HomeMy WebLinkAbout20201529 Ver 1_Pre-Filing Meeting Request_20201020ID#* 20201529
Version* 1
Regional Office* Winston-Salem Regional Office - (336) 776-9800
Reviewer List* Sue Homewood
Pre -Filing Meeting Request submitted 10/20/2020
Contact Name *
Contact Email Address*
Project Name*
Project Owner*
Project County*
Owner Address:
Chuck Truby
chuckt@cptengineering.com
Rich Fork Heights
HPT Investment Holdings
Forsyth
Street Address
455 2nd St. SE 5th Floor
Address Line 2
aty
Charlottesville
Rbstal / Zip Code
22902
Is this a transportation project?* r Yes r No
State / Frovince / Region
VA
Country
USA
Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - F- 401 Water Quality Certification -
Regular Express
r- Individual Permit r- Modification
r- Shoreline Stabilization
Does this project have an existing project ID#?*
r Yes r No
Do you know the name of the staff member you would like to request a meeting with?
Sue Homewood
Please give a brief project description below.
Propose 0.059 acres of wetland impacts and temporay wetland impact of
0.03 acres for a sewer line and 38' of temporary stream impacts for a
sewer line crossing.
Please give a couple of dates you are available for a meeting.
10/28/2020
10/29/2020
11 /4/2020
Please attach the documentation you would like to have the meeting about.
PCN revised exhibits 9-22-20.pdf 329.39KB
PCN Submittal Package 9-14-2020.pdf 8.55MB
pdf only
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:
• This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
• I understand by signing this form that I cannot submit my application until 30 calendar days after this pre -filing
meeting request.
• I also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you can submit an
application.
Signature
Submittal Date 10/20/2020
Preliminary ORM Data Entry Fields for New Actions
ACTION ID #: SAW- Begin Date (Date Received):
Prepare file folder [| Assign Action ID Number in ORM [|
1. Project Name [PCN Form A2a]: Rich Fork Heights
2. Work Type: [V Private [__|institutional [_covernment [ |commereial
3. Project Description / Purpose [PCN Form B3d and B3e]:
The development of a 164 lot subdivision with streets, utilities, storm sewer and wet detention ponds. Equipment Used: Track Hoes,
Bull Dozers , Pans, Dump Trucks / Residential Subdivision
4. Property Owner / Applicant [PCN Form A3 or A4]: HPT Investment Holdings, LLC / True Homes, LLC
5. Agent / Consultant [PNC Form A5 — or ORM Consultant ID Number]:
Chuck Truby / CPT Engineering and Surveying, Inc.
6. Related Action ID Number(s) [PCN Form B5b]:
7. Project Location — Coordinates, Street Address, and/or Location Description [PCN Form B1b]:
Lat: 36.018778 Long: -80.05547
8. Project Location — Tax Parcel ID [PCN Form Bla]: 6882-77-3453
9. Project Location — County [PCN Form A2b]: Forsyth
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: High Point
11. Project Information — Nearest Waterbody [PCN Form B2a]: Rich Fork
12. Watershed / 8-Digit Hydrologic Unit Code [PCN Form B2c]: Yadkin- Pee Dee
Authorization: Section 10 [| Section 404 Section 10 and 404 [|
Regulatory Action Type:
[| Standard Permit [__|Pre-Application Request
Nationwide Permit # |_| Unauthorized Activity
Regional General Permit # Compliance
L] Jurisdictional Determination Request No Permit Required
Revised 20150602
of MATES Ay DIVISig A ine? 3
Office Use Only:
Corps action ID no.
DWO project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
ja. Type(s) of approval sought from the Corps: Section 404 Permit CD Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 29 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? C1 Yes No id. Type(s) of approval sought from the DWQ (check all that apply):
401 Water Quality Certification — Regular
( 401 Water Quality Certification — Express
[1 Non-404 Jurisdictional General Permit
Riparian Buffer Authorization
1e. Is this notification solely for the record For the record only for DWQ For the record only for Corps Permit:
because written approval is not required? 401 Certification:
CJ Yes No CL] Yes 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 CJ Yes No
or in-lieu fee program.
