20160516 Ver 1_401 Application_20160516

Montalvo, Sheri A
From: Baldwin, Alexander <[e-mail]>
Sent: Friday, May 20, 2016 2:21 PM
To: Montalvo, Sheri A
Subject: RE. Miller Park Deferred Maintenance Master PLan
Attachments: Miller-Park-Deferred-Maintenance-Master-Plan-PCNvl.4_pagel0-signed pdf
Sheri,
I apologize for that oversight. I have attached the signed version of page 10.
Thank you,
Alex
Alex Baldwin, LSS, PWS
Senior Environmental Scientist
Stantec
801 Jones Franklin Road Suite 300 Raleigh NC 27606-3394
Phone: [phone]
Fax. [phone]
Alex [e-mail]
41 Stantec
000000
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V Please consider the environment before printing this email
From: Montalvo, Sheri A [mailto:[e-mail]]
Sent: Friday, May 20, 2016 1:39 PM
To: Baldwin, Alexander
Subject: Miller Park Deferred Maintenance Master PLan
Importance: High
Alex,
We have received the above project. The signature page 10 of 10 was not signed. Please email that paged signed to
sheri montalvo(2cncdenr. o so that I can take this project off hold and forward it through the review process
Thanks
Shea MovLtaLVo
401 & Buffer Permitting Unit - Administrative Assistant
Division of Water Resources
Department of Environmental Quality
919-807-6303 (office)
sheri montalvo(Dncdenr gov
Physical: 512 N. Salisbury St., Ste 942-D, Raleigh, NC 27604

Mailing: 1617 Mail Service Center, Raleigh, NC 27699-1617

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. WIII this project occur in or near an area with federally protected species or
Yes ❑ No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ❑X No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted
-
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
See attached for additional information
6. Essential Fish Habitat (Corps Requirement)
6a WIII this project occur In or near an area designated as essential fish habitat?
❑ Yes 0 No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
1998 Final Habitat Plan for the South Atlantic Region* Essential Fish Habitat Requirements for Fishery
South Atlantic Fishery Management Council Habitat and Ecosystem Atlas (http //ocean floridamanne org/safmc_atlasn
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a WIII this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
0 Yes ❑ No
status (e g„ National Historic Trust designation or properties significant In
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would Impact historic or archeological resources?
The NCSHPO GIS web service shows Miller Park (HPO Site ID: FY3124) is included within the Ardmore Historic District (HPO Site ID. FY2614) which
was added to the National Register of Historic Places in 2004. See pages 250 and 251 of the attached PDF http //gis ncdcr gov/hpoweb
8. Flood Zone Designation (Corps Requirement)
8a WIII this project occur in a FEMA -designated 100 -year floodplain?
❑ Yes ❑X No
8b If yes, explain how project meets FEMA requirements:
n/a
8c. What source(s) did you use to make the floodplain determination?
NC Floodplain Mapping / FIRM
Alex Baldwin LSS, PWS
�tT
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agr nt's signature is valid only if an authorization
letter from the applicant isprovided.)
Page 10 of 10

(3 Stantec
PAD
May 19, 2016
NC Division of Water Resources
Wetlands Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
To Whom It May Concern:
Reference: Miller Park Stream Restoration Pre -Construction Notification
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Please find the attached Pre -Construction Notification (PCN) and supporting documentation to
apply for a Nationwide Permit (NWP) No. 27 for the Miller Park Stream Restoration in Winston-
Salem, NC.
Miller Park is a public park owned by the City of Winston-Salem (City). Approximately 30 ac of land
for the park was donated by Clint Miller in 1941 with the City contributing the additional -8 ac of
land to complete the park area for a total of -38 ac. The park was finished in July 1942 and has
many amenities including athletic fields and courts, playgrounds, walking trails, and a recreational
center. Stantec Consulting Services, Inc. (Stantec) is providing landscape architecture and
engineering services for the Miller Park Deferred Maintenance Master Plan to provide analysis,
recommendations, and repairs for the infrastructure of the park. Included in this effort is stream
restoration of a section of Bottom Branch and two unnamed tributaries to improve bed and bank
stabilization and improve associated ecological functions.
Bottom Branch and the two associated tributaries (UT1 and UT2) have been severely degraded by
headcuts and bank erosion to the point that Miller Park is losing land, multi -use trails, and park
aesthetics. The existing streams have vertical banks with heights of 6 to 16 ft. Additionally, sections
of the multiuse trail have fallen into the streams as a result of the bank erosion.
The project area was delineated by Stantec on September 3, 2015. A preliminary jurisdictional
determination request is included within this permit package. There are three jurisdictional waters
within the project area including Bottom Branch (908 If), UT1 (326 If), and UT2 (752 If). The
jurisdictional request only covers the immediate project area where disturbance is to occur but
the entire limits of the jurisdictional waters within the park were assessed in September 2015. There
were no wetlands delineated within the park property.
Stream impacts will occur to 79 If of Bottom Branch, 245 If of UT1, and 384 If of UT2 as a result of the
proposed realignment, raising the channel bed, creating a floodplain bench, and regrading the
banks. The streams will be moved away from the more severe banks and be placed on top of in-
situ soil as opposed to fill. The stream beds will also be raised to create a more stable longitudinal
slope, more width for floodplain access, and more suitable overbank slopes. Following
construction, regraded areas will be planted with native riparian vegetation.
Design with community in mind
I-

April 29, 2016
Page 2 of 2
'Reference: Miller Park Stream Restoration Pre-Construction"Notification' ,
The NC Natural Heritage Data Explorer and U.S. Fish and IWildlife Service (USFWS) Information for
Planning and Conversation (IPaC) were reviewed to evaluate threatened and endangered
species occurrences in the project area. The following species were listed in the IPaC report for the
project area, one endangered flowering plant (Small-anthered Bittercress - Cardamine
micronthera) and one threatened mammal (Northern Long-eared Bat (NLEB) - Myotis
septentrionalis). However, there are no critical habitats in this location. The small-anthered
bittercress is a historic record and is not known to be present near our project area. The forested
areas along Bottom branch, UTI, and UT2 do contain suitable roost habitat (trees > 3 in dbh) for
the NLEB; however no known roost trees are known to occur in or near Miller Park per an online
review of the USFWS - Asheville Field Office website
(http://www.fws.gov/asheville/htmis/project review/NLEB in WNC.html).
The North Carolina State Historic Preservation Office (NC SHPO) GIS web service was reviewed
and shows Miller Park (HPO Site ID: FY3124) is within the Ardmore Historic District (HPO Site ID:
FY2614). The Ardmore Historic District was added to the National Register of Historic Places (NRNP)
in 2004. Miller Park itself along with bridges, shelters, paved multi -use trail, stone steps, and
amphitheater have a status of contributing and were factors in the request to be placed on the
NRHP. The stream restoration project proposes to realign the stream and remove the pedestrian
bridge associated with stream UTI. This stream has undermined the existing concrete lined
channel located underneath the bridge, and has a resulted in an approximately 15+ foot
headcut. If left unabated, the pedestrian bridge will continue to be a public safety hazard.
The attachments contain the PCN form, vicinity map, USGS topoquad map, soils map, NWI map,
jurisdictional features map, and wetland assessment map. Additional attachments include Site
Plans, Impact Map, NCNHP report, USFWS IPaC report, and excerpts from the NRHP
documentation. Please contact me if you have any questions.
Regards,
Stantec Consulting Services, Inc.
Alex Baldwin, LSS, PWS
Senior Environmental Scientist
Phone: [phone]
[e-mail]
Attachment: 5 copies of PCN packet
Design with community in mind

W A T�c9
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y Corps action ID no -
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DWQ project no
Form Version 14 January 2009
Pre -Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the Corps
❑X Section 404 Permit ❑ Section 10 Permit
1b Specify Nationwide Permit (NWP) number 27 or General Permit (GP) number
1c. Has the NWP or GP number been verified by the Corps?
❑X Yes ❑ No
1 d. Type(s) of approval sought from the DWQ (check all that apply).
401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes ❑X No
For the record only for Corps Permit:
❑ Yes ❑X No
1f Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts? If so, attach the acceptance letter from mitigation bank
or in -lieu fee program.
❑ Yes ❑R No
1g Is the project located in any of NC's twenty coastal counties If yes, answer 1 h
below
E] Yes ❑X No
1h Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2. Project Information
2a. Name of project
Miller Park Deferred Maintenance Master Plan - Stream Restoration
2b County-
Forsyth
2c Nearest municipality / town:
Winston-Salem
2d Subdivision name.
Ardmore
2e NCDOT only, T I P or state project no:
n/a
3. Owner Information
3a. Name(s) on Recorded Deed.
City of Winston-Salem - Recreation and Parks Department
3b Deed Book and Page No.
Block/Lot - 6086 101 C, Neighborhood - 40
3c Responsible Party (for LLC if
applicable)
William Royston
3d Street address-
PO BOX 2511
3e City, state, zip.
Winston-Salem, NC 27102
3f Telephone no
336-397-7908
3g. Fax no.
3h. Email address:
[e-mail]
Page 1 of 10
PCN Form — Version 1.4 January 2009

4.
Applicant Information (if different from owner)
4a
Applicant is
❑X Agent ❑ Other, specify*
4b
Name
William L Royston, Capital Project Planner
4c
Business name
(if applicable):
City of Winston-Salem, Recreation and Parks Department
4d
Street address.
100 E First Street, Suite 407
4e
City, state, zip:
Winston-Salem, NC, 27101
4f.
Telephone no:
[phone]
4g
Fax no.
4h
Email address*
[e-mail]
5.
Agent/Consultant Information (if applicable)
5a
Name
Alex Baldwin, LSS, PWS
5b. Business name
(if applicable)
Stantec Consulting Services, Inc.
5c
Street address
801 Jones Franklin Road, Suite 300
5d
City, state, zip.
Raleigh, NC, 27604
5e
Telephone no
[phone]
5f
Fax no
5g
Email address:
Alex Baldwin@stantec corn
Page 2 -of 10

B.
Project Information and Prior Project History
1.
Property Identification
1a
Property identification no. (tax PIN or parcel ID):
6825-02-9417.00
1b
Site coordinates (in decimal degrees)
I Latitude. 36 085292 Longitude -80.283432
1c
Property size 38.7 acres
2.
Surface Waters
2a
Name of nearest body of water to proposed project: Bottom Branch
2b
Water Quality Classification of nearest receiving water C
2c
River basin Yadkin
3.
Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application
Protect site consists of a meandering stream and 2 tributaries paralleled by a multi-use trail Both streams begin as intermittent streams from culvert
outfalls along the northern protect area south of Queen St Miller Parks vegetation is mostly mature hardwood trees with a dense sapling/shrub
understory in natural areas along the streams and trails The surrounding landuse is mostly residential with some commercial business to the north
3b
List the total estimated acreage of all existing wetlands on the property- 0
3c
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property. 1,986
3d Explain the purpose of the proposed project:
See attached
3e Describe the overall project in detail, including the type of equipment to be used:
See attached
4.
Jurisdictional Determinations
4a
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project(including all priorphases) in thepast?
❑ Yes ❑X No ❑ Unknown
Comments: Prelim JD is requested as part of this permit applicati
4b.
If the Corps made the jurisdictional determination, what type
of determination was made?
Preliminary ❑ Final
4c
If yes, who delineated the jurisdictional areas?
Name (if known) A Baldwin
Agency/Consultant Company: Stantec
Other:
4d
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
S.
Project History
5a
Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes ❑X No ❑Unknown
5b
N/A
If yes, explain in detail according to "help file" instructions.
6.
Future Project Plans
6a.
Is this a phased project?
❑ Yes ❑X No
6b
N/A
If yes, explain.
Page 3 of 10
PCN Form — Version 14 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
la Which sections were completed below for your project (check all that apply).
❑ Wetlands 0 Streams — tributaries ❑ Buffers ❑ Open Waters ❑ Pond Construction .
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
Wetland impact
number
Permanent (P) or
Temporary
2b
Type of impact
2c
Type of wetland
-
2d.
Forested
2e
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1
Choose one
Choose one
Yes/No
W2
Choose one
Choose one
Yes/No
W3
Choose one
Choose one
Yes/No
W4
Choose one
Choose one
Yes/No
-
W5 -
Choose one
Choose one
Yes/No
-
W6
Choose one
Choose one
Yes/No
2g. Total Wetland Impacts:
2h. Comments.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 P
Stream Restoration
UT1 to Bottom Branch
INT
Corps
10
245
S2 P
Stream Restoration
UT2 to Bottom Branch
PER
Corps
5
394
S3 P
Stream Restoration
Bottom Branch
PER
Corps
8
79
S4
Choose one
-
S5
Choose one
S6
Choose one
-
3h Total stream and tributary impacts
718
31. Comments.
Page 4 of 10
PCN Form —Version 1.4 January 2009

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U S then indiv ually list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary T
4b
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01 -
Choose one
Choose
02
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
0
4g Comments n a
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below
5a
Pond ID number
5b
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
5f Total:
0
0
0
0
0
0
0
5g Comments n/a
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no- n/a
51 Expected pond surface area (acres).
5j Size of pond watershed (acres).
5k Method of construction
n/a
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then vou MUST fill out Section D of this form
6a. Project is in which protected basin?
❑ Neuse ❑ Tar -Pamlico ❑ Catawba ❑ Randleman ❑ Other
6b
Buffer Impact
number —
Permanent(P)or
TemporaryT
6c
Reason for impact
6d
Stream name
6e
Buffer
mitigation
required
6f.
Zone 1
impact
(square
feet)
6g
Zone 2
impact
(square
feet
131
Yes/No
B2
Yes/No
B3
Yes/No
B4
Yes/No
B5
Yes/No
B6
Yes/No
6h Total Buffer Impacts:
0
0
6i Comments n/a
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
As this protect is a stream stabilization and habitat enhancement protect, it is impossible to completely avoid impacts to jurisdictional waters However,
considerations were made to minimize disturbance to the extent necessary to provide appropriate functional uplift Impacts to UT1 and 2 due to the
realignment were deemed necessary to address deficiencies in the dimension, pattern and profile of the channels
lb Specifically describe measures taken to avoid or minimize the proposed Impacts through construction techniques
See attached
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
Impacts to Waters of the U S or Waters of the State?
❑ Yes ❑X No
2b If yes, mitigation is required by (check all that apply).
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project
❑ Mitigation bank
❑ Payment to In -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank. n/a
3b. Credits Purchased (attach receipt and letter)
Type- Choose one
Type Choose one
Type. Choose one
Quantity
Quantity
Quantity
n/a
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a Approval letter from In -lieu fee program is attached.
❑ Yes
4b Stream mitigation requested:
0 linear feet
4c If using stream mitigation, stream temperature:
Choose one
4d Buffer mitigation requested (DWQ only).
0 square feet
4e Riparian wetland mitigation requested,
0 acres
4f Non -riparian wetland mitigation requested
0 acres
4g. Coastal (tidal) wetland mitigation requested.
0 acres
4h Comments- n/a
5. Complete if Using a Permittee Responsible Mitigation Plan
5a If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
n/a
Page 6 of 10
PCN Form — Version 1 4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ❑X No
6b If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation Calculate the
amount of mitigation required
Zone
6c.
Reason for impact
6d
Total impact
(square feet)
Multiplier
6e
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f Total buffer mitigation required:
o
6g If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h Comments:
Page 7 of 10

