTON DISTRICT
KSL SEDGEFIELD PILOT, LLC
AND
NORTH CAROLINA STATE HISTORIC PRESERVATION OFFICER
FOR
THE CONSTRUCTION OF THE PILOT AT SEDGEFIELD
MIXED -USE DEVELOPMENT SEWER IMPROVEMENTS
GREENSBORO, GUILFORD COUNTY, NORTH CAROLINA
KSL Sedgefield Pilot, LLC
"DocuSigned by:
4470B7F1A4D04AE...
Craig Taylor
Secretary/General Counsel
KSL Sedgefield Pilot, LLC
10/15/2019
Date
MOA — The Pilot at Sedgefield, Guilford County, North Carolina

MEMORANDUM OF AGREEMENT BETWEEN
U.S. ARMY CORPS OF ENGINEERS, WILMINGTON DISTRICT
KSL SEDGEFIELD PILOT, LLC
AND
NORTH CAROLINA STATE HISTORIC PRESERVATION OFFICER
FOR
THE CONSTRUCTION OF THE PILOT AT SEDGEFIELD
MIXED -USE DEVELOPMENT SEWER IMPROVEMENTS
GREENSBORO, GUILFORD COUNTY, NORTH CAROLINA
North Carolina State Historic Preservation Officer
/o•zz_ ZvlS
KeviJ Cherry, Ph.D. Date
NC State Historic Preservation Officer
North Carolina Department of Natural and Cultural Resources
MOA — The Pilot at Sedgefield, Guilford County, North Carolina

MEMORANDUM OF AGREEMENT BETWEEN
U.S. ARMY CORPS OF ENGINEERS, WILMINGTON DISTRICT
KSL SEDGEFIELD PILOT, LLC
AND
NORTH CAROLINA STATE HISTORIC PRESERVATION OFFICER
FOR
THE CONSTRUCTION OF THE PILOT AT SEDGEFIELD
MIXED -USE DEVELOPMENT SEWER IMPROVEMENTS
GREENSBORO, GUILFORD COUNTY, NORTH CAROLINA
FILED:
Advisory Council on Historic Preservation
Council Staff
Date
MOA — The Pilot at Sedgefield, Guilford County, North Carolina

MEMORANDUM OF AGREEMENT BETWEEN
U.S. ARMY CORPS OF ENGINEERS, WILMINGTON DISTRICT
KSL SEDGEFIELD PILOT, LLC
AND
NORTH CAROLINA STATE HISTORIC PRESERVATION OFFICER
FOR
THE CONSTRUCTION OF THE PILOT AT SEDGEFIELD
MIXED -USE DEVELOPMENT SEWER IMPROVEMENTS
GREENSBORO, GUILFORD COUNTY, NORTH CAROLINA
APPENDIX A
Site Map showing the Development, Historic Property, and Historic District
High Point Road, Greensboro
Guilford County, North Carolina
MOA — The Pilot at Sedgefield, Guilford County, North Carolina

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The Pilot at
Sedgefield
UNIFIED
5300 High Point Road
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RXEMPCPLAT FOR
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5300 HIGH POIIVT ROAD
APRII.Ia 2019
ARQIJNA
EVANS ENGINEERING, INC.
.GINS ew aeaaSURVEY r� Is�ze)INERS
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MEMORANDUM OF AGREEMENT BETWEEN
U.S. ARMY CORPS OF ENGINEERS, WILMINGTON DISTRICT
KSL SEDGEFIELD PILOT, LLC
AND
NORTH CAROLINA STATE HISTORIC PRESERVATION OFFICER
FOR
THE CONSTRUCTION OF THE PILOT AT SEDGEFIELD
MIXED -USE DEVELOPMENT SEWER IMPROVEMENTS
GREENSBORO, GUILFORD COUNTY, NORTH CAROLINA
APPENDIX B
Form of Viewshed Easement for the Pilot Life Insurance Headquarters Campus
High Point Road, Greensboro
Guilford County, North Carolina
An easement across that certain portion of the Parcel described on Exhibit * attached hereto
and incorporated herein by this reference, and depicted on Exhibit * attached hereto and incorporated
herein by this reference (the "Viewshed Easement Area"), for unobstructed visibility at grade between
the historic buildings located on the Historic Parcel and High Point Road (the "Viewshed Easement")
with the duration of such Viewshed Easement being only for so long as the building known as the
former Pilot Life Insurance Company headquarters remains as a structure, with all exterior structural
historical walls of the five story building substantially intact, located on the Historic Property. The
Viewshed Easement shall include the right of the easement owner or Holder to remove and trim any
trees and other vegetation within the Viewshed Easement Area including, without limitation, the right
of access across the Viewshed Easement Area to accomplish the foregoing. In furtherance of the
Viewshed Easement, the construction of any man-made improvements on the Viewshed Easement Area
is prohibited without the prior written consent of the easement owner or Holder, which consent may be
withheld or conditioned in the sole discretion of the easement holder. [DRAFTING NOTE:
REFERENCE TO ANY PRIOR APPROVED PLANS TO BE INSERTED PRIOR TO
EXECUTION]. The Viewshed Easement shall be governed by Article 4 of Chapter 121, Conservation
and Historic Preservation Agreements Act, of the North Carolina General Statutes, as hereafter
amended or modified. Without limiting any other applicable rights to assignment, the right to enforce
the Viewshed Easement may be assigned, either as an exclusive right or a non-exclusive right, to any
Holder, as such term is defined in N.C.G.S. Section 121-35(2), as hereafter amended or modified. The
owner of the Historic Property and the Holder, or either of them, shall have the right to install, maintain,
repair and replace from time to time historic markers within the Viewshed Easement Area including,
without limitation, a right of access across the Viewshed Easement Area to accomplish the foregoing
installation, maintenance, repair and replacement.
MOA — The Pilot at Sedgefield, Guilford County, North Carolina

