20200440 Ver 1_PCN Form Submission_20200330

DWR
mrlslon of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20200440
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Reviewing Office *
Mooresville Regional Office - [phone]
Information for Initial Review
1a. Name of project:
Prosperity Church Road Site
1a. Who is the Primary Contact?*
Kelly Roth
1b. Primary Contact Email:*
[e-mail]
Date Submitted
3/30/2020
Nearest Body of Water
Stony Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude: Longitude:
35.374303-80.783833
A. Processing Information
County (or Counties) where the project is located:
Mecklenburg
Is this project a public transportation project?*
r Yes r No
1a. Type(s) of approval sought from the Corps:
W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?
* Nationwide Permit (NWP)
* Regional General Permit (RGP)
7 Standard (IP)
Version#*
1
What amout is owed?*
IT $240.00
r $570.00
Select Project Reviewer*
Alan Johnson:eads\adjohnson1
1c. Primary Contact Phone:*
[phone]
L.1

1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
F Individual Permit
29 - Residential Developments
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR401 Certification:
For the record only for Corps Permit:
F 401 Water Quality Certification - E)press
F Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
r Owner W Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Barbara Ann Hampton Reitzel
2b. Deed book and page no.:
23654-542
2c. Responsible party:
2d.Address
Street Address
8600 Johnson Street
Address Line 2
City
Concord
Postal / Zip Cate
28027
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
State / Province / Regim
NC
Country
USA
2f. Fax Number:
r Yes r No
r Yes r No
3a. Name:
Patrick Budronis

3b. Business Name:
Encore Real Estate
3c.Address
Street Address
1646 W Snow Ave.
Address Line 2
#63
City
Tampa
Postal / Zip Code
33606
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Kelly Roth
4b. Business Name:
McAdams Company
4c.Address
Street Address
2905 Meridian Parkway
Address Line 2
City
Durham
Postal / Zip Code
27713
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
01_ERE19000_ProsperityCh_Agent Authorization_Reitzel_signed.pdf
02_ERE19000_ProsperityCh_Agent Authorization_EncoreRE_signed.pdf
State / Province / legion
FL
Country
USA
3e. Fax Number:
State / Province / legion
NC
Country
USA
4e. Fax Number:
1.21 MB
212.83KB
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:
Charlotte
2 Project Identification
2a. Property Identification Number:
2b. Property size:
02941109
6.9
2c. Project Address
Street Address
5150 Old Ridge Road
Address Line 2
City
State / Province / legion
Charlotte
NC
Postal / Zip (ode
Country
28269
USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Stony Creek

3b. Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401050103
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinityof the project at the time of this application:*
The majority of the site is comprised of disturbed shrub -scrub vegetation. There is a graded, gravel pad in the southwest corner of the site that was used for a local farmer's market.
The northwest and northeast corners of the site contain mature mixed pine -hardwood forest stands. The soil on site is mostly Cecil sandy clay loam. Land use in the vicinity of the
project includes primarily residential and commercial uses with fragmented forested areas. Please refer to the attached USGS Location Map (Figure 1), NRCS Web Soil Survey Map
(Figure 2) and Subject Property Aerial Map (Figure 3) for more information on the project setting.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
03_ERE19000_ProsperityCh_Fig 1 USGS.pdf 2.16MB
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
04_ERE19000_ProsperityCh_Fig 2 Web SS.pdf 1.37MB
4f. List the total estimated acreage of all existing wetlands on the property:
0.045 ac
4g. List the total estimated linear feet of all existing streams on the property:
67 LF
4h. Explain the purpose of the proposed project:*
The purpose of the proposed project is to provide residential and commercial uses to the northern portion of the Charlotte metro area.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The proposed project is a high -density, mixed -use development that will incorporate multi -family residential and commercial development including roads, parking areas, utilities, storm
water infrastructure and amenities. The proposed project includes a multi -family building that will result in an impact to a jurisdictional wetland. The attached Jurisdictional Delineation
Map (Figure 4) shows the location of jurisdictional features on the site. The Overall Wetland Impact Map (Figure 5) depicts the overall project plan view and Inset 1 shows details of the
proposed impact area. Heavy equipment typical for road construction, utility installation and grading will be used to construct the proposed project such as track hoes, bulldozers, dump
trucks and graders.
4j. Please upload project drawings for the proposed project.
06_ERE19000_ProsperityCh_Fig 5 Overall Impact Map.pdf 819.77KB
07_ERE19000_ProsperityCh_Fig 5 Inset 1.pdf 535.75KB
05_ERE19000_ProsperityCh_Fig 3 Aerial.pdf 2.17MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No r Unknown
Comments:
See attached Jurisdictional Delineation Map (Figure 4)
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary f Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Jennifer Burdette
Agency/Consultant Company: McAdams Company
Other:
5d1. Jurisdictional determination upload
08_ERE19000_ProsperityCh_Fig 4 Delineation map.pdf 101.19KB
6. Future Project Plans
6a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed projector related activity?