ig. oe miele located in any of NC’s twenty coastal counties. If yes, answer 1h C1 Yes No
th. Is the project located within a NC DCM Area of Environmental Concern (AEC)? 0 Yes No
2. Project Information
2a. Name of project: Rich Fork Heights
2b. County: Forsyth
2c. Nearest municipality / town: | High Point
2d. Subdivision name: Rich Fork Heights
2e. NCDOT only, T.!.P. or state project no: |
3. Owner Information
3a, Name(s) on Recorded Deed: | HPT Investment Holdings, LLC
3b. Deed Book and Page No. DB 3511 PG 1504
3c. Responsini Party (for LLC if Andy Dondero
applicable):
3d. Street address: 455 2nd Street S.E. 5th Floor
3e. City, state, zip: Charlotesville, Va. 22902
3f. Telephone no.: 434-245-4905
3g. Fax no.: N/A
3h. Email address:
Page 1 of 10
PCN Form — Version 1.4 January 2009
4. Applicant Information (if different from owner)
4a. Applicant is: CO Agent Other, specify: Owner
4b. Name: Jeff Guernier
4c. Business jets True Homes, LLC (if applicable): ‘
4d. Street address: 2649 Breckonridge Dr.
4e. City, state, zip: Monroe NC 28110
4f. Telephone no.: 336-451-6682
4g. Fax no.: 336-369-1336
4h. Email address: jguernier@truehomesusa.com
5. Agent/Consultant Information (if applicable)
5a. Name: Chuck Truby
ob. ee CPT Engineering and Surveying, Inc.
5c. Street address: 4400 Tyning Street
5d. City, state, zip: High Point NC 27165
5e. Telephone no.: 336-812-8800 x 304
5f. Fax no.: 336-812-8780
5g. Email address: chuckt@cptengineering.com
Page 2 of 10
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 6882-7 7-3453
1b. Site coordinates (in decimal degrees): | Latitude: 36.018778 Longitude: -80.05547
1c. Property size: 41.665 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Rich Fork
2b. Water Quality Classification of nearest receiving water: Cc
2c. River basin: Yadkin- Pee Dee 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:
Wooded Land surrounded by interstate highway to the north.
3b. List the total estimated acreage of all existing wetlands on the property: 3.23
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 2,826
3d. Explain the purpose of the proposed project:
Residential Subdivision
3e. Describe the overall project in detail, including the type of equipment to be used:
The development of a 164 lot subdivision with streets, utilities, storm sewer and wet detention ponds. Equipment Used: Track Hoes, Bull Dozers , Pans
4. Jurisdictional Determinations
4a, Have jurisdictional wetland or stream determinations by the Y
Corps or State been requested or obtained for this property / Cc ed es LI No Cy Unknown project (including all prior phases) in the past? omments: SAW-2018-01914
4b. If the Corps made the jurisdictional determination, what type a 5
of determination was made? Preliminary C] Final
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: Progress Environmental Group
Name (if known): Jay Lawson Other: 4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation. 11/7/2018
5. Project History
5a. Have permits or certifications been requested or obtained for this project (including alll prior phases) in the past? LlYes No [Unknown 5b. If yes, explain in detail according to “help file” instructions.
6. Future Project Plans
6a. Is this a phased project? | C1 Yes No
6b. If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009
C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
Wetlands Streams — tributaries C) Buffers 1] Open Waters 1 Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2d. 2e. 2f.
Wetland impact Type of impact Type of wetland Forested Type of jurisdiction | Area of
number Corps (404,10) or impact
Permanent (P) or DWQ (401, other) | (acres)
Temporary (T)
W1 P Fill Headwater Wetland Yes Corps 0.059
We2 T Sewer Line Headwater Wetland Yes Corps 0.03
W3 : Choose one Choose one Yes/No 5
Ww4 = Choose one Choose one Yes/No -
W5 - Choose one Choose one Yes/No
W6 - Choose one Choose one Yes/No -
2g. Total Wetland Impacts: 0.048 2h. Comments:
3. Stream Impacts
lf there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial (PER) or Type of Average Impact
number intermittent (INT)? | jurisdiction stream length
Permanent (P) or width (linear
Temporary (T) (feet) feet)
S1 T Sanitary Sewer Rich Fork PER Corps 13 28
$2 T Coffer Dam (Other) Rich Fork PER Corps 13 10
83 Choose one -
S4 - Choose one - -
S5 : Choose one - -
S6 = Choose one z z
3h. Total stream and tributary impacts 128
3i. 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 individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number (if applicable) Type of impact Waterbody | Area of impact (acres)
Permanent (P) or type
Temporary (T)
O1 " Choose one Choose
O2 - Choose one Choose
03 Choose one Choose
O4 - Choose one Choose
4f. Total open water impacts 4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID number Proposed use or Wetland Impacts (acres) Stream Impacts (feet) Upland
purpose of pond (acres)
Flooded | Filled | Excavated Flooded Filled | Excavated
P1 Choose one
P2 Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required? LJ Yes [J No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
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 you MUST fill out Section D of this form.