MEMORANDUM OF AGREEMENT BETWEEN
U.S. ARMY CORPS OF ENGINEERS, WILMINGTON DISTRICT
KSL SEDGEFIELD PILOT, LLC
AND
NORTH CAROLINA STATE HISTORIC PRESERVATION OFFICER
FOR
THE CONSTRUCTION OF THE PILOT AT SEDGEFIELD
MIXED -USE DEVELOPMENT SEWER IMPROVEMENTS
GREENSBORO, GUILFORD COUNTY, NORTH CAROLINA
APPENDIX C
Site Map showing the approved Biocell Stormwater Retention Area
within the Viewshed Easement Area
High Point Road, Greensboro
Guilford County, North Carolina
MOA — The Pilot at Sedgefield, Guilford County, North Carolina

EROSION CONTROL NARRATIVE:
\ MEIFEDCT�D"CAIF ""
NSIES, PARKING LOTS, AND GARAGES. AP'NGI MATELY T.S"STRUCI DUE reA.. NLLLTBE DISTURBED DURING (ELDERLYBCONSTRUCTIONAPEWOD.. ME SITE ISRII
11B
ACRES LOCATED IN GIILFORD COUNTY. OF BE XICN POINT ROAD AND ALAMANGL ROAD.
\ EMSIING COND N
THE SIR H S RULLY TOPOGRAPHY WIN SLOPES GENERALLY 5 TO TOR SLOPES STEEPEN TO ISRIN PORTIONS OF ME AREA TO S
DEVELOPED. A TER F RUNS BOSSMROUGHHI THE TNT SELVERN THIRD M ME PROPERTY THAT DRAINS A LARGE PORTION M THE ME SITE AS WELL AS
PIPED STORMW NU FROM ACROSS HIGH POINT ROAD. THE SIR IS SITE CONY COVERED WITH iAll CRASS AND SMALL GROUPINGS NORTHWEST
FEES.
MERE IS F T E AREA
a SIGNIFICANT EROSION UNDER PRESENT SITE RING CO SS THERE II A GROUPING OF TREES TO ME NBUFFER i
PORTION OF ME AREA TO BE DEVELOPEDAAS THAT WILL BE PROECRD DURING CF THE CTON IN ADDITION i0 ME TREES IN ME BUFFER ZONE
O ME UNNAMED STREAM MAi ACE AS ME PROPERTY LINE i0 ME WEST QU ME SIE.
ADJACENT AREAS
LAND USE IN ME 1.11 OF THE PROPERTY IS COAMERGAL. THE LAND IMMEDIATELY TO THE NORM, WEFT, AND EAST HAVE BEEN DEVELOPED
FOR COUMEMIIAL USE. ME LAND TO ME SOUTH UP ME PROPERTY IS RESIDENTIAL. THE UN -NAMED STREAM ACTING AS ME PROPERTY
BOUNDARY ACOUTLETSTOR TS AS ME POINT FOR .MR DISCHARGE FOR ME SITE, TROLEASU , SEDIMENT CONMRES wLL BE TAKEN TO
PREVENT DAMAGE TO ME STREAM.
THERE IS A STORM SEWER PIPE THAT DISCHARGES WARR ONTO THE SHE FROM ACROSS HIGH POINT ROAD. THE PIPE IS TO BE REMOLD AND
WATER RE-ROUTED THROUGH A DRAINAGE DITCH AROUND THE PROPERTY.
BEER i0 ME SOILS DATA ON SHEET 1.
ACCORDING TO ME NRCS SOIL SURVEY ME PREOOMINANr SOILS TO BE IS TJMll ONSIR ARE COON FINE SANDY LOAM,
MAP UNIT EY NON FINE SANDY L.M. 2-6R SLOPES
IBQUT BGINCHBE MKKTLYPIME SIIRFAGE LALR HASG ALOW CONTENT OF ORGANIC MATTER. THE SLOWEST PERMEABILITY IS SLOWS IT HAS A SANDY AN /
MODERATE AVAILABLE WATER CAPACITY AND A LLMIED SHRINK SWELL PORNTAL. THIS SOIL IS NOT FLOODED AND IS NOT PONDED, ME
SEASONAL HIGH WATER TABLE IS AT A DEPN UP MORE MAN 6 FEET. ME LAND CAPABILITYCLASSIFICATION IS 2E. ITS SOIL IS PARTIALLY
HYDRIG
MAP UNIT EAC-ENON FINE SANDY LOAN 6-1OR -PEI
TENON IS A MODERATE AGDNG TO STEEP SLOPING, VERY DEEP, WELL ORKNED SOL. TYPICALLY THE SURFACE LAYER IS FINE SANDY LOAM