No.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries
r Open Waters F Pond Construction
2. Wetland Impacts
F' Buffers
2a. Site #* (?) 2at Reason (?) 2b. Impact type * (?) �2c. Type of W. * 2d. W. name * 2e. Forested* 2f. Type of Impact
Jurisdicition(?)]2g.
area
t Fill/Grading P Headwater Forest W-2 Yes Both 0.011
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.011
2h. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.011
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The conceptual plan for this site entirely avoids impacts to stream feature S-1 and the adjacent wetland feature W-1. W-2 is the upper end of a linear
feature that has been impacted by clearing, which is reflected in a low NCWAM rating as shown on the attached form. A small portion of W-2 (0.011
ac) protrudes into the footprint required to create buildable area for four connected town home units making it impractical to avoid.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
A Sediment and Erosion Control Plan for the project will be developed and approved by Charlotte -Mecklenburg Storm Water Services, and the project
will comply with the supplementary NPDES Construction Stormwater Permit (NCG010000)
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?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The proposed project will impact less than 0.1 acre of jurisdictional wetlands. The wetland to impacted (W-2), received an NCWAM score of Low (see attached NCWAM form).
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes r No
If no, explain why:
The project is located within the Yadkin -Pee Dee watershed, which is not included in any of the NC Riparian Buffer Protection Rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15ANCAC 02H .1003(2)?
r Yes r No
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater
program?
r Yes r No
2d. Which of the following stormwater management program(s) apply:
V Local Government r State
Local Government Stormwater Programs

V Phase II r NSW r USMP r Water Supply
Please identify which local government stormwater program you are using.
City of Charlotte
Comments:
The Stormwater Management Plan will be reviewed and approved by the City of Charlotte.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r Yes r No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
The proposed project is a mixed -use development including residential and commercial uses. It is not anticipated that this project will result in
additional development that would impact downstream water quality.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated
at a treatment plant, list the capacity available at that plant.
Wastewater generated by the development Will be sent to the City of Charlotte sanitary sewer system. The City will reviewthe project to ensure
sufficient treatment capacity is available.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
r Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
r Yes r No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS IPaC Web tool (https://ecos.fws.gov/ipac/), accessed 3/19/2020
NC NHP Data Explorer (http://ncnhde.natureserve.orgleontenVmap), accessed 3/20/2020
Consultation Documentation Upload
09_ERE19000_ProsperityCh_FWS Species List. pdf 664.97KB
10_ERE19000_ProsperityCh_NHP Project report.pdf 1.14MB
6. Essential Fish Habitat (Corps Requirement)

6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes f• No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA Essential Fish Habitat (EFH) Mapper (http://mm.habitat.noaa.gov/protection/efh/efhmapper/), accessed 3/19/2020
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 status?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
State Historic Preservation Office Historic Properties online buffer tool (https://nc.maps.arogis.com/apps/vebappviev<er/index.htmi?
id=773b7da94dc0478390cbOc3186b7a498), accessed 3/19/2020 (note: does not include archaeological data); McAdams submitted a request for
Environmental Review to the NC SHPO on March 30, 2020. A response has not been received at this time.
7c. Historic or Prehistoric Information Upload
11_ERE19000_ProsperityCh_Cultural Resources pkg.pdf 4.44MB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
FEMA FIRM map number 3710456900K (effective 11/16/2018), accessed 3/13/2020
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
12_ERE19000_ProsperityCh_NCWAM_W-2.pdf 213.38KB
Signature
*
W By checking the box and signing below, I certify that
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Kelly K Roth
Signature
Date
3/30/2020

LEASE
OMPLET
1111
= WADAMS AGENT AUTHORIZATION FORM
All Blanks To Be Filled In By The Current Property Owner
PIN(s):
02941109
Name:
Barbara Ann Hampton Reitzel
Address:
, Concord, NC 28027 Sb N)
Phone/Email:
D 1� [e-mail]
Project Name:
Prosperity Church Road Site
Project Number:
ERE-19000
Project Manager:
Eddie Moore
US Army Corps of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
Re: Wetlands Related Consulting and Permitting
To Whom It May Concern:
NC Division of Water Resources
401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
I hereby designate and authorize The John R. McAdams Company, Inc. to act on my behalf as my agent in obtaining
verification of wetland delineations and processing of permit applications for the project listed above.
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) and NC Division of Water Resources
to enter upon the property herein described for the purpose of conducting on -site investigation and issuing a
determination associated with Water of the U.S. subject to Federal jurisdiction under Section 404 of the Clean Water
Act/Section 10 of the Rivers and Harbors Act of 1899 and/or Waters of State and/or Riparian Buffer Rules.
This notification supersedes any previous correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only for government officials to
enter the property when accompanied by The John R. McAdams Company, Inc. staff.
3 An D
Print Property Owner N me
Title (if applicable)
1111111!i VA
Signature '_�w
M 4h f : L -1 ©---d
Date
creating experiences through experience
2905 Meridian Parkway, Durham, NC / 919. 361. 5000

