20191637 Ver 2_MRTF-2020-01162_20201118

CompensatoryMitigationResponsibilityTransferForm

Permittee:EnvisionHomes,JoshSwindell ActionID:SAWͲ2020Ͳ01162
ProjectName:TullamoreSubdivisionCounty:Wake


InstructionstoPermittee:ThePermitteemustprovideacopyofthisformtotheMitigationSponsor,eitheranapproved
MitigationBankortheNorthCarolinaDivisionofMitigationServices(NCDMS),whowillthensigntheformtoverifythe
transferofthemitigationresponsibility.OncetheSponsorhassignedthisform,itisthePermittee’sresponsibilitytoensure
thattotheU.S.ArmyCorpsofEngineers(USACE)ProjectManageridentifiedonpagetwoisinreceiptofasignedcopyofthis
formbeforeconductingauthorizedimpacts,unlessotherwisespecifiedbelow.IfmorethanonemitigationSponsorwillbe
usedtoprovidethemitigationassociatedwiththepermit,oriftheimpactsand/orthemitigationwilloccurinmorethanone
8ͲdigitHydrologicUnitCode(HUC),multipleformswillbeattachedtothepermit,andtheseparateformsforeachSponsor
and/orHUCmustbeprovidedtotheappropriatemitigationSponsors.

InstructionstoSponsor:TheSponsormustverifythatthemitigationrequirements(credits)shownbelowareavailableatthe
identifiedsite.Bysigningbelow,theSponsorisacceptingfullresponsibilityfortheidentifiedmitigation,regardlessof
whetherornottheyhavereceivedpaymentfromthePermittee.Oncetheformissigned,theSponsormustupdatethebank
ledgerandprovideacopyofthesignedformandtheupdatedbankledgertothePermittee,theUSACEProjectManager,and
theWilmingtonDistrictMitigationOffice(seecontactinformationonpage2).TheSponsormustalsocomplywithall
reportingrequirementsestablishedintheirauthorizinginstrument.

PermittedImpactsandCompensatoryMitigationRequirements:
PermittedImpactsRequiringMitigation*8ͲdigitHUCandBasin:03030002,CapeFearRiverBasin
StreamImpacts(linearfeet)WetlandImpacts(acres)
WarmCoolColdRiparianRiverineRiparianNonͲRiverineNonͲRiparianCoastal
 0.122
*Ifmorethanonemitigationsponsorwillbeusedforthepermit,onlyincludeimpactstobemitigatedbythissponsor.

CompensatoryMitigationRequirements:8ͲdigitHUCandBasin:03030002,CapeFearRiverBasin
StreamMitigation(credits)WetlandMitigation(credits)
WarmCoolColdRiparianRiverineRiparianNonͲRiverineNonͲRiparianCoastal
0.158

MitigationSiteDebited:NCDMS
(Listthenameofthebanktobedebited.Forumbrellabanks,alsolistthespecificsite.ForNCDMS,listNCDMS.IftheNCDMS
acceptanceletteridentifiesaspecificsite,alsolistthespecificsitetobedebited).

SectiontobecompletedbytheMitigationSponsor

StatementofMitigationLiabilityAcceptance:I,theundersigned,verifythatIamauthorizedtoapprovemitigation
transactionsfortheMitigationSponsorshownbelow,andIcertifythattheSponsoragreestoacceptfullresponsibilityfor
providingthemitigationidentifiedinthisdocument(seethetableabove),associatedwiththeUSACEPermitteeandAction
IDnumbershown.Ialsoverifythatreleasedcredits(and/oradvancecreditsforNCDMS),asapprovedbytheUSACE,are
currentlyavailableatthemitigationsiteidentifiedabove.Further,IunderstandthatiftheSponsorfailstoprovidethe
requiredcompensatorymitigation,theUSACEWilmingtonDistrictEngineermaypursuemeasuresagainsttheSponsorto
ensurecomplianceassociatedwiththemitigationrequirements.