ABOUT 8 INCHES NICK. ME SURFACE LAYER HAS A LOW CONTENT OF ORGANIC MATTER. ME SLOWEST PERMEABILITY IS SLOW. IT HAS A
MODERATE AVAILABLE WATER CAPACITY AND A UMITm SHRINK SWELL POENTAL. MIS SOIL IS NOT FLOODED AND IS NOT PONDES' ME
SEASONAL HIGH WATER TABLE 15 AT A DEPTH UP MURE MAY 6 FRET. THE LAND CAPABIUM CLASSIHCAIGN IS SIE. MI5 SOIL IS PARTIALLY
HYDRIG
E&S PHASE 1 CONSTRUCTION SEQUENCE:
I
1
I II PRIOR TO ME START OF CONSTRUCTION CONTRACTOR SHNL OBTAIN ALL RE UIRED PERMITS AND HOLD AN ONSIIE Pm-CONSimCTON MEETING WIN ME I
I
INSPECTOR, ENGINEER INITIAL
0 z
2 FLAGONG,EOSITE ONLY R FENC NG �TO 0 MEE INITIAL LIMITS Of CLEARING
AS SHOW. AREAS WHICH ARE NET 70 BE DISTURBED IN PHASE I KILL BE CLEARLY MARKED WIN
T NS
3. PRIOR TO ANY OEMOLInON ON ME SITE, INSTALL E&S MEASURES AS SHOWN ON ME PHASE I E&S PUN.
CONTRACTOR SHALL OBTAIN FAR INSPECTOR APPROVAL PRIOR TO ADVANCING TO PHASE 2 OF EAB PLAN.
—
/ �-�-- E&S MAINTENANCE SEQUENCE:
y
/ f
/ I. ALL EROSION AND SEDIMENT CONTRA PRACTICES NY BE CHECKED FOR STPBILLTY AND OPERATION FOLLOWING EVERY RUNOFF-PROOUGNC RAINFALL
/ ^\ mi IN NO CASE I£SS MAN ONCE EVERY WEEK. PNT NEEDED REPAIRS WLL BE MADE IMMEDIATELY TO MPINTAIN ALL PRACTICES AS DESIGNED.
2. SEE SHEET ] \ B FOR INDIWDUAL Ek5 CONTRA MAINTENANCE SPECINCAnONSa e� /
20.VE i a _
NAINTA ED FCOORRDING i0 MINIMUM STANDARDS µDSSSFEGGfnlcanOEROSION
s Of MC NORTH CAROUNA EROSION AND SEDIMENT BECONSTRUCTED
PLANNNO
AND DESIGN MANUAL AND GUILFORDADD RED IN ME MINIMUM STANDARDS OF AP NORM GY A VA EROSION AND SEDIMENT CONEa PUNNING — // /./ / / / / / \ — —
ND aG N MANUAL G ALL ED ADHERED TD DxLE55 OTHERWISE wMLD GR APPRD m BY A M MANGE.ED
_ All DURING
SITE DEVELOPMENT ARIAS ARE TO DRAIN TO APPROVED SEDIMENT CONTROL MEASURES Ai P1L TIMES DURING LAND DISNRBLNC ACTNTES AND — / �/ / / / j / // / I / / / \ \ \ \( � \ \\ = tD
O
DURING SIE AREASARUNTIL FINAL STAGUZVED S / �+/ / — _
ME CONTRACTOR IS RESPONSIBLE FOR ME INSTALLATION OF ANY ADDITIQUAL EROSION CONTROL MEASURES NECESSARY TO PREVENT EROSION
AND SEDIMENTATION AS DETERMINED BY ME ENMRONMENTAL ENGINEERING DEPARMENi
smucnau PAcnces: -REFER To PUN AND STATE MINIMUM STANDARDS a sPEcvlcnnoxs. / i % / /
// LGETATL PRACTICES -REFER i0 PLAN AND STATE MINIMUM STANDARDS & SPECIFlC,ATONS.
PERunx PERMABLLLT STAG / / ✓/// "�//
o. SEE PERMANENT STPBIUZATON NOES ON SHEET 2. / / �-./ �(((, 1 % / / / P ,(/ /// / / / / // / / / / / / / / // W. LU Z
TOPSOIL TO MEET ASTM D5268 STANDARD SPEIMCATIONS: NATURAL. FRIABLE. FERTILE. FINE LOAMY SOIL POSSESSING CHARACTERISIICS BE ,% ��\ ` $ % / / / / / / / I / I I / / � ` \ — \ \ \ /IF IIIr ¢ G O
REPRESENTATL TOCRUEPSOIL IN ME NGNItt MAi PRODUCES HEAVY CROWM. TOPSOIL SHALL HAVE A PH RANGE O 5.5 N ).4 PERCENT, FREE /\ ` / // / / / i I ( I I I I II I \ \ \ B41.Y� \ \ \ \ \ \ \ \ \ I F 1 Lu