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1 a
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ❑X No
within one of the NC Riparian Buffer Protection Rules?
1 b
If yes, then is a diffuse flow plan included? If no, explain why
n/a
❑ Yes ❑ No
2.
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
0
2b
Does this project require a Stormwater Management Plan?
❑ Yes ❑X No
2c
If this project DOES NOT require a Stormwater Management Plan, explain why
This project is a restoration and enhancement project and does not include increases in impervious area
2d
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan
n/a
2e
Who will be responsible for the review of the Stormwater Management Plan?
n/a
3.
Certified Local Government Stormwater Review
3a
In which localgovernment's jurisdiction is this project?
n/a
❑ Phase II
❑ NSW
3b
Which of the following locally -implemented stormwater management programs
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
❑ Other
3c
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4.
DWQ Stormwater Program Review
❑Coastal counties
❑HQW
4a.
Which of the following state -implemented stormwater management programs apply
❑ORW
(check all that apply)
❑Session Law 2006-246
❑Other
4b
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b
Have all of the 401 Unit submittal requirements been mets
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 14 January 2009

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
la
Does the project involve an expenditure of public (federal/state/local) funds or the
0 Yes
❑ No
use of public (federal/state) land?
lb
If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes
❑X No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter ) Protect is non -compensatory stream restoration/enhancement and therefore falls
❑ Yes
❑ No
Comments. under the provisions of 15NCAC 01C 0408 and does not require env documentation
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
E] Yes
❑X No
or Riparian Buffer Rules (15A NCAC 26 0200)?
2b
Is this an after -the -fact permit application?
El Yes
❑X No
2c
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s)
n/a
3.
Cumulative Impacts (DWQ Requirement)
3a
Will this project (based on past and reasonably anticipated future impacts) result in
❑Yes
❑X No
additional development, which could impact nearby downstream water quality
3b
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
This project is a restoration project and will not lead to additional development
4.
Sewage Disposal (DWQ Requirement)
4a
Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
theproposed project, or available capacity of the subject facility
Wastewater
will not be generated as part of this stream restoration/enhancement protect
Page 9 of 10
PCN Form — Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this project occur in or near an area with federally protected species or
Yes ❑ No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ❑X No
impacts?
5c If yes, indicate the USFWS Field Office you have contacted
-
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
See attached for additional information
6. Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ❑X No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
1998 Final Habitat Plan for the South Atlantic Region Essential Fish Habitat Requirements for Fishery
South Atlantic Fishery Management Council Habitat and Ecosystem Atlas (http //ocean floridamanne org/safmc_atlaso
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑x Yes ❑ No
status (e g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
The NCSHPO GIS web service shows Miller Park (HPO Site ID FY3124) is included within the Ardmore Historic District (HPO Site ID FY2614) which
was added to the National Register of Historic Places in 2004 See pages 250 and 251 of the attached PDF http //gis ncdcr gov/hpoweb
8. Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA -designated 100 -year floodplain?
❑ Yes ❑X No
8b If yes, explain how project meets FEMA requirements
n/a
8c What source(s) did you use to make the floodplain determination?
NC Floodplain Mapping / FIRM
Alex Baldwin LSS, PWS
04-29-2016
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided
Page 10 of 10

PRE -CONSTRUCTION NOTIFICATION (PCN) FORM —ATTACHED INFORMATION
63d. Explain the purpose of the
proposed project
The proposed Miller Park Stream restoration project is primarily a
public safety and stabilization project. Stream banks of Bottom
Branch and associated tributaries have eroded and are encroaching
and compromising surrounding walking trails. The banks are
extremely steep and pose a risk to patrons and make one of the
park amenities a hazard. The project will also provide habitat
enhancement as a part of the overall restoration effort. The goal of
the project is to improve in -stream habitat, enhance native riparian
vegetation, and improve recreational opportunities and access.
133e. Describe the overall project
The tributaries to Bottom Branch have been severely degraded by
in detail, including the type of
headcuts and bank erosion to the point that Miller Park is losing
equipment to be used
land, multi -use trails, and park aesthetics. The existing streams
have vertical banks with heights of 6 to 16 feet. The proposed
restoration involves channel realignment, raising the channel bed,
creating a floodplain bench, and regrading banks. The streams will
be moved away from the more severe banks and on top of in-situ
soil as opposed to fill. The stream beds will also be raised to create
a more stable longitudinal slope, more width for floodplain access,
and more suitable overbank slopes. The beds of the tributaries are
currently dominated by riffle/run facets with cobble substrate
heavily embedded with sand from the eroding banks. The restored
UT 1 to Bottom Branch will be comprised of boulder step pools. UT
2 to Bottom Branch will features boulder step pools below an
existing footbridge and aerial sewer line. The remainder of the
channel will have riffle/pool facets composed of boulders, logs, and
woody debris. Below the confluence, a short transition reach in
Bottom Branch will contain riffles and pools similar to UT 2.
Regraded areas will be planted with native riparian vegetation. The
work will be completed predominantly via track hoes with hydraulic
thumbs, front-end loaders, back hoes, and off road haul trucks.
D1b. Specifically describe
Typical sediment and erosion control measures will be taken on
measures taken to avoid or
site. Tree protection fencing will be used to protect jurisdictional
minimize the proposed impacts
waters that will not be impacted. Appropriately sized equipment
through construction techniques.
will be utilized to prevent excessive compacting and minimize
clearing. Construction scheduling and staging will be timed to
minimize the amount of time spent working in the stream channel.
Pump arounds will be used to complete work in the dry to a feasible
extent for working in the creek. An Erosion and Sediment Control
Plan will be submitted to the NC Department of Energy, Mineral,
and Land Resources.

F5d. Endangered Species Federally protected species listed for Forsyth County with potential habitat
and Designated Critical onsite include the northern long-eared bat and small-anthered bittercress.
Habitat The NC Natural Heritage Program (NCNHP) data explorer and USFWS —
Information for Planning and Conservation tool were used to assess known
occurrences of protected species. According to NCNHP, none of these
species or any designated critical habitat were found to be within a mile of
the project site. The northern long-eared bat (NLEB) is thought to use trees
as little as 3" dbh for roosting during summer months. The forested areas
along Bottom Branch, UT1, and UT2 do contain suitable roost habitat for
NLEB; however no known roost trees are known to occur in or near Miller
Park per an online review of the USFWS—Asheville Field office website
(http://www.fws.gov/asheville/htmis/gro*ect review/NLEB in WNC.html).
Additionally, the small-anthered bittercress is a historic record and is not
known to be present near our project area. The NCNHP USFWS IPaC
reports are attached to this permit application.

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 6096-101 C PLAN NO. PARCEL ID: 6825-02-9417.00
STREET ADDRESS: 400 Leisure Lane, Winston-Salem, NC 27103
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Alex Baldwin, LSS, PWS of Stantec Consulting Services, Inc
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, Issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
1 Q� t= i—r,Zs � ST►zC—ice— , � r� �i �% ��-i.ca �
Telephone:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorize i
Date: A, —Z.G1 1l0
Authorized Signature
Date:

Jurisdictional Determination Request
US Army Corps
of Engineers.
Wilmington Distna
This form is intended for use by anyone requesting a jurisdictional determination (JD) from the
U S Army Corps of Engineers, Wilmington District (Corps) Please include all supporting
information, as described within each category, with your request You may submit your request
to the appropriate Corps Field Office (or project manager, if known) via mail, electronic mail, or
facsimile A current list of county assignments by Field Office and project manager can be
found on-line at http-//www.saw usace army mil/Missions/RegulatoryPermitPro r� am aspx , by
telephoning 910-251-4633, or by contacting any of the field offices listed below
ASHEVILLE REGULATORY FIELD OFFICE
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
General Number [phone]
Fax Number [phone]
RALEIGH REGULATORY FIELD OFFICE
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest; North Carolina 27587
General Number [phone]
Fax Number [phone]
WASHINGTON REGULATORY FIELD OFFICE
US Almy Corps of Engineers
2407 West Fifth Street
Washington, North Carolina 27889
General Number [phone]
Fax Number [phone]
WILMINGTON REGULATORY FIELD OFFICE
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, North Carolina 28403
General Number 910-251-4633
Fax Number [phone]
Version: December 2013 Page 1

Jurisdictional Determination Request
INSTRUCTIONS.
All requestors must complete Parts A, B, C, D, E and F
NOTE TO CONSULTANTS AND AGENCIES If you are requesting a JD on behalf of a
paying client or your agency, please note the specific submittal requirements in Part G
NOTE ON PART D — PROPERTY OWNER AUTHORIZATION Please be aware that all JD
requests must include the current property owner authorization for the Corps to proceed with the
determination, which may include inspection of the property when necessary This form must be
signed by the current property owner to be considered a complete request
NOTE ON PART D - NCDOT REQUESTS Property owner authorization/notification for JD
requests associated with North Carolina Department of Transportation (NCDOT) projects will be
conducted according to the current NCDOT/USACE protocols.
NOTE TO USDA PROGRAM PARTICIPANTS A Corps approved or preliminary JD 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 also request a certified wetland determination from the local office of the Natural
Resources Conservation Service, prior to starting work
Version: December 2013 Page 2

Jurisdictional Determination Request
A. PARCEL INFORMATION
Street Address- 400 Leisure Lane
City, State Winston-Salem, NC
County. Forsyth
Directions (From Raleigh) I-4OW and IAOBUS WNS-421 N to Cloverdale Ave NW in Winston-Salem Take exit 4A from 1-00BUS W/US-421 N
Take a Telt oft Cloverdale Ave NW to Magnolia St SW Take a right on Queen SI Take a left on Leisure Ln Park is on the left
Parcel Index Number(s) (PIN) 6825-02-9417 00
B. REQUESTOR INFORMATION
Name
Mailing Address
Telephone Number
Electronic Mail Addressi
Alex Baldwin - Stantec Consulting Services
801 Jones Franklin Road, Suite 300, Raleigh, NC 27606
919-865-7583
alex baldw)n@stantec com
Select one.
❑ I am the current property owner
❑✓ I am an Authorized Agent or Environmental Consultant
❑ Interested Buyer or Under Contract to Purchase
❑ Other, please explain.
C. PROPERTY OWNER INFORMATION
Name City of Winston-Salem
Mailing Address- Po Box 2511
Winston-Salem, NC 27102
Telephone Number
Electronic Mail Address 3.
❑✓ Proof of Ownership Attached (e.g a copy of Deed, County GIS/Parcel/Tax Record data)
1 If available
2 Must attach completed Agent Authorization Form
3 If available
Version: December 2013 Page 3

Jurisdictional Determination Request
D. PROPERTY OWNER CERTIFICATION'
I, the undersigned, a duly authorized owner of record of the property/properties identified herein,
do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps)
to enter upon the property herein described for the purpose of conducting on-site investigations
and issuing a determination associated with Waters of the U.S. subject to Federal jurisdiction
under Section 404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of
1899.
E. JURISDICTIONAL DETERMINATION TYPE
Select One:
F0I am requesting that the Corps provide a preliminary JD for the property identified herein.
This request does include a delineation.
F] I am requesting that the Corps provide a preliminary JD for the property identified herein.
This request does NOT include a delineation.
F] I am requesting that the Corps investigate the property/project area for the presence or
absence of WoUS5 and provide an approved JD for the property identified herein. This
request does NOT include a request for a verified delineation.
F] I am requesting that the Corps delineate the boundaries of all WoUS on a property/project
area and provide an approved JD (this may or may not include a survey plat).
❑ I am requesting that the Corps evaluate and approve a delineation of WoUS (conducted
by others) on a property/project area and provide an approved JD (may or may not
include a survey plat).
4 For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
5 Waters of the United States
Version: December 2013 Page 4

Jurisdictional Determination Request
F. ALL REQUESTS
✓❑ Map of Property or Project Area (attached). This Map must clearly depict the boundaries
of the area of evaluation
❑✓ Size of Property or Project Area 38.7 acres
n✓ I verify that the property (or project) boundaries have recently been surveyed and marked
by a licensed land surveyor OR are otherwise clearly marked or distinguishable
G. JD REQUESTS FROM CONSULTANTS OR AGENCIES
(1) Preliminary JD Requests
❑✓ Completed and signed Preliminary Jurisdictional Determination Form
Project Coordinates: 36.085292 Latitude "80.283432 Longitude
Maps (no larger than 11x17) with Project Boundary Overlay:
7 Large and small scale maps that depict, at minimum streets, intersections, towns
❑✓ Aerial Photography of the project area
❑✓ USGS Topographic Map
❑✓ Soil Survey Map
Other Maps, as appropriate (e g National Wetland Inventory Map, Proposed Site
Plan, previous delineation maps, LIDAR maps, FEMA floodplain maps)
6 See Appendix A of this Form. From Regulatory Guidance Letter No 08-02, dated June 26, 2008
Version: December 2013 Page 5

Jurisdictional Determination Request
Delineation Information (when applicable)
Wetlands
❑ Wetland Data Sheets
Tributaries
❑✓ USACE Assessment Forms
❑ Upland Data Sheets ❑✓ Other Assessment Forms
(when appropriate)
✓❑ Landscape Photos, if taken
z Field Sketch overlain on legible Map that includes
■ All aquatic resources (for sites with multiple resources, label and identify)
• Locations of wetland data points and/or tributary assessment reaches
■ Locations of photo stations
■ Approximate acreage/linear footage of aquatic resources
(2) Approved JDs including Verification of a Delineation
❑ Project Coordinates
Latitude
Longitude
Maps (no larger than 11x17) with Project Boundary Overlay
❑ Large and small scale maps that depict, at minimum streets, intersections, towns
❑ Aerial Photography of the project area
❑ USGS Topographic Map
❑ Soil Survey Map
❑ Other Maps, as appropriate (e g National Wetland Inventory Map, Proposed Site Plan,
previous delineation maps)
1987 Manual Regional Supplements and Data forms can be found at:
http'//www usace.army.miI/Missions/CivilWorks/RegulatoryProgramandPermits/reg supp.aspx
Wetland and Stream Assessment Methodologies can be found at:
hun'Hoortal ncdenr org/c/document library/get file?uwd=76f3c58b-dab8-4960-ba43-45b7faf06f4c&grouold=38364 and,
http•//www.saw.usace army mil/Portals/59/docs/regulatory/publicnotices/2013/NCSAM Draft User Manual 130318 Of
8 Delineation information must include, at minimum, one wetland data sheet for each wetland/community type.
Version: December 2013 Page 6

Jurisdictional Determination Request
Delineation Information (when applicable)
Wetlands•
❑ Wetland Data Sheets
Tributaries
❑ USACE Assessment Forms
❑ Upland Data Sheets ❑ Other Assessment Forms
(when appropriate)
❑ Landscape Photos, if taken
❑ Field Sketch overlain on legible Map that includes
• All aquatic resources (for sites with multiple resources, label and identify)
• Locations of wetland data points and/or tributary assessment reaches
• Locations of photo stations
• Approximate acreage/linear footage of aquatic resources
Supporting Jurisdictional Information (for Approved JDs only)
❑ Approved Jurisdictional Determination Form(s) (also known as "Rapanos
Form(s)")
❑ Map(s) depicting the potential (or lack of potential) hydrologic connection(s),
adjacency, etc to navigable waters
9 Delineation information must include, at minimum, one wetland data sheet for each wetland/community type.
Version: December 2013 Page 7

ATTACHMENT A
PRELIMINARY JURISDICTIONAL DETERMINATION FORM
BACKGROUND INFORMATION
A. REPORT COMPLETION DATE FOR PRELIMINARY JURISDICTIONAL
DETERMINATION (JD): April 29, 2016
B. NAME AND ADDRESS OF PERSON REQUESTING PRELIMINARY JD:
Alex Baldwin - 801 Jones Franklin Road, Suite 300, Raleigh, NC 27606
C. DISTRICT OFFICE, FILE NAME, AND NUMBER:
D. PROJECT LOCATION(S) AND BACKGROUND INFORMATION:
Miller Park Deferred Maintenance Master Plan
(USE THE ATTACHED TABLE TO DOCUMENT MULTIPLE WATERBODIES AT DIFFERENT
SITES)
State: NC
County/parish/borough: Forsyth
City: Wnston-Salem
Center coordinates of site (lat/long in degree decimal format):
Lat. 36 085292 ON; Long. -80 283432
Universal Transverse Mercator: 17N
Name of nearest waterbody:
Bottom Branch
OW.
Identify (estimate) amount of waters in the review area:
Non -wetland waters:
1,986 linear feet: 4-10 width (ft) and/or acres.
Cowardin Class: R3SB and R4SB
Stream Flow: Perennial and Intermittent
Wetlands: 0 acres.
Cowardin Class: NSA
Name of any water bodies on the site that have been identified as Section 10
waters:
Tidal: none
Non -Tidal: none
1