MitigationSponsorName:

NameofSponsor’sAuthorizedRepresentative:


SignatureofSponsor’sAuthorizedRepresentativeDateofSignature
NCDMS
Kelly Williams
17 November 2020


ConditionsforTransferofCompensatoryMitigationCredit:
x OncethisdocumenthasbeensignedbytheMitigationSponsorandtheUSACEisinreceiptofthesignedform,the
Permitteeisnolongerresponsibleforprovidingthemitigationidentifiedinthisform,thoughthePermitteeremains
responsibleforanyothermitigationrequirementsstatedinthepermitconditions.
x Constructionwithinjurisdictionalareasauthorizedbythepermitidentifiedonpageoneofthisformcanbeginonlyafter
theUSACEisinreceiptofacopyofthisdocumentsignedbytheSponsor,confirmingthattheSponsorhasaccepted
responsibilityforprovidingthemitigationrequirementslistedherein.ForauthorizedimpactsconductedbytheNorth
CarolinaDepartmentofTransportation(NCDOT),constructionwithinjurisdictionalareasmayproceeduponpermit
issuance;however,acopyofthisformsignedbytheSponsormustbeprovidedtotheUSACEwithin30daysofpermit
issuance.NCDOTremainsfullyresponsibleforthemitigationuntiltheUSACEhasreceivedthisform,confirmingthatthe
Sponsorhasacceptedresponsibilityforprovidingthemitigationrequirementslistedherein.
x SignedcopiesofthisdocumentmustberetainedbythePermittee,MitigationSponsor,andintheUSACEadministrative
recordsforboththepermitandtheBank/ILFInstrument.ItisthePermittee’sresponsibilitytoensurethattheUSACE
ProjectManager(addressbelow)isprovidedwithasignedcopyofthisform.
x Ifchangesareproposedtothetype,amount,orlocationofmitigationafterthisformhasbeensignedandreturnedto
theUSACE,theSponsormustobtaincaseͲbyͲcaseapprovalfromtheUSACEProjectManagerand/orNorthCarolina
InteragencyReviewTeam(NCIRT).Ifapproved,highermitigationratiosmaybeapplied,aspercurrentDistrictguidance
andanewversionofthisformmustbecompletedandincludedintheUSACEadministrativerecordsforboththepermit
andtheBank/ILFInstrument.

Comments/AdditionalConditions:AletterfromNCDMS,confirmingtheyarewillingandabletoaccepttheapplicant’s
compensatorymitigationresponsibility,dated9/9/2020wasincludedwiththepreconstructionnotification.

ThisformisnotvalidunlesssignedbelowbytheUSACEProjectManagerandbytheMitigationSponsoronPage1.Once
signed,theSponsorshouldprovidecopiesofthisformalongwithanupdatedbankledgerto:1)thePermittee,2)theUSACE
ProjectManagerattheaddressbelow,and3)theWilmingtonDistrictMitigationOffice,Attn:ToddTugwell,11405Falls
ofNeuseRoad,WakeForest,NC27587(email:[e-mail]).Questionsregardingthisformoranyofthe
permitconditionsmaybedirectedtotheUSACEProjectManagerbelow.

USACEProjectManager:LylePhillips
USACEFieldOffice:RaleighRegulatoryOffice
USArmyCorpsofEngineers
3331HeritageTradeDrive,Suite105
WakeForest,NorthCarolina27587
Email:[e-mail]



11/13/2020
USACEProjectManagerSignatureDateofSignature

CurrentWilmingtonDistrictmitigationguidance,includinginformationonmitigationratios,functionalassessments,and
mitigationbanklocationandavailability,andcreditclassifications(includingstreamtemperatureandwetlandgroupings)is
availableathttp://ribits.usace.army.mil
PHILLIPS.GEORGE.L.
1574018311
Digitally signed by
PHILLIPS.GEORGE.L.1574018311
Date: 2020.11.13 09:06:33 -05'00'