'J McADAMS AGENT AUTHORIZATION FORM
All Blanks To Be Filled In By The Current Contract Purchaser
PIN(s):
02941109
Name:
Encore Real Estate — POC: Patrick Budronis
Address:
1646 W Snow Ave. #63 Tampa FL 33606
Phone/Email:
[e-mail] 813.495.6536
Project Name:
Prosperity Church Road Site
Project Number:
ERE-19000
Project Manager:
Eddie Moore
US Army Corps of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
Re: Wetlands Related Consulting and Permitting
To Whom It May Concern:
NC Division of Water Resources
401 & Buffer Permitting Branch
512 N. Salisbury Street
Raleigh, NC 27604
I hereby designate and authorize The John R. McAdams Company, Inc. to act on my behalf as my agent in obtaining
verification of wetland delineations and processing of permit applications for the project listed above.
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) and NC Division of Water Resources
to enter upon the property herein described for the purpose of conducting on -site investigation and issuing a
determination associated with Water of the U.S. subject to Federal jurisdiction under Section 404 of the Clean Water
Act/Section 10 of the Rivers and Harbors Act of 1899 and/or Waters of State and/or Riparian Buffer Rules.
This notification supersedes any previous correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only for government officials to
enter the property when accompanied by The John R. McAdams Company, Inc. staff.
Encore Real Estate— Patrick Budronis
Print Property Owner Name
Project Manager
Title (if applicable)
Signature
3.19.20
Date
creating experiences through experience 2905 Meridian Parkway, Durham, NC / 919. 361. 5000

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NOTES:
1. USGS; 7.5 MINUTE, QUAD, "DERITA" AND "CORNELIUS," NORTH CAROLINA; 2019
2. LAT: 35.374303, LONG:-80.783833
0 1,000 2,000
FIGURE 1. USGS TOPOGRAPHIC VICINITY MAP Feet
PROSPERITY CHURCH ROAD SITE 1 inch = 2,000 feet
CHARLOTTE, MECKLENBURG COUNTY, NC VERSION: 1
DATE: 2/7/2020
McADAMS JOB NO: ERE-19000
DRAWN BY: burdette
Y:\Projects\ERE\ERE-19000\Storm\Natural Resources\GIS\ERE19000 ProsperityCh Fig 1 USGS.mxd, 2/7/2020 10:43:56AM, burdette

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Legend
Project Area
Soil Map Unit
` s
Hydric
Map Unit Soil K
Symbol Map Unit Name Rating
CeB2 Cecil sandy clay loam, 2 to 8 percent slopes, moderately eroded No
EnB Enon sandy loam, 2 to 8 percent slopes No
HeB Helena sandy loam, 2to 8 percent slopes No 201 NC C- 'e f G- p is I f rmati n &A
NOTES:
Web Soil Survey SSURGO Spatial Data: Mecklenburg County (Version 18, Sep 16, 2019)
0 50 100
J FIGURE 2. NRCS WEB SOIL SURVEY Feet
PROSPERITY CHURCH ROAD SITE 1 inch =100 feet
CHARLOTTE, MECKLENBURG COUNTY, NC VERSION: 1
DATE: 2/7/2020
McADAMS JOB NO: ERE-19000
DRAWN BY: burdette
':\Proiects\ERE\ERE-19000\Storm\Natural Resources\GIS\ERE19000 ProsoeritvCh Fia 2 Web SS.mxd. 2/7/2020 3:04:19 PM. burdette

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+/- 67 LF
\
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LEGEND
Q Project Area
Wetlands
— — Streams
— Roads
— 2-ft contours
0 37.5 75
FIGURE 4. JURISDICTIONAL AND ISOLATED WATERS DELINEATION MAP ROAD SITE
N
Feet
PROSPERITY CHURCH
Itch=75feet
CHARLOTTE, MECKLENBURG COUNTY, NC
VERSION: 1
DATE: 2/7/2020
MCADAMS
ERE-19
JOB NO: ERE-19000
DRAWN BY: burdette
Y:\Projects\ERE\ERE-19000\Storm\Natural
Resources\GIS\ERE19000_ProspentyCh_Fig
4 Delineation
map.mxd, 2r7/20203:10:20 PM, burdette

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