E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT
APPLY):
❑ Office (Desk) Determination. Date:
❑✓ Field Determination. Date(s): september 3, 2015
SUPPORTING DATA. Data reviewed for preliminary JD
(check all that apply - checked items should be included in case file and,
where checked and requested, appropriately reference sources below):
0 Maps, plans, plots or plat submitted by or on behalf of the
applicant/consultant:
✓❑ Data sheets prepared/submitted by or on behalf of the
app 'cant/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: 24KWinston-Salem West
USDA Natural Resources Conservation Service Soil Survey.
Citation: Forsyth County 1976
❑✓ National wetlands inventory map(s). Cite name: Forsyth 100k quads
❑ State/Local wetland inventory map(s):
❑ FEMA/FIRM maps:
❑ 100 -year Floodplain Elevation is:
(National Geodectic Vertical Datum of 1929)
❑✓ Photographs: ❑✓ Aerial (Name & Date): NAiP-2015
❑ Other (Name & Date):
❑ Previous determination(s). File no. and date of response letter:
❑ Other information (please specify):
2
or

1. The Corps of Engineers believes that there may be jurisdictional waters of the
United States on the subject site, and the permit applicant or other affected party
who requested this preliminary JD is hereby advised of his or her option to
request and obtain an approved jurisdictional determination (JD) for that site.
Nevertheless, the permit applicant or other person who requested this
preliminary JD has declined to exercise the option to obtain an approved JD in
this instance and at this time.
2. In any circumstance where a permit applicant obtains an individual permit, or
a Nationwide General Permit (NWP) or other general permit verification requiring
"pre -construction notification" (PCN), or requests verification for a non -reporting
NWP or other general permit, and the permit applicant has not requested an
approved JD for the activity, the permit applicant is hereby made aware of the
following: (1) the permit applicant has elected to seek a permit authorization
based on a preliminary JD, which does not make an official determination of
jurisdictional waters; (2) that the applicant has the option to request an approved
JD before accepting the terms and conditions of the permit authorization, and
that basing a permit authorization on an approved JD could possibly result in less
compensatory mitigation being required or different special conditions; (3) that
the applicant has the right to request an individual permit rather than accepting
the terms and conditions of the NWP or other general permit authorization; (4)
that the applicant can accept a permit authorization and thereby agree to comply
with all the terms and conditions of that permit, including whatever mitigation
requirements the Corps has determined to be necessary; (5) that undertaking
any activity in reliance upon the subject permit authorization without requesting
an approved JD constitutes the applicant's acceptance of the use of the
preliminary JD, but that either form of JD will be processed as soon as is
practicable; (6) accepting a permit authorization (e.g., signing a proffered
individual permit) or undertaking any activity in reliance on any form of Corps
permit authorization based on a preliminary JD constitutes agreement that all
wetlands and other water bodies on the site affected in any way by that activity
are jurisdictional waters of the United States, and precludes any challenge to
such jurisdiction in any administrative or judicial compliance or enforcement
action, or in any administrative appeal or in any Federal court; and (7) whether
the applicant elects to use either an approved JD or a preliminary JD, that JD
will be processed as soon as is practicable. Further, an approved JD, a proffered
individual permit (and all terms and conditions contained therein), or individual
permit denial can be administratively appealed pursuant to 33 C.F.R. Part 331,
and that in any administrative appeal, jurisdictional issues can be raised (see 33
C.F.R. 331.5(a)(2)). If, during that administrative appeal, it becomes necessary
to make an official determination whether CWA jurisdiction exists over a site, or
to provide an official delineation of jurisdictional waters on the site, the Corps will
provide an approved JD to accomplish that result, as soon as is practicable.

This preliminary JD finds that there "may be" waters of the United States on the
subject project site, and identifies all aquatic features on the site that could be
affected by the proposed activity, based on the following information:
IMPORTANT NOTE: The information recorded on this form has not
necessarily been verified by the Corps and should not be relied upon for
later jurisdictional determinations.
Signature and date of
Regulatory Project Manager
(REQUIRED)
4
Signature and date of
person requesting preliminary JD
(REQUIRED, unless obtaining
the signature is impracticable)

Estimated
Site
Latitude
Longitude
Cowardin
amount of
Class of Aquatic
number
Class
aquatic resource
Resource
in review area
Bottom
Non -section 10
Branch
36.084616
-80.282727
R3SB
908 linear feet
non -wetland
Non -section 10
UT1- Int
36.086212
-80.283175
R4SB
326 linear feet
non -wetland
Non -section 10
UT2 - Int
36.087402
-80.282428
R4SB
166 linear feet
non -wetland
Non -section 10
UT2 - Per
36.086677
-80.282612
R3SB
586 linear feet
non -wetland

Miller Park - Photos
Photo 1. Stream UT2 - Intermittent - facing
downstream near upstream end of project
Photo 2. Stream UT2 - Intermittent - facing
downstream data point S5
Photo 3. Stream UT2 - Intermittent/Perennial
Break - facing downstream
Photo 4. Stream UT2 -Perennial - section where
stream is subterranean facing upstream

.t"
Photo 4. Stream UT2 -Perennial - upstream of Photo 5. Bottom Branch -Perennial -
confluence with Stream B facing downstream downstream of confluence with Stream UT1
facing upstream
Photo 7. Bottom Branch - Perennial - facing
downstream data point S2
Photo 8. Stream UTI - Intermittent - facing
downstream data point S4

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Property Report
Forsyth County, NC Convert to PDF 4/26/2016
Parcel ID Property Address January 1 Property Owner
6825-02-9417.00 Miller Park Cir City Of Winston Salem
Summary Appraisal Report - Commercial
�" \ {i �u
Owner 1
Owner 2
Mailing
Address
City, State Zip
Page 1 of 3
Bldgs: 1
Current Owners
City Of Winston Salem
PO BOX 2511
Winston Salem NC 27102-
2511
Mobile
Maps and 1 �y
Information
I I f 117 I I I
Disclaimer: The values and information provided on this property record card are based upon the best available
information on 01/01/2013. This information is subject to change because of changes to the property, correction of
existing information, additional information, or as the result of an appeal of the property.
Parcel Information
Block/Lot Neighborhood
6086 101C 40
Assessed Values All Cards
Total Land Value Total Buildings Value Total Misc Imp Value Total Assessed Value
$4,956,642 $1,302,754 $304,274 $6,563,700
Roads
Road/Topography/Utilities
Topography
Land Valuation
Utilities
Type Zoning Acres SgFt Rate Ut Size LC RF TO SH AC EZ Value
CL IP 0 1,721,056 3.60 1 1 1 1 0.8 1 1 1 $4,956,642
Total SgFt Total Acres Total Value
1,721,056 0 $4,956,642
Building Detail
Forsyth County considers all standard approaches to value. The assessed value on this building was
determined based upon the Income and Expense Approach.
Commercial Summary Information
Company Name Primary Address Occupancy Total Gross SgFt Net Lease SgFt Units
Miller Park Miller Park CIR Misc 20,278 20,278 0
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Property Report Page 2 of 3
Commercial Buildings Summary
Bldg Building Name Physical Addr Story Year Construction Occupancy Value
Built
1 Miller Park Comm. 0 Miller Park 1 1985 Mas 1617- $1,302,754
Center CIR COMRECCTR
Total Buildings Value $1,302,754
Miscellaneous Improvements
Type
Construction Height
Area
Year Built
Value
Lt Pole35 M
Metal 0
4
1995
$10,640
Lt Fx M
0
12
1995
$8,400
Lt Fx 1
0
8
1990
$2,340
Lt Pole30 F
0
4
1990
$7,280
Shelter 4
0
450
1985
$4,455
Shelter 4
0
450
1985
$4,084
Restr Bldg 2
0
375
1985
$12,272
Restr Bldg 1
0
240
1985
$5,874
Restr Bldg 2
0
600
1985
$19,635
Total Miscellaneous Value $304,274
Taxing Jurisdictions
Jurisidiction Fire District
Winston-Salem 100% FD
Income Detail
Income information on this report reflects market research and not specific data from the property.
Cost Detail
Detail Appraisal Report - Commercial Bldg:
1 of 1
Total Value from Cost
Total Section Total Addition Local Replacement
Physical Depr Econ/Func
Value Value Multiplier Cost
Depr
$2,326,286 $8,400 0.9 $2,101,217
38% 0%($0.00)
$798,462.46
Depriciated Value Misc Imp. Value Total Bldg Value
Land Value Total All Bldgs
$1,302,754 $292,002 $1,594,756
$4,956,642 $6,563,700
Building Information
Company Building Physical Occupancy
Year Year Condition
Name Address
Built Remod
Miller Park Miller Park Comm. 0 Miller Park 1617-1985
0 Average
Center CIR COMRECCTR
Foundation Construction Total Story Roof Roof Cover Ext
Walls Insul Walls Insul Ceiling
Mas 1 Flat/Flat
N N
Section Details
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Property Report
Page 3 of 3
Occupancy
Sqft/
Units
Base
Cost
Heat/
AC 1
Heat/
AC 2
Heat
Adj
Adj
Base
#
Stories
Story
Hgt
Perimeter
Cost
Sqft Cost
1617-
COMRECCTR
5,900
$10056
Heat
Pump
0%
$1255
11
1
111
0 862
3181
1 043
1 03
$104 74
$617,966
0%
$8,400
Lt Pole 30'/Fluoresc
100%
1990
35%
0%
$7,280
Lght Fx Incandescent
8 $450
1617-
COMRECCTR
6,600
$10056
Heat
Pump
0%
$1255
1 1
1
171
1 026
3321
1 036
1 03
$123 86
$817,476
0%
$5,874
Restroom Budding
100%
1985
A
45%
0%
$12,272
Shelter
450 $1650
1617-
COMRECCTR
1,250
$10056
Heat
Pump
0%
$1255
1 1
1
111
0 862
1501
1.198
1 03
$120 35
$150,438
0%
$4,455
Restroom Budding
100%
1985
A
45%
0%
$19,635
Shelter
1,800 $20.75
1807-Sch
Gym
6,528
$8479
Heat
Pump
0%
$12 90
1 1
1
201
1 184
3321
101
$113 42
$740,406
0%
$100,361
Fence 10'/Top Rad
100%
1980
45%
0 971
$6,119
Tennis Court Asphalt
4 $30,000 1
Sketched Additions
Type Description Area Rate Value
PORCH4 Open Porches 210 $40 $8,400
Miscellaneous Improvements for this Bldg
Jurisidiction
Type
Const I Area Rate
YearBuilt
Condition
Grade
Phy
EF
I Value
Lt Pole 35'/Merc Vp
Metal 4 $3,800
1995
30%
0%
$10,640
Light Fx Merc Vapor
12 $1,000
1995
30%
0%
$8,400
Lt Pole 30'/Fluoresc
4 $2,800
1990
35%
0%
$7,280
Lght Fx Incandescent
8 $450
1990
35%
0%
$2,340
Restroom Building
240 $4450
1985
A
45%
0%
$5,874
Restroom Budding
375 $5950
1985
A
45%
0%
$12,272
Shelter
450 $1650
1985
A
45%
0%
$4,084
Shelter
450 $1650
1985
A
40%
0%
$4,455
Restroom Budding
600 $5950
1985
A
45%
0%
$19,635
Shelter
1,800 $20.75
1985
A
45%
0%
$20,542
Paving Asp & Base
81,100 $225
1985
45%
0%
$100,361
Fence 10'/Top Rad
500 $2225
1980
45%
0%
$6,119
Tennis Court Asphalt
4 $30,000 1
1980
1
25%
0%
$90,000
Taxing Jurisdictions
Jurisidiction
Fire District
Winston-Salem 100%
FD
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Ephemeral Stream
DP -S1
NC DWO Stream identification Farm Vercinn 4.11
Date: 9/3/2015
Project/Site: Miller Park
Latitude: 36.083606
Evaluator: A. Baldwin
County: Forsyth
Longitude: -80.283010
Total Points: 18.5
Stream Determination (circle one)
Other
Stream is at least intermittent
if 2: 19 or erennialif_:30•
Ephemeral Intermittent Perennial
p
a Quad Name:
9 Winston -Sale
west
= 10.5
Absent
Weak
Moderate
Strong
,a Continuity of channel bed and bank
0
1
2
3
2 Sinuosity of channel along thalweg
0
1
2
3
3 In -channel structure ex riffle -pool, step -pool,
—ripple -pool se uence
0
j1\
2
3
4 Particle size of stream substrate
0
/1'
2
3
5 Active/relict floodplain
0
1
2
3
6 Depositional bars or benches
0
1
2
3
7 Recent alluvial deposits
0
1
2
3
8 Headcuts
0
1
2
3
9 Grade control
0
05
1 1
15
10 Natural valley
0
05
1 1
1 5
11 Second or greater order channel
a
No = 0
Yes = 3
Sketch
altilMai unuics aia iwi iaicu, bm u15Gusslunu in manual
B. Hvdroloav (Subtotal = 2 1
12 Presence of Baseflow
0
1
2
3
13 Iron oxidizing bacteria
0
1
2
3
14 Leaf litter
15
1
05
0
15 Sediment on plants or debris
0
05
1
1 5
16 Organic debris lines or piles
0
05
1 1
1 5
17 Soil -based evidence of high water tablet
0
No = 0
Yes = 3
1 5
LWAn1 ISIlOL \`M NIP U] N] P- I Fi M
18 Fibrous roots in streambed
3
2
1
0
19 Rooted upland plants in streambed
3
2
1
0
20 Macrobenthos (note diversity and abundance)
0'
1
2
3
21 Aquatic Mollusks
0
1
2
3
22 Fish
0"
05
1
1 5
23 Crayfish
0
05
1 1
1 5
24 Amphibians
10
05
1
15
25 Algae
'0j
05
1
1 5
26 Wetland plants in streambed
FACW = 0 75, OBL = 1 5
Other = 0
'perennial streams may also be identified using other methods See p 35 of manual
Notes:
i
Sketch

Bottom Branch
DP - S2
NC DWQ Stream Identification Form Version 4.11
Date: 9/3/2015
Project/Site: Miller Park
Latitude: 36.083568
Evaluator: A. Baldwin
County: Forsyth
Longitude: -80.283045
Total Points: 37
Stream is at least termittent
Stream Determination (circle one
Other
lin
if 2: 19 or perennial �f>_ 30*
Ephemeral Intermittent Perennial
P
a Quad Name:
9 Winston -Sale
West
= 22
Absent
Weak
Moderate
Strong
1 a Continuity of channel bed and barik
0
1
2
3
2 Sinuosity of channel along thalweg
0
1
2
3
3 In -channel structure ex riffle -pool, step -pool,
—ripple -pool sequence
0
1
2
3
4 Particle size of stream substrate
0
1
2
3
5 Active/relict floodplain
0
1
2
3
6 Depositional bars or benches
0
1
2
3
7 Recent alluvial deposits
0
1
2
3
8 Headcuts
0
1
2
3
9 Grade control
0
05
1
1 5
10 Natural valley
0
1 05
1 1
15
11 Second or greater order channel
a .
No = 0
Yes = 3
Sketch
anmciai ditches are not rated, see discussions in manual
B. Hydrology (Subtotal = 8.5 )
12 Presence of Baseflow
0
1
2
3
13 Iron oxidizing bacteria
0
1
2
3
14 Leaf litter
15
1
05
0
15 Sediment on plants or debris
0
05
1
1 5
16 Organic debris lines or piles
0
1 05
1
1 5
17 Sod -based evidence of high water table?
0,
No = 0
Yes = 3
1 5
C. Biology (Subtotal = 6.5
18 Fibrous roots in streambed
3
2
1
0
19 Rooted upland plants in streambed
3
2
1
0
20 Macrobenthos (note diversity and abundance)
0
1
2
3
21 Aquatic Mollusks
0
1
2
3
22 Fish
0
05
1
1 5
23 Crayfish
0,
05
1
1 5
24 Amphibians
0
05
1
15
25 Algae
'0"
05
1
15
26 Wetland plants in streambed
FACW = 0 75,
OBL = 15 Other = 0
*perennial streams may also be identified using other methods Seep 35 of manual
Notes.
Sketch