=FEN Q
HERBICIDES, TOXIC
SUBSTIOC£S, OR ANY OMER AlMALIL, UNION, SNUS, FCLAN WXICH MATNES LARGER MAN BE HARMFUL TO PLAINNCH IN ARYAN ORETER, STONES, ROUTS, MASH, FINDER PLANING OPE ATEUS. / I`
TOPSOIL 5AJ_ CONTAIN A MINIMUM AM MREE PERCENT (SIR) ORGANIC NARMAL. CONTRACTOR TO NOTIFY ENGINEER. OWNER, AND ESTNG / I / / I I I \ \ • BL I \ ` M1 6 ( Z Lu m
AGENCY WHEN SOIL IS READY FOR TESTING
9 WL \ ) l I \ ( Z
sraRM%MNAc TB W
CALCULATION O RUNOF BEFORE AND AFTER DEVELOPMENT INDICATES THAT TITS EASING BYP'S ARE DESIGNED TO ACCONMODAR RUNOFF j / / / / / 1 ' I l I I I I I 1 \ \ I I 1 \ \ \ \ \ — / / / I I N w
FROM ME DEVELOPED SHE CONSEQUENTLY, NO ADDITIONAL STERMWATER MANAGEMENT PRACTICES ARE PRCPCSED. / llll
W cr
GALReGferlo SHEET 8
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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 10/25/2019.
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: Phillip Shannin, Review Officer
60 Forsyth Street SW, Room 1OM15
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 o the determination in this correspondence.**
Corps Regulatory Official:
David E. Bailey
Date of JD: 10/25/2019 Expiration Date of JD: N/A

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
A licant: Cameron General Contractors (Attn: Bob Lewis File Number: SAW-2018-01939 Date: 10/25/2019
Attached
is:
See Section below
❑
INITIAL PROFFERED PERMIT Standard Permit or Letter ofpermission)
A
❑
PROFFERED PERMIT Standard Permit or Letter ofpermission)
B
❑
PERMIT DENIAL
C
❑
APPROVED JURISDICTIONAL DETERMINATION
D
®
PRELIMINARY JURISDICTIONAL DETERMINATION
E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at or hqp://www.usace.g=.mil/Missions/CivilWorks/ReizulatoryProf4ramandPermits.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 future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.
E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.

SECTION II - REQUEST FOR 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. Phillip Shannin, 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 opportuni to participate in all site investigations.
Date:
Telephone number:
Signature of appellant or agent.
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. Phillip Shannin, Administrative
Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 1OM15, Atlanta, Georgia 30303-8801
Phone: [phone]

Action ID Number: SAW-2018-01939 County: Guilford
Permittee: Cameron General Contractors (Attn: Bob Lewis)
Project Name: The Pilot at Sedgefield / Senior Living Facility / 5300 High Point Road / Tract 4 / Greensboro /
Guilford County / residential
Date Verification Issued: 10/28/2019
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