UT1 - DS
DP - S3
NC DWQ Stream Identification Form Version 4.11
Date: 9/3/2015
Project/Site Miller Park
Latitude: 36.086010
Evaluator: A. Baldwin
County: Forsyth
Longitude: -80.283164
Total Points:21.5
Stream is at least intermittent
Stream Determination (circle one)
Other
if_ 19 or erennialif_30`
Ephemeral, Intermittent Perennial
__
a Quad Name:
9 WlristOri-Sale
West
GearnarpholoqV = 7.5
Absent
Weak
Moderate
Strong
1a Continuity of channel bed and bank
0
1
2
3,
2 Sinuosity of channel along thalweg
(0)
1
2
3
3 In -channel structure ex riffle -pool, step -pool,
—ripple -pool se uence
0
��
`1/
2
3
4 Particle size of stream substrate
0
1
j2)
3
5 Active/relict floodplain
(0)
1
2
3
6 Depositional bars or benches
0
(1)
2
3
7 Recent alluvial deposits
;01,
1
2
3
8 Headcuts
;0)
1
2
3
9 Grade control
i0)
05
1
15
10 Natural valley
0
1\0 5)
1
1 5
11 Second or greater order channel
a
;No = 0)
Yes = 3
artificial ditches are not rated, see discussions in manual
B. Hydrology (Subtotal= 6.5 )
12 Presence of Baseflow
0
2
2
3
13 Iron oxidizing bacteria
0
(1)
2
3
14 Leaf litter
15
(1)
05
0
15 Sediment on plants or debris
0)
05
1
15
16 Organic debris lines or piles
0
1 (0 5)
1
15
17 Soil -based evidence of high water table?
0
No = 0
Yes = 3)
1 5
C. Biology (Subtotal = 7.5
18 Fibrous roots in streambed
(3)
2
1
0
19 Rooted upland plants in streambed
(3)
2
1
0
20 Macrobenthos (note diversity and abundance)
'v
1
2
3
21 Aquatic Mollusks
;0)
1
2
3
22 Fish
j0;
05
1
1 5
23 Crayfish
0
(0 5)
1
1 5
24 Amphibians
0
(0 5)
1
1 5
25 Algae
0
(0 5)
1
1 5
26 Wetland plants in streambed
FACW = 0 75,
OBL = 1 5 Other =,0
'perennial streams may also be identified using other methods See p 35 of manual
Notes Data point taken — 100 -ft downstream from
pedestrian bridge.
Sketch:

UTI - US
DP -S4
NC DWO Stream Identification Form Version 4.11
Date: 9/3/2015
Project/Site. Miller Park
Latitude: 36.086768
Evaluator: A. Baldwin
County: Forsyth
Longitude: -80.283453
Total Points:26.5
Stream Determination (circle one)
Other
Stream rs at least Intermittent
if >_ 19 or perennial if 2: 30•
Ephemeral Intermittent Perennial
p
a Quad Name:
9 Winston -Sale
West
A. Geomorphology (Subtotal= 12.5
Absent
Weak
Moderate
Strong
1a Continuity of channel bed and bank
0
1
2
3
2 Sinuosity of channel along thalweg
0
1
2
3
3 In -channel structure ex riffle -pool, step -pool,
—ripple -pool sequence
0
1'
2
3
4 Particle size of stream substrate
0
1
2
3
5 Active/relict floodplain
0
1
2
3
6 Depositional bars or benches
0
1
2
3
7 Recent alluvial deposits
0
1
2
3
8 Headcuts
0
1
2
3
9 Grade control
0
05
1
15
10 Natural valley
0
1 05
1 1
15
11 Second or greater order channel
Sketch
No = 0
Yes = 3
artiticiai ditches are not rated, see discussions in manual
B Hydrology (Subtotal = _ 8 )
12 Presence of Baseflow
0
1
2
3
13 Iron oxidizing bactena
0
1
2
3
14 Leaf litter
1 5
1
05
0
15 Sediment on plants or debris
0
05
1
1 5
16 Organic debris lines or piles
0
05
1
1 5
17 Soil -based evidence of high water table'?
0'
No = 0
Yes = 3
1 5
u tslology (subtotal = 6.5
18 Fibrous roots in streambed
3
2
1
0
19 Rooted upland plants in streambed
3
2
1
0
20 Macrobenthos (note diversity and abundance)
0
1
2
3
21 Aquatic Mollusks
0
1
2
3
22 Fish
0
05
1
1 5
23 Crayfish
0'
05
1
1 5
24 Amphibians
0
05
1
1 5
25 Algae
(0'
05
1
1 5
26 Wetland plants in streambed
FACW = 0 75, OBL = 1 5
Other = 0
'perennial streams may also be identified using other methods See p 35 of manual
Notes Data point taken -5-ft below 3.4 -ft concrete culvert. Overland stormwater flow from parking
lot and
landscaped are also contributing to stream
flow -
Sketch

UT2 (Int)
DP - S5
NC DWQ Stream Identification Form Version 4.11
Date: 9/3/2015
Project/Site Miller Park
Latitude: 36.087435
Evaluator: A. Baldwin
County: Forsyth
Longitude: -80.282412
Total Points: 27.5
Stream Determination (circle one)
Other
Streaif2:19 rperenIs at stmtermIttent
if>_ 19 or erenmal if>_ 30'
Ephemeral jntermittent Perennial
p �
a Quad Name:
9 Winston -Sale
West
A. Geomorphology Subtotal = 12.5
Absent
Weak
Moderate
Strong
10 Continuity of channel bed and bank
0
1
2
3,
2 Sinuosity of channel along thalweg
0
1;
2
3
3 In -channel structure ex riffle -pool, step -pool,
ripple -pool se uence
0
1
`2i'
3
4 Particle size of stream substrate
0
11
2
3
5 Active/relict floodplain
0
1!
2
3
6 Depositional bars or benches
0
1
2)
3
7 Recent alluvial deposits
0
1;
2
3
8 Headcuts
'0;

USACE AID# DWQ # Site # Rottom Rranch - S2 (indicate on attached map)
M
STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
1. Applicant's name: City of Winston-Salem
3. Date of evaluation- 9/3/2015
2. Evaluator's name
4. Time of evaluation.
5. Name of stream- Bottom Branch 6. River basin.
7. Approximate drainage area: 183 ac 8. Stream order
9. Length of reach evaluated: 908 ft
A. Baldwin
10:40
Yadkin
Second
10. County- Forsyth
11 Site coordinates (if known): Prefer in decimal degrees. 12. Subdivision name (if any). Ardmore
Latitude (ex 34.872312) 36.083568 Longitude (ex. - 77.556611)• -80.283045
Method location determined (circle) GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location) See attached man
14. Proposed channel work (if any)- None
15. Recent weather conditions: Trace rain events on 8/19, 8/23, 8/24, and 8/31. Last measurable rain was -0 9 -in
16. Site conditions at time of visit- Sunnv
17. Identify any special waterway classification known. _ Section 10 _Tidal Waters _Essential Fisheries Habitat
,Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters _Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? YES ®O If yes, estimate the water surface area.
19. Does channel appear on USGS quad map? ES NO 20. Does channel appear on USDA Soil Surveys ES NO
21. Estimated watershed land use: 60 % Residential 20 % Commercial _% Industrial _% Agricultural
15 % Forested 5 % Cleared / Logged _% Other (
22. Bankf ill width: 7 ft 23. Bank height (from bed to top of bank): 1.5 ft
24. Channel slope down center of stream X % Flat (Oto 2%) % Gentle (2 to 4%) % Moderate (4 to 10%) _% Steep (>10%
25. Channel sinuosity: _Straight Occasional bends X Frequent meander _% Very sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain,
vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion. Assign points to each characteristic within the
range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet Scores should
reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions enter 0 in
the scoring box and provide an explanation in the comments section Where there are obvious changes in the character of a stream under review
(e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form
used to evaluated each reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of
the highest quality
Total Score (from reverse): 57 Comments:
Evaluator's Signature: A //Az Date: 9/3/2015
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the
data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting
from the completion of this form is subject to USACE approval and does not imply a particular mitigation ration or requirement. Form
subject to change - version 06/03. To Comment, please call 919-8776-8441 x 26
1

STREAM QUALITY ASSESSMENT WORKSHEET
s These characteristics are not assessed in coastal streams.
#
CHARACTERISTICS
ECOREGION POINT RANGE
SCORE
Coastal
Piedmont
Mountain
1
Presence of flow / persistent pools in stream
0-5
0-4
0-5
3
(no flow or saturation=0; strong flow--maxpoints)
2
Evidence of past human alteration
0-6
0-5
0-5
4
(extensive alteration=0; no alteration=max points)
3
Riparian zone
0-6
0-4
0-5
2
(no buffer --0; contiguous, wide buffer—maxpoints)
4
Evidence of nutrient or chemical dischargers
0-5
0-4
0-4
2
(extensive discharges=0; no dischar es=max points)
5
Groundwater discharge
0-3
0-4
0-4
1
Q
(no dischar a=0; springs, see s, wetlands, etc.=max oints)
U
6
Presence of adjacent floodplain
0-4
0-4
0-2
2
y,
(no floodplain=0; extensive flood lain=maxpoints)
a
7
Entrenchment / floodplain access
0-5
0-4
0-2
2
(deeply entrenched=0; frequent flooding=max points)
8
Presence of adjacent wetlands
0-6
0-4
0-2
0
(no wetlands=0; large adjacent wetlands=max points
9
Channel sinuosity
0-5
0-4
0-3
4
(extensive channelization=0; natural meander --max points)
0
Sediment input
0-5
0-4
0-4
1
(extensive de osition=0; little or no sediment--maxpoints)
11
Size & diversity of channel bed substrate
NA
0-4
0 — 5
2
(fine, homo eneous=0; large, diverse sizes=max points)
12
Evidence of channel incision or widening
0-5
0-4
0-5
3
(deeply incised=0; stable bed & banks=maxpoints)
F13
Presence of major bank failures
0-5
0-5
0-5
4
.�
(severe erosion=0; no erosion, sable banks=maxpoints)
m
Q
14
Root depth and density on banks
0-3
0-4
0-5
4
(no visible roots=0; dense roots throughout --max points)
15
Impact by agriculture, livestock, or timber production
0-5
0-4
0-5
4
(substantial im act=0; no evidence=maxpoints)
16
Presence of riffle-pool/ripple-pool complexes
0-3
0-5
0-6
4
(no riffles/ripples or ools=0; well-developed= ax points)
Q
17
Habitat complexity
0-6
0-6
0-6
4
F
(little or no habitat -0; frequent, varied habitats=max points)
18
Canopy coverage over streambed
0-5
0-5
0-5
5
_
(no shading ve etation=0; continuous canopy=maxpoints)
19
Substrate embeddedness
NA*
0-4
0-4
2
(deeply embedded=0; loose structure=maxpoints)
20
Presence of stream invertebrates (see page 4)
0-4
0-5
0-5
1
(no evidence=0; common, numerous types=maxpoints)
>"
U
21
Presence of amphibians
0-4
0-4
0-4
1
O
(no evidence=0; common, numerous ty es=max points
O
22
Presence of fish
0-4
0-4
0-4
0
p�
(no evidence=0; common, numerous types=rnaxpoints)
23
Evidence of wildlife use
0-6
0-5
0-5
2
(no evidence=0; abundant evidence=maxpoints)
Total Points Possible
100
100
100
57
TOTAL SCORE (also enter on first page)
s These characteristics are not assessed in coastal streams.

USACE AID# DWQ # Site # UTI - S3 (indicate on attached map)
0 STREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
1. Applicant's name: City of Winston-Salem 2. Evaluator's name: A. Baldwin
3. Date of evaluation. 9/3/2015 4. Time of evaluation: 11.15
5. Name of stream: UT to Bottom Branch
7. Approximate drainage area: 29 ac
9. Length of reach evaluated: 326 ft
11 Site coordinates (if known). Prefer in decimal degrees.
Latitude (ex. 34.872312): 36 086010
6. River basin- Yadkin
8. Stream order. First
10. County: Forsyth
12. Subdivision name (if any): Ardmore
Longitude (ex. - 77.556611): -80.283164
Method location determined (circle). GPS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location): See attached mar).
14. Proposed channel work (if any) None.
15. Recent weather conditions: Trace rain events on 8/19, 8/23, 8/24, and 8/31. Last measurable rain was 0.9 -in
16. Site conditions at time of visit:
17. Identify any special waterway classification known: _ Section 10 _Tidal Waters _Essential Fisheries Habitat
_Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters _Water Supply Watershed (I-IV)
18. Is there a pond or lake located upstream of the evaluation point? YES ®O If yes, estimate the water surface area
19. Does channel appear on USGS quad map? ES NO 20. Does channel appear on USDA Soil Surveys ES NO
21. Estimated watershed land use- 70 %Residential 15 %Commercial _% Industrial _% Agricultural
10 % Forested 5 % Cleared / Logged _% Other (
22. Bankfull width. loft 23. Bank height (from bed to top of bank)- 3 ft
24. Channel slope down center of stream: X % Flat (Oto 2%) % Gentle (2 to 4%) -% Moderate (4 to 10%) _% Steep (>10%
25. Channel sinuosity- X Straight Occasional bends Frequent meander _% Very sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain,
vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion Assign points to each characteristic within the
range shown for the ecoregion Page 3 provides a brief description of how to review the characteristics identified in the worksheet Scores should
reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions enter 0 in
the scoring box and provide an explanation in the comments section. Where there are obvious changes in the character of a stream under review
(e.g , the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form
used to evaluated each reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of
the highest quality.
Total Score (from reverse): 38 Comments:
Evaluator's Signature: -41.4e_ Date: 9/3/2015
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the
data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting
from the completion of this form is subject to USACE approval and does not imply a particular mitigation ration or requirement. Form
subject to change - version 06/03. To Comment, please call 919-8776-8441 x 26.
1

STREAM QUALITY ASSESSMENT WORKSHEET
* These characteristics are not assessed in coastal streams.
#
CHARACTERISTICS
ECOREGION
POINT RANGE
SCORE
Coastal
Piedmont
Mountain
1
Presence of flow / persistent pools in stream
0-5
0-4
0-5
2
(no flow or saturation=0; strop flow--maxpoints)
2
Evidence of past human alteration
0-6
0-5
0-5
1
(extensive alteration=0; no alteration=maxpoints)
3
Riparian zone
0-6
0-4
0-5
2
(no buffer -0; contiguous, wide buffer—maxpoints)
4
Evidence of nutrient or chemical dischargers
0-5
0-4
0-4
2
(extensive dischar es=0; no dischar es=max points)
5
Groundwater discharge
0-3
0-4
0-4
2
Q
(no dischar a=0; springs, see s, wetlands, etc.=maxpoints)
U
6
Presence of adjacent floodplain
0-4
0-4
0-2
0
>-
(no floodplain=0; extensive flood Iain=maxpoints)
a=.
7
Entrenchment / floodplain access
0-5
0-4
0-2
0
(deeply entrenched=0; frequent floodin =maxpoints)
8
Presence of adjacent wetlands
0-6
0-4
0-2
0
(no wetlands=0; large adjacent wetlands=max points
9
Channel sinuosity
0-5
0-4
0-3
1
(extensive channelization=0; natural meander—maxpoints)
10
Sediment input
0-5
0-4
0-4
2
(extensive deposition=0; little or no sediment=max oints)
11
Size & diversity of channel bed substrate
NA*
0-4
0-5
3
(fine, homo eneous=0; large, diverse sizes=maxpoints)
12
Evidence of channel incision or widening
0-5
0-4
0-5
0
(deeply incised=0; stable bed & banks=max oints)
Ems-
13
Presence of major bank failures
0-5
0-5
0-5
1
.�
(severe erosion=0; no erosion, sable banks=maxpoints)
m
Q
14
Root depth and density on banks
0-4
0-5
3
(no visible roots=0; dense roots throughout --max points)0-3
15
Impact by agriculture, livestock, or timber production
0-5
0-4
0-5
4
(substantial impact --O; no evidence=maxpoints)
16
Presence of riffle-poot/ripple-pool complexes
0-3
0-5
0-6
1
(no riffles/ripples or ools=0; well-develo ed=maxpoints)
Q
17
Habitat complexity
0-6
0-6
0-6
2
F
(little or no habitat --O; frequent, varied habitats=max points)
Q18
Canopy coverage over streambed
0-5
0-5
0-5
5
_
(no shading ve etation=0; continuous canopy=maxpoints)
19
Substrate embeddedness
NA*
0-4
0-4
3
(deeply embedded=0; loose structure=maxpoints)
20
Presence of stream invertebrates (see page 4)
0-4
0-5
0-5
1
(no evidence=0; common, numerous ty es=max points)
>"
0
21
Presence of amphibians
0-4
0-4
0-4
1
p
(no evidence=0; common, numerous ty es=max points)
O
22
Presence of fish
0-4
0-4
0-4
0
pp
(no evidence=0; common, numerous types=maxpoints)
23
Evidence of wildlife use
0-6
0-5
0-5
2
(no evidence=0; abundant evidence=maxpoints)
Total Points Possible
100
100
100
38
TOTAL SCORE (also enter on first page)
* These characteristics are not assessed in coastal streams.

I
USACE AID# DWQ # Site # -=— S5 (indicate on attached am p)
MSTREAM QUALITY ASSESSMENT WORKSHEET
Provide the following information for the stream reach under assessment:
1. Applicant's name- City of Winston-Salem 2. Evaluator's name: A. Baldwin
3. Date of evaluation. 9/3/2015
5. Name of stream: UT to Bottom Branch
7. Approximate drainage area: 23 ac
9. Length of reach evaluated. 166 ft
11 Site coordinates (if known): Prefer in decimal degrees.
4. Time of evaluation: 14.55
6. River basin Yadkin
8. Stream order. First
10. County: Forsyth
12. Subdivision name (if any): Ardmore
Latitude (ex. 34.872312). 36 087435 Longitude (ex. — 77 556611): -80.282412
Method location determined (circle) PS Topo Sheet Ortho (Aerial) Photo/GIS Other GIS Other
13. Location of reach under evaluation (note nearby roads and landmarks and attach map identifying stream(s) location) See attached man
14. Proposed channel work (if any). None
15. Recent weather conditions: Trace rain events on 8/19, 8/23, 8/24, and 8/31 Last measurable rain was--0.9-in
16. Site conditions at time of visit. Sunnv
17. Identify any special waterway classification known. _ Section 10 _Tidal Waters _Essential Fisheries Habitat
_Trout Waters Outstanding Resource Waters Nutrient Sensitive Waters _Water Supply Watershed
18. Is there a pond or lake located upstream of the evaluation point? YES ® If yes, estimate the water surface area -
19. Does channel appear on USGS quad map? ES NO 20. Does channel appear on USDA Soil Survey? ES
21. Estimated watershed land use: 30 % Residential 70 % Commercial _% Industrial _% Agricultural
_% Forested _% Cleared / Logged % Other (
22. Bankfull width- 4 ft 23. Bank height (from bed to top of bank):
(I -1V)
NO
1.5 ft
24. Channel slope down center of stream: X % Flat (Oto 2%) % Gentle (2 to 4%) % Moderate (4 to 10%) _% Steep (>10%
25. Channel sinuosity _Straight X Occasional bends Frequent meander _% Very sinuous _Braided channel
Instructions for completion of worksheet (located on page 2): Begin by determining the most appropriate ecoregion based on location, terrain,
vegetation, stream classification, etc. Every characteristic must be scored using the same ecoregion Assign points to each characteristic within the
range shown for the ecoregion. Page 3 provides a brief description of how to review the characteristics identified in the worksheet. Scores should
reflect an overall assessment of the stream reach under evaluation. If a characteristic cannot be evaluated due to site or weather conditions enter 0 in
the scoring box and provide an explanation in the comments section. Where there are obvious changes in the character of a stream under review
(e.g., the stream flows from a pasture into a forest), the stream may be divided into smaller reaches that display more continuity, and a separate form
used to evaluated each reach The total score assigned to a stream reach must range between 0 and 100, with a score of 100 representing a stream of
the highest quality
Total Score (from reverse): 43 Comments:
Evaluator's Signature: �/ Date: 9/3/2015
This channel evaluation form is intended to be used only as a guide to assist landowners and environmental professionals in gathering the
data required by the United States Army Corps of Engineers to make a preliminary assessment of stream quality. The total score resulting
from the completion of this form is subject to USACE approval and does not imply a particular mitigation ration or requirement. Form
subject to change — version 06/03 To Comment, please call 919-8776-8441 x 26
1

STREAM QUALITY ASSESSMENT WORKSHEET
* These characteristics are not assessed in coastal streams
#
CHARACTERISTICS
ECOREGION POINT RANGE
SCORE
Coastal
Piedmont
Mountain
1
Presence of flow / persistent pools in stream
0-5
0-4
0-5
2
(no flow or saturation=0; strong flow—maxpoints)
2
Evidence of past human alteration
0-6
0-5
0-5
2
(extensive alteration=0; no alteration=maxpoints)
3
Riparian zone
0-6
0-4
0-5
1
(no buffer -0; contiguous, wide buffer—maxpoints)
4
Evidence of nutrient or chemical dischargers
0-5
0-4
0-4
1
(extensive discharges=0; no discharges=max points)
5
Groundwater discharge
0-3
0-4
0-4
2
Q
(no dischar a=0; springs, see s, wetlands, etc.=maxpoints)
U
6
Presence of adjacent floodplain
0-4
0-4
0-2
1
(no flood lain=0; extensive floodplain=max points)
a7
Entrenchment / floodplain access
0— 5
0— 4
0— 2
2
(deeply entrenched=0; frequent flooding=max points)
8
Presence of adjacent wetlands
0-6
0-4
0-2
0
(no wetlands=0; large adjacent wetlands=max points
9
Channel sinuosity
0-5
0-4
0-3
2
(extensive channelization=0; natural meander—maxpoints)
10
Sediment input
0-5
0-4
0-4
2
(extensive de osition=0; little or no sediment --max points)
11
Size & diversity of channel bed substrate
NA*
0-4
0-5
2
(fine, homo eneous=0; large, diverse sizes=max points
12
Evidence of channel incision or widening
0-5
0-4
0-5
2
(deeply incised=0; stable bed & banks=max oints)
F13
Presence of major bank failures
0-5
0-5
0-5
2
(severe erosion=0; no erosion, sable banks=max points)
Q
14
Root depth and density on banks
0-3
0-4
0-5
3
(no visible roots=0; dense roots throughout—max points)
15
Impact by agriculture, livestock, or timber production
0-5
0-4
0-5
4
(substantial im act=0; no evidence=maxpoints)
16
Presence of riffle-pool/ripple-pool complexes
0-3
0-5
0-6
3
(no riffles/ripples or pools=0; well-developed= ax points)
Q
17
Habitat complexity
0-6
0-6
0-6
2
F
(little or no habitat --O; frequent, varied habitats=maxpoints)
18
Canopy coverage over streambed
0-5
0-5
0-5
4
_
(no shading ve etation=0; continuous canopy=max points)
19
Substrate embeddedness
NA*
0-4
0-4
3
(deeply embedded=0; loose structure=maxpoints)
20
Presence of stream invertebrates (see page 4)
0-4
0-5
0-5
0
(no evidence=0; common, numerous ty es=max points)
>'
U
21
Presence of amphibians
0-4
0-4
0-4
1
(no evidence=0; common, numerous ty es=max points)
O
22
Presence of fish
0-4
0-4
0-4
0
(no evidence=0; common, numeroustypes--maxpoints)
23
Evidence of wildlife use
0-6
0-5
0-5
2
(no evidence=0; abundant evidence=maxpoints)
Total Points Possible
100
100
100
43
TOTAL SCORE (also enter on first page)
* These characteristics are not assessed in coastal streams

NORTH CAROLINA DEPARTMENT OF NATURAL AND CULTURAL RESOURCES
Pat McCrory Bryan Gossage Susan Kluttz
Governor Executive Director Secretary
Clean Water Management Trust Fund
NCNHDE-1439
March 29, 2016
Alexander Baldwin
Stantec Consulting Services Inc.
801 Jones Franklin Road
Raleigh, NC 27606
alex baldwin@stantec com
RE Miller Park Deferred Maintenance Master Plan; 178440120
Dear Alexander Baldwin
The North Carolina Natural Heritage Program (NCNHP) appreciates the opportunity to provide information
about natural heritage resources from our database that have been compiled for the project referenced
above.
A query of the NCNHP database indicates that there are records for rare species, important natural
communities, natural areas, or conservation/managed areas within the proposed project boundary submitted
with your request for information These results are presented in the attached 'Documented Occurrences'
table and map
Also attached is a table summarizing rare species and natural communities that have been documented
within a one -mile radius of the project boundary The proximity of these records suggests that these natural
heritage elements may potentially be present in the project area if suitable habitat exists and is included for
reference. In the event that rare species are found within the project area, please contact the NCNHP so that
we may update our records Tables of natural areas and conservation/managed area within a one -mile
radius, if any, are also included in this report
Please note that natural heritage element data are maintained for the purposes of conservation planning,
project review, and scientific research, and are not intended for use as the primary criteria for regulatory
decisions Information provided by the NCNHP database may not be published without prior written
notification to the NCNHP, and the NCNHP must be credited as an information source in these publications.
Maps of NC Natural Heritage Program data may not be redistributed without permission from the NCNHP
Also please note that the NC Natural Heritage Program may follow this letter with additional correspondence
if a Dedicated Nature Preserve (DNP), Registered Heritage Area (RHA), or an occurrence of a Federally -
listed species is documented within or near the project area
Thank you for your inquiry If you have questions regarding the information provided in this letter or need
additional assistance, please contact John Finnegan at john finneaanO)ncdenr.aov or 919 707 8630.
Sincerely,
NC Natural Heritage Program
Page 1 of 4

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U.S. Fish & Wildlife Seivice
Miller Park Stream
Restoration
IPaC Trust Resources Report
Generated April 26, 2016 11:02 AM MDT., IPaC v3.0.2
This report is for informational purposes only and should not be used for planning or
analyzing project level impacts. For project reviews that require U.S. Fish & Wildlife
Service review or concurrence, please return to the IPaC website and request an official
species list from the Regulatory Documents page.
IPaC - Information for Planning and Conservation (https Hecos fws gov/ipac/): A project planning tool to help
streamline the U.S. Fish & Wildlife Service environmental review process.

Table of Contents
IPaC Trust Resources Report.........................................................
ProjectDescription...............................................................
Endangered Species..............................................................
MigratoryBirds..................................................................
Refuges & Hatcheries.............................................................
Wetlands.......................................................................
1
1
2
3
5
6

U.S. Fish & Wildlife Service
IPaC Trust Resources Report
NAME
Miller Park Stream Restoration
LOCATION
Forsyth County, North Carolina
DESCRIPTION
This is a stream restoration project to
stabilize bed and banks of
approximately 718 If of Bottom branch
and two unnamed tributaries within
Miller Park in Winston-Salem, NC
IPAC LINK
https://ecos.fws.gov/ipac/promecU
5CSM3-LQV4N-EODJ1P-1P32HR-NC2AQU
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U.S. Fish & Wildlife Service Contact Information
Trust resources in this location are managed by:
Asheville Ecological Services Field Office
160 Zillicoa Street
Asheville, NC 28801-1082
[phone]

Endangered Species
Proposed, candidate, threatened, and endangered species are managed by the
Endangered Species Program of the U.S. Fish & Wildlife Service.
This USFWS trust resource report is for informational purposes only and should
not be used for planning or analyzing project level impacts.
For project evaluations that require USFWS concurrence/review, please return to the
IPaC website and request an official species list from the Regulatory Documents
section.
Section 7 of the Endangered Species Act requires Federal agencies to "request of the
Secretary information whether any species which is listed or proposed to be listed may
be present in the area of such proposed action" for any project that is conducted,
permitted, funded, or licensed by any Federal agency.
A letter from the local office and a species list which fulfills this requirement can
only be obtained by requesting an official species list either from the Regulatory
Documents section in IPaC or from the local field office directly.
The list of species below are those that may occur or could potentially be affected by
activities in this location:
Flowering Plants
Small-anthered Bittercress Cardamine micranthera Endangered
CRITICAL HABITAT
No critical habitat has been designated for this species.
http //ecos fws gov/tess-public/profile/speciesProfile action?spcode=Q1 UO
Mammals
Northern Long-eared Bat Myotis septentrionalis Threatened
CRITICAL HABITAT
No critical habitat has been designated for this species.
http //ecos.fws.gov/tess _p u IbI ic/profi le/speci es P rofi leaction ?spcode=AOJE
Critical Habitats
There are no critical habitats in this location
4/26/2016 11:02 AM �aC ,_` C 2 Page 2

IPaC Trust Resources Report
Migratory Birds
Migratory Birds
Birds are protected by the Migratory Bird Treaty Act and the Bald and Golden Eagle
Protection Act.
Any activity that results in the take of migratory birds or eagles is prohibited unless
authorized by the U.S. Fish & Wildlife Service.111 There are no provisions for allowing
the take of migratory birds that are unintentionally killed or injured.
Any person or organization who plans or conducts activities that may result in the take
of migratory birds is responsible for complying with the appropriate regulations and
implementing appropriate conservation measures.
1. 50 C F R. Sec. 10 12 and 16 U.S.C. Sec 668(a)
Additional information can be found using the following links:
• Birds of Conservation Concern
http://www.fws.gov/birds/management/managed-species/
birds-of-conservation-concern.php
• Conservation measures for birds
http://www fws gov/birds/management/project-assessment-tools-and-guidance/
conservation-measures.php
• Year-round bird occurrence data
http://www fws gov/birds/management/project-assessment-tools-and-guidance/
akn-histogram-tools.php
The following species of migratory birds could potentially be affected by activities in this
location:
American Bittern Botaurus lentiginosus Bird of conservation concern
Season Wintering
http://ecos.fws.gov/tesspuubIic/profile/speciesProfi le action ?socode=BOF3
Bald Eagle Haliaeetus leucocephalus Bird of conservation concern
Year-round
hyo //ecos fws gov/tess-public/ rop file/speciesProfile action'?secode=BO08
Blue -winged Warbler Vermivora pinus Bird of conservation concern
Season Breeding
Brown -headed Nuthatch Sitta pusilla Bird of conservation concern
Year-round
Chuck -will's -widow Caprimulgus carolinensis Bird of conservation concern
Season Breeding
4/26/2016 11 02 AM IPaC v3 0 2 Page 3

IPaC Trust Resources Report
Migratory Birds
Fox Sparrow Passerella iliaca
Bird of conservation concern
Season Wintering
Kentucky Warbler Oporornis formosus
Bird of conservation concern
Season Breeding
Least Bittern Ixobrychus exilis
Season Breeding
hyo Hecos.fws gov/tess_ue blic/profile/speciesProfile action?spcode=B092
Loggerhead Shrike Lanius ludovicianus
Bird of conservation concern
Year-round
htto Hecos fws gov/tess_uo blic/rop file/speciesProfile action?spcode=BOFY
Prairie Warbler Dendroica discolor
Bird of conservation concern
Season Breeding
Prothonotary Warbler Protonotaria citrea
Bird of conservation concern
Season Breeding
Red-headed Woodpecker Melanerpes erythrocephalus
Bird of conservation concern
Year-round
Rusty Blackbird Euphagus carolinus
Bird of conservation concern
Season Wintering
Short -eared Owl Asio flammeus
Bird of conservation concern
Season Wintering
htto //ecos.fws.gov/tess-public/profile/speciesProfile.action?spcode=BOHD
Wood Thrush Hylocichla mustelina
Bird of conservation concern
Season Breeding
Worm Eating Warbler Helmitheros vermivorum
Bird of•conservation concern
Season Breeding
4/26/2016 11 02 AM IPaC Q 0 2 Page 4

IPaC Trust Resources Report
Refuges & Hatcheries
Wildlife refuges and fish hatcheries
There are no refuges or fish hatcheries in this location
4/26/2016 11 02 AM IPaC Q 0 2 Page 5

IPaC Trust Resources Report
Wetlands
Wetlands in the National Wetlands Inventory
Impacts to NWI wetlands and other aquatic habitats may be subject to regulation under
Section 404 of the Clean Water Act, or other State/Federal statutes.
For more information please contact the Regulatory Program of the local U.S. Army
Corps of Engineers District.
DATA LIMITATIONS
The Service's objective of mapping wetlands and deepwater habitats is to produce reconnaissance level information
on the location, type and size of these resources The maps are prepared from the analysis of high altitude imagery
Wetlands are identified based on vegetation, visible hydrology and geography A margin of error is inherent in the use
of imagery, thus, detailed on -the -ground inspection of any particular site may result in revision of the wetland
boundaries or classification established through image analysis
The accuracy of image interpretation depends on the quality of the imagery, the experience of the image analysts,
the amount and quality of the collateral data and the amount of ground truth verification work conducted Metadata
should be consulted to determine the date of the source imagery used and any mapping problems
Wetlands or other mapped features may have changed since the date of the imagery or field work There may be
occasional differences in polygon boundaries or classifications between the information depicted on the map and the
actual conditions on site
DATA EXCLUSIONS
Certain wetland habitats are excluded from the National mapping program because of the limitations of aerial
imagery as the primary data source used to detect wetlands These habitats include seagrasses or submerged
aquatic vegetation that are found in the intertidal and subtidal zones of estuaries and nearshore coastal waters
Some deepwater reef communities (coral or tuberficid worm reefs) have also been excluded from the inventory
These habitats, because of their depth, go undetected by aerial imagery
DATA PRECAUTIONS
Federal, state, and local regulatory agencies with jurisdiction over wetlands may define and describe wetlands in a
different manner than that used in this inventory There is no attempt, in either the design or products of this
inventory, to define the limits of proprietary jurisdiction of any Federal, state, or local government or to establish the
geographical scope of the regulatory programs of government agencies Persons intending to engage in activities
involving modifications within or adjacent to wetland areas should seek the advice of appropriate federal, state, or
local agencies concerning specified agency regulatory programs and proprietary jurisdictions that may affect such
activities
Wetland data is unavailable at this time.
4/26/2016 11 02 AM IPaC v3 0 2 Page 6

NPS Form 10-900 OMB No 10024-0018
(Rev 10-90)
United States Department of the Interior
National Park Service
National Register of Historic Places
Registration Form
This form is for use in nominating or requesting determinations for individual properties and districts. See instructions in Now to Complete the
National Register of Historic Places Registration Form (National Register Bulletin 16A). Complete each item by marking "x" in the appropriate
box or by entering the information requested. If any item does not apply to the property being documented, enter "N/A" for "not applicable." For
functions, architectural classification, materials, and areas of significance, enter only categories and subcategories from the instructions Place
additional entries and narrative items on continuation sheets (NPS Form 10-900a). Use a typewriter, word processor, or computer, to complete
all items.
1. Name of Property
historic name Ardmore Historic District
other names/site number
2. Location -
street & number _roughly bounded by Knollwood, Queen Duke and Ardsley streets not for publication N/A
city or town Winston-Salem vicinity NIA
state North Carolina code NC county Forsyth code 067 zip code 27103
3. State/Federal Agency Certification
As the designated authority under the National Historic Preservation Act of 1986, as amended, I hereby certify that this _X_
nomination
request for determination of eligibility meets the documentation standards for registering properties in the National Register of
Historic Places and meets the procedural and professional requirements set forth to 36 CFR Part 60. In my opinion, the property
X meets _ does not meet the National Register Criteria. I recommend that this property be considered significant
_ nationstatewide _X_ locally. ( _ See continuation sheet for additional comments.)
s
pp
A&14�
a-gpb OVID*
Signature i i I Dat
North Caro na elpartment of Cultural Resources
State or Federal agency and bureau
In my opinion, the property _ meets _ does not meet the National Register criteria (_ See continuation sheet for
additional comments.)
Signature of commenting or other official Date
State or Federal agency and bureau
4. National Park Service Certification
I, hereby certify that this property is- Signature of the Keeper Date of Action
entered in the National Register
See continuation sheet
determined eligible for the
National Register
See continuation sheet.
_ determined not eligible for the
National Register
,removed from the National
Register
other (explain):

Ardmore Historic District
Name of Property
5. Classification
Forsyth County, North Carolina
County and State
Ownership of Prperty Category of Property Number of Resources within Property
(Check as many boxes as apply) (Check only one box) (Do not include previously listed resources in the count)
private
building(s)
Contributing
Noncontributing
_X_
public -local
_
district
2093
255
buildings
_
public -State
_X_
site
2
0
sites
public -Federal'
_
structure
0
0
structures
_
object
0
0
objects
2095
255
Total
Name of related multiple property listing V
(Enter "N/A" if property is not part of a multiple property listing.)
N/A
6. Function or Use
Historic Functions
(Enter categories from instructions)
DOMESTIC: single dwelling
DOMESTIC: multiple dwelling
COMMERCE/TRADE: store
RELIGION: church
EDUCATION: school
RECREATION: park
7. Description
Architectural Classification
(Enter categories from instructions)
Late Victorian: Queen Anne
Bunaalow / Craftsman
Colonial Revival
Tudor Revival
Modern Movement: International Style
Materials
(Enter categories from instructions)
foundation Brick
walls WOOD. weatherboard
roof Asphalt
other Brick
Wood
Number of contributing resources previously listed
in the National Register
N/A
- Current Functions
(Enter categories from instructions)
DOMESTIC: sinale dwellin
DOMESTIC: multiple dwelling
COMMERCE/TRADE: store
RELIGION: church
EDUCATION: school
RECREATION: park
Narrative Description
(Describe the historic and current condition of the property on one or more continuation sheets )

Ardmore Historic District
Name of Property
Forsyth County, North Carolina
County and State
8. Statement of Significance
Applicable National Register Criteria Areas of Significance
(Mark "x" in one or more boxes for the criteria qualifying the (Enter categories from instructions)
property
for National Realster listina)
x A Property is associated with events that have
madea significant contribution to the broad patterns
of our history
B Property is associated with the lives of persons
significant in our past.
x C Property embodies the distinctive characteristics
of a type, period, or method of construction or
represents the work of a master, or possesses
high artistic values, or represents a significant and
distinguishable entity whose components lack
individual distinction.
D Property has yielded, or is likely to yield,
information important in prehistory or history.
Criteria Considerations
(Mark "X" In all the boxes that apply )
Property is:
_ A owned by a religious institution or used for
religious purposes.
_ B removed from its original location.
_ C a birthplace or a grave.
_ D a cemetery.
_ E a reconstructed building, object,or structure
_ F a commemorative property.
_G less than 50 years of age or achieved
significance within the past 50 years.
Narrative Statement of Significance
(Explain the significance of the property on one or more continuation sheets.)
Community Planning and Development
Architecture
Period of Significance
c.1910 - 1956
Significant Dates
c.1914
Significant Person
(Complete if Criterion B is marked above)
N/A
Cultural Affiliation
N/A
Architect/Builder
Crews, Hall -
Northup & O'Brien
Northuo, Lamar
9. Major Bibliographical References
Bibliography
(Cite the books, articles, and other sources used in preparing this form on one or more continuation sheets.)
Previous documentation on file (NPS):
preliminary determination of individual listing (36
CFR 67) has been requested.
previously listed in the National Register
X previously determined eligible by the National
Register
designated a National Historic Landmark
_ recorded by Historic American Buildings Survey
recorded by Historic American Engineering
Record #
Primary Location of Additional Data
X State Historic Preservation Office
_ Other State agency
_ Federal agency
_ Local government
University
Other
Name of repository:
NC Archives & History

Ardmore Historic District
Name of Property
10. Geographical Data
Acreage of Property approx. 600 acres
UTM References
(Place additional UTM references on a continuation sheet)
Forsyth County, North Carolina
County and Slate
1 17 564180 3993540
Zone Easting Northing
2 17 564770 3994110
Zone Easting Northing
3 17 565060 3994180 i
Zone Easting Northing
4 17 566270 3994000
Zone Easting Northing
X See continuation sheet
Verbal Boundary Description
(Describe the boundaries of the property on a continuation sheet.)
Boundary Justification
(Explain why the boundaries were selected on a continuation sheet.)
11. Form Prepared By
name/title Sherry Joines Wyatt
organization date April 8, 2004
street & number 102 Junkin Street telephone [phone]
city or town Christiansburg state VA zip code 24073
Additional Documentation
Submit the following Items with the completed form:
Continuation Sheets
Maps
A USGS map (7.5 or 15 minute series) indicating the property's location.
A sketch map for historic districts and properties having large acreage or numerous resources.
Photographs
Representative black and white photographs of the property.
Additional items
(Check with the SHPO or FPO for any additional items)
Property Owner
(Complete this item at the request of the SHPO or FPO.)
name More than fifty
street & number
telephone
city or town state - zip code

Paperwork Reduction Act Statement, This information is being collected for applications to the National Register of Historic Places to
nominate properties for listing or determine eligibility for listing, to list properties, and to amend existing listings. Response to this request is
required to obtain
a benefit in accordance with the National Historic Preservation Act, as amended (16 U.S C 470 et seq.).
Estimated Burden Statement. Public reporting burden for this form is estimated to average 18.1 hours per response including the time for
reviewing instructions, gathering and maintaining data, and completing and reviewing the form Direct comments regarding this burden estimate
or any aspect of this form to the Chief, Administrative Services Division,

NPS Form 10-900-a
0108 Approval No 1024-0018
(8-B6)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 1 Ardmore Historic District
Forsyth County, North Carolina
7. Description
Architectural Classifcation
Mission/ Spanish Colonial
Art Deco
Other/ Period Cottage
Other/ Minimal Traditional
Other/ Ranch
Materials
Foundation
STONE/ Granite
CONCRETE
Walls
ASBESTOS
ALUMINUM
STONE/ Granite
STUCCO
VINYL -
WOOD/ Shingle
OTHER/German siding
Roof
METAL
SLATE
TILE
Narrative Description The Ardmore Historic District is located approximately three miles
southwest of downtown Winston-Salem and is roughly bounded by Queen Street and Cloverdale
Avenue on the north, Duke Street and Sunset Drive on the east, Ardsley Street and Walker
Avenue on the south, and Knollwood Street on the west. The district is quite large, consisting of
more than 2200 properties and extending approximately thirteen blocks in length and about ten
blocks in depth. The district is overwhelmingly,residential and consists of at least ten platted
residential developments from 1910 through 1924 as well as three large apartment complexes
from 1947 through 1951. In addition to single and multi -family housing, the district contains a
collection of historic commercial and institutional buildings including several churches, two

NPS Form 10-900-a
OMB Approval No 1024-0018
(8-86)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 2 Ardmore Historic District
Forsyth County, North Carolina
schools, and one building from the large regional hospital located at the district's edge. The
district also contains two historic parks.
Ardmore was built on rolling terrain that contains some of the highest elevations within
the circa 1925 city limits. Rising up from Peter's Creek on its northern and eastern edges,
Ardmore's steepest hills are typically found east of Hawthorne Road. Small streams run through
several of the lower areas of Ardmore, notably in Lockland and Miller Parks.
Hawthorne Road predates the neighborhood and is situated along a high ridge. It bisects
the district diagonally from northeast to southwest. Six of the platted areas in the district include
sections of Hawthorne Road (originally known as Ardmore Avenue). Each plat has a unique
street pattern, but most follow a loose grid interspersed with curving streets. Unifying the various
platted developments are relatively consistent, small lot sizes, narrow distances between houses,
and uniform, narrow setbacks from the street. The lots in Crafton Heights and the early Ardmore
development are slightly smaller than in the Westfield development.
The topography of the neighborhood plays an important role in its character. Corona
Street in Crafton Heights as well as Queen and Grace streets in the early phases of the Ardmore
development make modest use of the steep topography in their design by loosely following
contour lines. The houses, also respond to the topography and are often situated above street
level with distinctive stone retailing walls made of randomly -laid, rough-hewn granite. One of
the most extensive examples is 260 Sunset Drive (c.1920), and incorporates a large flight of
steps with the retaining wall. Another excellent example is at 1820 Grace Street (c.1930). More
typical are the walls, often with integrated steps, in the 1400 block of Academy Street. The use
of recycled concrete from old sidewalks is often found in Ardmore. The broken concrete pieces
are laid randomly like stone walls although the concrete pieces tend to be larger than the pieces
of stone. The date of these walls is unknown, but they appear to have been constructed within the
period of significance. Two good examples exist at 1616 Elizabeth Avenue and at 855
Knollwood Street. The terrain flattens in the Westfield and Westover Park developments making
the use of retaining walls less frequent and providing a broader, more open appearance.
Though the response to topography is not strong in the layout of the streets, the overall
design of a few areas was influenced by the curvilinear, hill -hugging streets in many earlier,
naturalistic suburban developments, such as West End in Winston-Salem. The graceful curves of
the 2000 block of Elizabeth Avenue (laid out c.1920), Grace Street, and the 1700-1800 blocks of
Queen Street (the latter two platted in 1922) were constructed such that the traveler was not
given the full view of the streetscape ahead. This feature does not appear in the later phases of
the neighborhood platted after 1922. It appears only once more in the very slight curve of the
2200 block of Fairway Drive. Elsewhere the streets were laid out in a loose grid pattern although

NPS Form 10-900-a
OMB Approval No 1024-0018
(B-66)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 3 Ardmore Historic District
Forsyth County, North Carolina
the Westfield development does feature triangular medians at its streets' junctions with Miller
Street.
The earliest homes in the district are found in Crafton Heights and date from around
1910.402 Sunset Drive and 245 Corona Street are probably two of the oldest houses. The Sunset
Drive house is a typical Late Victorian design with a two stories, an L -plan, and wraparound
porch with turned posts. The Corona Street house is similar but features the popular, hip -roof,
Queen Anne form with a front -gable projection. Overall, however, these house styles are not
widespread in Ardmore, although there are a few transitional houses, such as the one at 1600
Academy, where elements of the Queen Anne style and the bungalow house type are mixed.
By the late 1910s, however, the early development in Ardmore had come to be dominated
by the bungalow and Colonial Revival -style houses. Among the bungalows, the Craftsman style
was most prevalent although Colonial Revival stylistic motifs became quite popular by the mid -
1920s. One of the earliest bungalows in Ardmore is the Alexander House. Dating to circa 1915,
this one -and -a -half -story, front -gable bungalow at 2210 Queen Street is unusually large and
features a wraparound porch with porte-cochere and paired, square posts on brick piers.
Displaying stronger Craftsman motifs is the Spoon House (c.1920) at 2006 Elizabeth Avenue.
This example also has a front -gable 'roof, but is ornamented with a shingled gable end and a
partially engaged porch with battered posts on brick piers. Another early example is more typical
of bungalows across the neighborhood during the 1920s. 1418 Academy Street (c.1920) has a
side -gable roof and front -gable porch, with Craftsman details including false beams, exposed
rafter tails, and knee braces.
Arguably the best example of a Craftsman bungalow is at 2116 Queen Street. Built in
1926, this one -and -a -half -story house has both shed -roof and eyebrow dormers and a side -gable
porch that extends into a porte-cochere. Its porch is its most significant feature with heavy,
battered posts ornamented with elongated diamond motifs. The posts rest on brick piers, while
the stuccoed gable ends feature half-timbering. Other outstanding Craftsman bungalows include
the 1919 Jerome House at 2002 Elizabeth Avenue, 1201 Hawthorne Road, and the Sparks House
at 2230 Queen Street (c.1926).
More typical of the Ardmore bungalows is the house located at 818 Miller Street. This
weatherboard -sheathed house was built about 1926 and has a shingle -sheathed, gable -roof
dormer, eight -over -one Craftsman -style windows', knee braces, and exposed rafter tails.
'The term "Craftsman -style window" refers to a multi -light upper sash (usually six or
nine -light) that is configured such that the lights are of unequal sizes where the upper comer
panes are small squares in a six -light and all comers are small squares in the nine -light. Common
on both bungalows and foursquare houses.

NPS Form 10-900-a
OMB Approval No 1024.0016
(8-86)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 4 Ardmore Historic District
Forsyth County, North Carolina
Illustrating the use of other exterior sheathing materials is the modestly -sized, front -gable, stucco
example at 641 Hawthorne. This house features wide, battered, stuccoed piers, knee braces, and
wooden casement windows on the side of the unusual attached carport.
The variety in bungalows is unequaled by any other architectural style in the
neighborhood. Ranging from the very simple, virtually unornamented form with wide eaves and
deep porches to full-blown Craftsman examples, the bungalow is the vehicle for a range of
stylistic expressions. In fact, bungalows account for roughly one-quarter of the housing stock in
Ardmore and there are more than three hundred Craftsman -style examples. Although accounting
for only about ten percent of the total number of bungalows, the use of Colonial Revival stylistic
motifs on bungalow forms is unusually frequent in Ardmore. Colonial Revival bungalows are
best represented by examples like the Browne House (c.1924, 1811 Elizabeth Avenue). This
side -gable, one -and -a -half -story house features a gable -roof entrance portico with arched
entrance and Tuscan columns as well as a side porch with Tuscan columns. One of the best
examples in the neighborhood is the circa 1933 Shutt House at 2316 Fairway Drive. This side -
gable, stuccoed house has wood casement windows, a gable -roof entry portico, a walled patio
and fanlight and sidelights at the entry.
After bungalows, Colonial Revival style houses were the most frequent houses built in
Ardmore before World War 11. Numbering about 125 examples, Colonial Revival -style houses
are found throughout the neighborhood. Many of the earliest and best examples are located on
Hawthorne Road. The house located at 444 Hawthorne Road (c.1920) is particularly well
executed and has the classic, two-story, double -pile, side -gable form with shingle -sheathed
dormer, Flemish bond brick, fanlight, modillions, and Tuscan columns on brick piers. A more
typical example is at 2252 Elizabeth Avenue. The Willis House, built circa 1925, features
massing similar to the above example, but is executed with weatherboard siding, six -over -one
windows, and a shed -roof porch with paired, square posts ornamented by trellis.
A variation of the Colonial Revival style, Dutch Colonial Revival, is unusually common
in Ardmore with close to fifty examples. These houses are most often found on Hawthorne Road
and in the Westfield development. 2234 Rosewood Avenue is a particularly good example and
represents the fashion in Ardmore for these houses to have brick lower levels and weatherboard
(or wood shingled) dormers and gable ends. This house has a gable -roof hood on consoles at its
entry. Another, unusually large, example is the Bowen House (c.1923, 462 Lockland Ave.). It
features weatherboard siding, pressed tin shingle roof, shed -roof dormer sheathed in wood
shingles, and a hip -roof porch with square posts.
Closely following the Colonial Revival style in popularity is the American Foursquare.
There are nearly one hundred examples built extensively throughout the neighborhood,
particularly in the Ardmore plats, the area between Academy Street and Ardsley Street, and in

NPS Form 10-900-a
OMB Approval No 1024-0018
(8-86)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 5 Ardmore Historic District
Forsyth County, North Carolina
the Westfield development. One excellent example is found at 1902 Elizabeth Avenue and dates
from around 1924. Having the typical, two-story, cube -like form and pyramidal hip roof, this
example features two exterior sheathing materials (weatherboard lower / wood shingles upper),
wrap around porch with paneled posts on brick piers, hip -roof dormer, and decoratively cut
exposed rafter tails. The house at 656 Sunset Drive is also an excellent example; displaying
German siding. A typical brick example is found at 2026 Academy Street. Built about 1930, this
house features six -over -one windows, hip -roof porch with square posts on brick piers, and brick
balustrade. Also representative is the Burton House located at 670 Irving Street. Built around
1928, this house has German siding, a hip -roof porch with a gable marking its entry, Tuscan
columns on brick piers, and Craftsman -style door and sidelights.
Completing the pre -Depression architectural pallette in Ardmore is the Tudor Revival
style and its simpler variation, Period or English Cottage. Tudor Revival is relatively uncommon
in Ardmore with less than twenty examples including the circa 1928 Utley House at 2039
Academy Street. Period Cottages, however are very numerous and are the most frequent house
type built during the 1930s with over one hundred examples. These houses tend to have brick
exteriors, double -pile massing with side gable roofs. The steeply -pitched, often asymmetrical,
front -gable entry pavilion is also a defining feature as are any number of the Tudor Revival
inspired motifs such as round -head doors. One of the most- architecturally exuberant Period
Cottages is the Katzin house located at 2231 Elizabeth Avenue (see Section 8). Another
outstanding example is the c.1937 Tucker House at 2380 Fairway Drive. Featuring clinker brick
exterior with casement windows, stuccoed gable with half-timbering, and dovecote in the gable
end this house illustrates some of the rustic and romantic elements common in Ardmore's Period
Cottages. The use of tile and roughly hewn stone like that found at 2079 Queen Street are also
common. The circa 1940 Reid House at 2020 Academy Street is typical. This simple brick house
has the round -head door and asymmetrical facade chimney that are the hall marks of the style.
Other houses in the district have even more restrained Period Cottage -style ornamentation,
taking on the more boxy massing of Minimal Traditional houses in combination with simple
entry pavilions, facade chimneys, and occasionally, round -head doors. A good example is
located at 1807 Elizabeth Avenue. This house was built about 1942 and features a shed roof
supported by curved brackets over its entry. While the facade has both a round -head door and
facade chimney, the house's simple, boxy shape, minimal eaves, and lack of steep gables is
similar to that found in Minimal Traditional houses.
A variation of the Period Cottage in Ardmore illustrates that not all of these houses have
connections to the Tudor Revival style. Rather, they combine elements of the Cape Cod style
such as steeply -pitched side -gable roof, double -pile massing, and gabled dormers with the
Tudor -derived asymmetrically -gabled entry pavilion. The house located at 2217 Elizabeth

NPS Forty 10-900-a
OMB Approval No 1024-0016
(6-66)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 6• Ardmore Historic District
Forsyth County, North Carolina
Avenue is an excellent example. Built about 1939, it is one -and -a -half -stories with gabled
dormers, and an asymmetrically -gabled entry pavilion with narrow, half-length sidelights. A
second good example is 1154 Hawthorne Road. This house, built about 1940, has massing
similar to the above example, but features a very steeply -pitched front -gable roof on the central
entry pavilion; there is also an attached garage wing.
By the end of the Great Depression, bungalows had fallen out of favor although Period
Cottages and Colonial Revival style houses continued to be built. A new house type, Minimal
Traditional, had begun to appear and by the postwar era had eclipsed all others in popularity and
even surpassed the bungalow in number. In fact, from the late 1930s through the mid-1950s there
were more than five hundred Minimal Traditional houses built in Ardmore. Minimal Traditional
houses tend to exhibit a variety of characteristics but simplicity of design and a lack of
ornamentation are common to all. Box -like massing, minimal eave depth or lack of eaves
altogether, and the use of a low -pitch, side gable roof are also common although a few front -
gable examples to exist.
Examples of Minimal Traditional houses are found throughout the neighborhood,
particularly on streets that developed at a later date (i.e. Bellview and Knollwood). A typical
example is 714 Bellview Street. This one-story, side gable house has asbestos shingle siding with
a front -gable projection and eight -over -eight, double -hung sash. Another good example is found
at 423 Brent Street. This brick house also has a front -gable projection with six -over -six and
eight -over -eight windows with sidelights. These numerous Minimal Traditional dwellings were
built alongside Cape Cod -style houses and Ranch houses from about 1945 through the mid-
1950s and into the 1960s. While most of the examples were built after 1953, a few early Ranch
houses were constructed around 1950. A good example is found at 715 Fenimore Street (c.1952).
This side -gable house has asbestos shingle siding, a picture window and eight -over -eight,
double -bung sash. There are very few houses in the district that date from after 1965.
Like Minimal Traditional houses, Cape Cod style houses were most often found on
streets that developed later, but were scattered throughout Ardmore as in -fill construction. The
Cape Cod style features double -pile massing in 'a house that is one or one -and -a -half -stories tall
with a central entry and without a front porch. The side gable roof of the Cape Cod tends to have
a steep pitch and gabled dormers are common as are modest Colonial Revival references. A
representative example, with side -gable roof and gabled dormers, is found at 2230 Elizabeth
Avenue. Ranch houses are less common in the district, although they are numerous immediately
south of the district boundary.
While Ardmore was marketed as a single-family neighborhood, duplexes and small-scale
apartment buildings played a distinct role in the neighborhood's development during the late
1920s through the mid-1950s. Several, excellent examples remain as rental property (fueled in

NPS Form 10-900-a
OMB Approval No 1024-0010
(8-K)
United States Department of the Interior,
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 7 Ardmore Historic District
Forsyth County, North Carolina
part by North Carolina Baptist Hospital students and staff) and are primarily located in the areas
platted by the Ardmore Company north of Academy Street and in the Irving / Fenimore streets
area. These buildings displayed a significant amount of architectural detail (see 707 Watson
Avenue in Section 8) that allowed them to blend seamlessly with their single-family neighbors.
The majority of both duplexes and quadraplexes were a variation of the Foursquare house form,
two-story with hip roof. Two separate entries with individual porches or porch roofs were often
provided. 340-342 Crafton Street is a representative example in brick with gabled porches,
sidelights, and square posts on brick piers. Wood siding and wood shingle ornamentation were
also common on duplexes, but less frequent on quadraplexes. An excellent quadraplex exists at
720 Hawthorne Road. This brick, two-story building has a hip roof and Colonial Revival stylistic
features such as Tuscan columns on the double -tier porch, modillions, and sidelights.
In addition to these early multi -family units are the Ardmore Terrace and Cloverdale
Apartments built about 1949 located in the 2300 Blocks of Queen Street and Cloverdale Avenue.
The Ardmore Terrace complex covers the entire block between Queen and Cloverdale while the
Cloverdale Apartments extend north of Cloverdale Avenue to the railroad tracks. Together, the
two complexes, which were built by the same company, includes ninety-one apartment buildings
and an office building. The apartment buildings feature restrained Colonial Revival stylistic
motifs on simple, two-story, brick buildings. The most notable feature of this complex is its use
of the superblock plan where the many buildings are situated in an open, park -like setting with
curved streets and mature trees. The buildings are set in multiple groupings forming front
courtyards and rear utility entrances and parking areas. A similar complex, Miller Park Circle
Apartments was platted in 1951 with twenty-four apartment buildings and a very small office
building. This complex is located in the 2500 Block of Queen Street across from Miller Park.
Other, later, apartment buildings were constructed in the late 1950s and 1960s, especially near
the district boundaries and are non-contnbuting to the district. These are few in number and
relatively modest in scale (like the circa 1960 Penburn Apartments at 501 Hawthorne Road) so
that they do not significantly alter the character of the district.
The important role of the automobile in Ardmore, as discussed in Section 8, is reflected
in the numerous garages in the neighborhood. About twenty-two percent of the pre -1953 houses
in the district have historic garages. These are usually detached single or double -bay buildings
often with wood siding although brick, stucco, and wood shingle examples are found. Many of
the most architecturally refined houses have garages that reiterate the stylistic motifs of the main
house. The garage at 2334 Fairway Drive is a good example that repeats the brick sheathing and
stuccoed gable ends of the house. The c.1936 garage at 821 Melrose Street is another excellent
brick example with one bay, hip roof, and its original double -leaf, multi -light wooden doors. The
single -bay, front -gable example at 426 Hawthorne Road is a weatherboard -clad building that

It
NPS Form 10.900-a
OMB Approval No 1024-0018
(8.66)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 8 Ardmore Historic District
Forsyth County, North Carolina
exhibits original rolling wooden doors. Double -leaf wooden doors were also common. Many
original doors have been removed and replaced with modern garage doors, but overall the level
of integrity of Ardmore's garages is extremely high.
In addition to residential properties, the Ardmore Historic District has a number of
institutional buildings including five pre -1945 churches and the North Carolina Baptist Hospital
Nurses' Home. The Nurses' Home is the only historic building on the hospital campus to
maintain its integrity; it is located on the northwest comer of Queen Street and Hawthorne Road.
Built in 1928, the Nurses' Home is a simple, three-story, side -gable, brick building with modest
Colonial Revival references. In fact, Colonial Revival is the dominate style for Ardmore's
institutional buildings reflecting the national trends during the early twentieth century.
The earliest church in the neighborhood is Ardmore Methodist Church (630 Hawthorne
Rd.), built in 1925. This Colonial Revival -style church is brick with a classical portico, three-tier
spire, arched, stained glass windows, and triple, arched, double -leaf entries. It was designed by
local architect Hall Crews. Ardmore Baptist Church, built in 1942, is similar. Ardmore Moravian
Church (1931), however, represents the local trend of following early Salem architectural
models. Designed by Northup and O'Brien, the church's design closely follows that of Home
Moravian Church (built 1800, Old Salem). The brick building's tall, steeply -gabled front facade
features a similar pattern of round -head windows surrounding the central, double -leaf entry with
round -head hood on curved brackets and the building is capped by an arcaded cupola. The
United Congregational Christian church (1933) has been altered, but is brick and is simpler in
design than the other churches with standard six -over -six, double -hung windows and a very
small cupola. Another small church is the Associated Reformed Presbyterian Church built about
1941. This brick, T -plan building features an entry pavilion with arched opening and stone
accents. A second presbyterian church, Highland Presbyterian, was built in 1956 at the comer of
Cloverdale Avenue and Magnolia Street. Its commanding Colonial Revival edifice with colossal
colonnade and its hill -top location repeat the monumental tone of the earliest Ardmore Churches.
Two final, important institutional buildings in Ardmore are Ardmore School completed in
1929 and Moore School built in 1951. Ardmore School, located at 1046 Miller Street, is a two-
story, brick and cast stone building, which features Art Deco bas-relief designs was also
designed by Northup and O'Brien. In contrast, is Moore School located at 451 Knollwood Street.
This school is a good example of a Modernist -style school from the 1950s with a flat roof and
brick, glass and porcelain enamel panel walls.
Very few commercial buildings are in the Ardmore Historic District. The only historic
commercial buildings are located at the corner of Hawthorne Road and Magnolia Street. Built
about 1950, these brick and concrete block buildings are one-story and have little ornamentation.

M
NPS Forth 10.900-a
OMB Approval No 1024-0018
(8-86)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 9 Ardmore Historic District
Forsyth County, North Carolina
A good example is 1309 - 1311 Hawthorne. Originally a furniture store, this building has a plate
glass storefront, stepped parapet and tile coping.
Overall, the Ardmore Historic District is an extremely large grouping of early twentieth
century residential properties with a high level of integrity. The district features many original
sidewalks, granite curbing, mature trees, and significant retaining walls that contribute greatly to
the character of the neighborhood. The houses themselves typically represent their original form
and character. Replacement siding and replacement windows are the most common alterations.
Enclosed porches and large additions can also be found, but are infrequent. The presence of a
large number of garages adds greatly to the integrity of the district and are significant in the
historical development of the neighborhood. Finally, as Ardmore grew from a fledgling suburb
into a large neighborhood, institutional buildings were constructed and many of them still exist
with a good level of integrity. Within the district there are relatively few non-contributing
properties and most of these are in keeping with the existing scale and character of the district.
The boundaries were drawn to exclude many potentially intrusive buildings such as the main
portion of the large, Baptist Hospital campus and the commercial areas at Hawthorne Road and
West First Street; at Hawthorne and Knollwood Street; at Cloverdale Avenue and Miller Street;
and at Knollwood and Cloverdale. Thus, the Ardmore Historic District embodies the character of
early twentieth century suburban life in Winston-Salem.

NPS Form 10-900-a
OMB Approval No 1024-0018
(8-86)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 10
Section 7.
Ardmore Historic District
Forsyth County, North Carolina
Inventory list
This list is arranged alphabetically by street. The information in this inventory list is based on the 2000 -
2002 survey of the area conducted by neighborhood volunteers led by Sherry Joines Wyatt. The inventory
Est is organized alphabetically by street and numerically by house number. Houses built before 1956 were
researched in the city directories in an effort to determine the original occupant. The dates for these
properties are based on their first appearance in the city directory. Buildings not appearing in the 1956
City Directory were given estimated construction dates. All properties are designated as contributing (C)
or non-contributing (NC) to the district. Contributing properties were constructed prior to 1956. They
retain sufficient integrity of design, setting, materials, workmanship, feeling, and association to contribute
to the historic character of the district. Properties built after 1956, are non-contributing due to age. In
some cases, properties built prior to 1956 have lost their architectural integrity because of substantial
additions or alterations that are incompatible with their historic character.
Address Property Name Date Status
Academy Street
1407 Academy Street Commercial c.1955 Contributing
Two story, concrete block and brick building with stepped parapet, one-story wing with stepped parapet,
and metal windows. 1956 CD: Royal Cake Company, Inc.
1412 Academy Street House c.1920 Contributing
Craftsman Bungalow. One story; front gable; asbestos shingle siding; nine -over -one, double -hung sash;
front -gable porch with square posts on stone piers; knee braces; stone retaining wall and steps from street.
Appears on 1921 Sanborn map.
1414 Academy Street Smith House c.1924 Contributing
Craftsman Bungalow. One story; gable -on -hip roof; asbestos shingle siding and vinyl siding; one -over -
one replacement windows; enclosed, front -gable porch; exposed rafter tails; knee braces; stone retaining
wall and steps from street. 1924 CD: Frank Smith, a clerk at Rosenbloom -Levy Company.
1415 Academy Street Alexander House c.1930 Non-contributing, integrity
Bungalow. One story; side gable; gable -roof dormer; six -over -six, double -hung sash; enclosed, engaged
porch; side porch; vinyl siding; stone retaining wall. 1930 CD: James Alexander, assistant manager at
Durham Life Insurance.
1417 Academy Street Frederick House c.1929 Contributing
Bungalow. One story; hip roof; vinyl siding; one -over -one replacement windows; engaged entry porch;

r
NPs Form 10-900-a
OMB Approval No 1024-0018
(8.86)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 245
Ardmore Historic District
Forsyth County, North Carolina
Minimal Traditional. One and a half -story; side gable; front -gable at eave line; front -gable porch at entry;
multi -light picture window; six -over -six, double -hung sash. 1953 CD: vacant.
2430 Queen Street Douse c.1955 Contributing
Minimal Traditional. One story; side gable; vinyl siding; front -gable projection; eight -over -eight double -
hung sash; shed -roof porch; metal_ posts. 1956 CD: Joseph Baragona, owner -occupant.
2434 Queen Street Rice House
c.1948 Contributing
Minimal Traditional. One and a half -story, side gable; one -over -one replacement windows; rock -faced
concrete block: front -cable entry porch: metal costs. 1948 CD: William Rice.
2450 Queen Street Cashion House ' c.1955 Contributing -
Modernist. One story; flat roof, aluminum siding; three -over -three windows; enclosed side porch. Owner
states that house was built in 1952 by Wesley Pack Construction. 1955 CD: Lewis and Faye Cashion,
employed at R. J. Reynolds Tobacco Company.
2500 Block Queen Street Miller Park . 1942 Contributing Site
Miller Park, built on land donated by Clint Miller and the City, was dedicated on July 4, 1942 and is
bounded by Queen Street to the North, Leisure Lane to the East, Westover Drive to the South, and
Knollwood Street to the West. It is approximately thirty-five acres in size and was developed in the rustic
and naturalistic styles. It has slightly rolling topography, is heavily wooded with a majority of hardwoods
and has a small stream flowing north to south through the eastern half of the park. Within the wooded
areas, there are also open spaces for various recreational activities including a baseball field at the western
edge of the park near the corner of Knollwood Street and Rosewood Avenue. Several other special use
areas and facilities include a paved multi -use trail, amphitheater, ball fields, tennis courts and a
contemporary recreation center. There are several rustic style shelters located throughout the park, as well
as pedestrian bridges over the stream, described below.
a Bridge 1 Contributing
Small, arched bridge carries pedestrian path over stream. Constructed of field stone, set in a random
pattern with mortar, the bridge houses a culvert through which the stream passes. The sides extend
approximately 1 %2 feet above grade at the edges of the path.
b Bridge 2 Contributing
Small stone & mortar bridge carries pedestrian path over stream. Bridge walls extend approximately two
feet above grade at edge of path. Associated with this bridge is a stone and mortar culvert, constructed as
a straight channel approximately five feet long with a `step', approximately 2 feet tall to accommodate the

r
NPS Form 10-900-a
OMB Approval No 1024-0018
(6-86)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 246
change in grade.
Ardmore Historic District
Forsyth County, North Carolina
C Bridge 3 Contributing
Small, arched bridge carries pedestrian path over stream. Constructed of field stone, set in a random
pattern with mortar, the bridge houses a culvert through which the stream passes. The sides extend
approximately 1 %2 feet above grade at the edges of the path.
d Shelter 1 Contributing
Rustic style shelter with open sides, and twelve battered stone piers supporting a gable roof. Rough hewn
log rafters are exposed under the roof and a stone fireplace and chimney are located in the center of one
end of the shelter. Concrete steps allow access at \the opposite end of the shelter and a wooden railing
surrounds two sides. The third side is at grade level.
e Shelter 2 Contributing
Rustic style shelter with open sides and ten battered stone piers supporting a gable roof. The foundation
level of this shelter is constructed of field stone and mortar and supports a concrete floor. The floor level
tapers back into the natural grade of the site, offering two sides open at ground level. Steps provide access
at the above grade side. Un -hewn log railings, surrounds the four open sides.
f -h Shelters 3-5 Contributing
Positioned at grade level on all sides, these rustic style shelters have open sides and eight stone battered
piers supporting the gable roof. Shelters 5 has a small additional concrete pad adjacent to it for picnic
tables.
i Shelter 10 Contributing
Rustic style shelter with open sides and eight battered stone piers supporting a gable roof. The concrete
floor is at grade level on all sides. There is an adjacent concrete pad to this shelter, which accommodates
additional picnic tables.
j paved Multi -Use Trail Contributing
The paved trail creates a network throughout the park drifting through woodland and open fields. Rustic
bridges carry the path over the stream that travels through the site and stone steps accommodate changes
in grade.
k Stone Steps Contributing
Built as an original feature, several sets of stones steps along the multi -use trail accommodate changes in

IT '
NPS Form 10.900-a
OMB Approval No 1024-0018
(8-86)
United States Department of the Interior
National Park Service
National Register of Historic Places
Continuation Sheet
Section number 7 Page 247
Ardmore Historic District
Forsyth County, North Carolina
grade throughout the park. The steps are constructed of field stone and mortar. A low stone and mortar
cheek wall runs along both sides of the steps, the top of which is at grade.
1 Amphitheater Contributing
The amphitheater consists of a half circle concrete `stage' at ground level with a series of simple wooden
benches located up the slight hillside, and facing the stage. The benches are planks on round piers with no
backs.
in Recreation Center Non -Contributing, age
Contemporary structure built c. 1980 with a c. 1995 addition, this building is located on the east side of
the park at Leisure Lane.
n Tennis Court Non-contributing, age
Constructed c.1980 the tennis court area accommodates three courts. It is of typical court construction
with asphalt base and is surrounded with a chain-link fence.
o Service Buildings Non -Contributing, age
Constructed in the second quarter of the twentieth century, these three small, brick and metal, one-story
buildings have gable roofs and are used for restroom and maintenance facilities.
p Bleachers and Brick Service Building Non-contributing, age
Located on the north and west sides of the open baseball field are small sets of wooden bleachers. A low,
one-story, brick building is located near the northern set of bleachers.
2501-2505 Queen Street Miller Park Circle Apts c.1952 Contributing
2500 - 2535 Miller Park Cir.
Superblock;Colonial Revival apartments. Twenty-four buildings. Two story; brick and asbestos shingle
siding; ; metal casement windows; gable roof entry porches; pilasters and sidelights at front entries; front
and rear entries. The most notable feature of this complex is its use of the superblock plan, albeit on a
small scale, where the many buildings are situated in an open, park -like setting with curved streets and
mature trees. The buildings are set in multiple groupings forming front courtyards and rear utility
entrances and parking areas. Miller Park Circle was platted and built in 1951.
a Office c.1952 Contributing
Tiny, side -gable, one-story building with asbestos shingle siding; metal casement windows, and pilasters
and architrave at entry.

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Miller Park
Winston-Salem, NC
Title
Existing Conditions
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2127 nyrsley Town Boulevard. Suite 300
Charlotte, North Carolina 28273
www.stontec.corn
License k F-0672
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Winston-Salem, NC
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_ Stantec
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Chotlolte. North Carolina 28273
vnynstonteacom
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EROSION CONTROL DETAILS
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Winston-Salem, NC
Title
Demolition Plan
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2127 nyrsley Town Boulevard. Suite 300
Charlotte, North Carolina 28273
wwwstantec.com
license N F-0672
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Winston-Salem, NC
Title
Plan and Profile
0
Revision By Apptl YY MM.DD Stantec
2127 Ayrsley Town BoOevdd Suite 300
Chodotte, North Carolina 28273
-.stantec.com
License # F-0672
-C lbacwod lwv "a ae reLponade la cl Eimervara. DD No, s .
Issued By npptl. YY.MM,DD eba g a en« oromssam Nal ae reporletl iO Slanlac wAq laea
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Winston-Salem, NC
Title
Plan and Profile
0
Revision By Apptl YY MM.DD Stantec
2127 Ayrsley Town BoOevdd Suite 300
Chodotte, North Carolina 28273
-.stantec.com
License # F-0672
-C lbacwod lwv "a ae reLponade la cl Eimervara. DD No, s .
Issued By npptl. YY.MM,DD eba g a en« oromssam Nal ae reporletl iO Slanlac wAq laea
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STA = 10+02.62
INVERT ELEV. =830.330
STA: 10+13.96
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INVERT ELEV. =829.745
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INVERT ELEV. =828.808
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ELEV: 827.05
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INVERT ELEV. =827.885
STA: 10+68.87
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INVERT ELEV. =826.9861
STA: 10+85.41
ELEV: 825.30
STA = 10+91.69 1
INVERTELEV.=826.160 1
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ELEV: 824.44 p
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INVERT ELEV. =825.301
STA: 11+19.73
STA = 11+25.72
INVERT ELEV. =824.462
\
STA: 11+36.52
ELEV: .76
STA = 11+42.93
INVERT ELEV. =823.619
STA: 11+53.58
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111
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INVERT ELEV. =822.757 /
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8
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INVERT ELEV. =820.067 7
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STA: 12+28.88
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o INVERT ELEV. =819.031
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/ INVERT ELEV. =818.420
STA: 12+73.42
/
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/
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INVERT ELEV. =817.881
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I_STA = 13+00.79
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v INVERT ELEV. =817.238
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Winston-Salem, NC
Title
Plan and Profile
0
Revision By Apptl YY MM.DD Stantec
2127 Ayrsley Town BoOevdd Suite 300
Chodotte, North Carolina 28273
-.stantec.com
License # F-0672
-C lbacwod lwv "a ae reLponade la cl Eimervara. DD No, s .
Issued By npptl. YY.MM,DD eba g a en« oromssam Nal ae reporletl iO Slanlac wAq laea
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STA: 20+12.48 ,
STA: 20+28.18
ELEV: .51
STA: 20a43.23
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INVERT ELEV. =830.375
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STA = 20+64.31
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STA: 20+74.67
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INVERT ELEV. =828.811 STA = 20+82.34
F
STA = 20+87.00 INVERT ELEV. =828.539
z
STA = D+91.01 INVERT ELEV. =828.180
INVERT ELEV 828:076__
STA: 20+99.72
L 2.
STA =21+03.65
INVERT ELEV. =827.566 SIA = 21+08.14
\
STA = 21+12.86 INVERT ELEV. =827.390
\
INVERT ELEV. =827.206
/
=
STA 2I+18.72
INVERT ELEV. X26.977
/
Z STA: 21+29.20
/
ELEV: 825.84
/
i STA = 21+34.44
/
> INVERT ELEV. =826.544
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/
INVERT ELEV. =826.309
I
o STA =21+45.82
1
INVERT ELEV. =825.996
_STA = 21+52.79
INVERT ELEV. =825.660
STA: 21+63.30 1
ELEV: 824.5
= 21+6879\
_STA
INVERT ELEV. =825.216 STA = 21+73.11 \
INVERT ELEV. =825.011
STA = 21+78.79
INVERT ELEV. =824.742 /
y
STA = 21+85.48
0
INVERT ELEV, =824.424 /�
D
STA: 21+95.19 /
n
ELEV: 823.28 1
z
STA = 22+00.04 I
INVERT ELEV. =823.979 /
m
STA =22+06.13 /
STA = 22+11.13 INVERT ELEV =823.701 /
INVERT ELEV. =823.474 /
STA = 22+17.82
INVERT ELEV. =823.169
_ -
22+27.52 _
r:8
STA = 22+32.36
_
INVERT ELEV. =822.733 <\22+37.44
STA =22+42.44 INVERT ELEV. =822.495
\
STA = 22+47.55 INVERT ELEV. =822.261
INVERT ELEV. =822.022
/
* = 22+61.82-
_STA
O INVERT ELEV=821.585 -"
/ STA = 22+67.54
STA = 22+73.01 INVERT ELEV. =821.309
INVERT ELEV. =821.046
STA = 22+79.92
INVERT ELEV. =820.714
STA = 22+92.10
INVERT ELEV. =820.354 STA = 22+97.13
STA = 23+02.13 INVERT ELEV, =820.100
INVERT ELEV. =819.848
STA = 23+08.24
INVERT ELEV. =819.540
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Winston-Salem, NC
Title
Plan and Profile
Revision
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2127 Aynley Town Boulevard Sude 300
Charlotte North Carolina 28273
wwwstantec com
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Miller Park
Winston-Salem, NC
Title
Plan and Profile
Revision
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By Apptl YYArM DD
2127 Ayrsley Town Boulevard Suite 300
Chodohe North Cororno 78273
www stontec com
License N F-0672
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