6a. Project is in which protected basin? [Neuse [] Tar-Pamlico [] Catawba [] Randleman Other:
6b. 6c. 6d. 6e. 6f. 6g.
Buffer Impact Reason for impact Stream name Buffer Zone 1 Zone 2
number — mitigation impact impact
Permanent (P) or required? (square (square
Temporary (T) feet) feet)
B1 No
B2 - No
B3 = No
B4 7 No
B5 “ Yes/No
B6 : Yes/No
6h. Total Buffer Impacts: 5,787 4,815 6i. Comments:
Page 5 of 10
D. Impact Justification and Mitigation
1. Avoidance and Minimization
ta. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The slopes are proposed to be 2:1 which is the steepest allowed. The pipe length is as short as possible to keep wetland impacts to the minimum amount possible.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Silt Fence will be installed to prevent erosion from entering wetiands
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for LC] Yes No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply): CL] pwa (1 Corps
O Mitigation bank
2c. ee mitigation option will be used for this oO Payment to in-lieu fee program
(J Permittee Responsible Mitigation
3.__ Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
Type: Choose one Quantity:
3b. Credits Purchased (attach receipt and letter) | Type: Choose one Quantity:
Type: Choose one Quantity:
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. 0 Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: Choose one
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
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.
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?
CJ Yes 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.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required: 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
1a. Does the project include or is it adjacent to protected riparian buffers identified Yes C1 No
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
Yes (J No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 37.87 %
Yes C1 No 2b. Does this project require a Stormwater Management Plan?
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
Wet Detention ponds are proposed to treat the runoff from all impervious areas. Runoff will be conveyed via storm pipes or swales.
2e. Who will be responsible for the review of the Stormwater Management Plan? | City of High Point
3. Certified Local Government Stormwater Review
3a. _In which local government's jurisdiction is this project? City of High Point
Phase II ; , . Cnsw 3b. Which of the following locally-implemented stormwater management programs [] UsMP
apply (check alll that apply): (J Water Supply Watershed
(J Other:
3c. Has the approved Stormwater Management Plan with proof of approval been Kl Yes CINo
attached?
4. DWQ Stormwater Program Review
4a. Which of the following state-implemented stormwater management programs apply
(check all that apply):
Ccoastal counties
HQW
CIoRw [Session Law 2006-246 LJOther:
4b. Has the approved Stormwater Management Plan with proof of approval been CyYes No
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? Yes [J] No
5b. Have all of the 401 Unit submittal requirements been met? Yes CI No
Page 8 of 10
PCN Form — Version 1.4 January 2009
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
ja. Does the project involve an expenditure of public (federal/state/local) funds or the
use of public (federal/state) land? Ll Yes Ne
ib. 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 LlyYes LINo
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. 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.) LD Yes LINo
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (154 NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, LlyYes No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? OlyYes No
2c. If you answered “yes” to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in Ces 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.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
All wastewater from the prppesed niaeG or available capacity of the subject facility.
‘Ss evelopment will be treated by the City of High Point. High Point has capacity for the sewer.
Page 9 of 10
PCN Form —- Version 1.4 January 2009
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
Sa. Will this project occur in or near an area with federally protected species or habitat? ¥R P Ces No
5b. Have you checked with the USFWS concerning Endangered Species Act Bl Yes CONo impacts?
5c. If yes, indicate the USFWS Field Office you have contacted. Raleigh 5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat? USFWS website with verification by USACE. https://ecos.fws.gov/ecpO/reports/species-by-current-range-county?fps=37081 and https:/lecos.fws.gov/ ecp/
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? Yes No 6b, What data sources did you use to determine whether your site would impact Essential Fish Habitat? http:/Awww.fws.gov/raleigh/species/cntylistcounty.htm! with verification by USACE. Site is not near salt marsh, oyster reef, or sea grass beds.
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 CO Yes No status (e.g., National Historic Trust designation or properties significant in a North Carolina history and archaeology)? 7b. What data sources did you use to determine whether your site would impact historic or archeological resources? State Historic Preservation Office
http://www, hpo.dcr.state.nc.us/ with verification from the USACE
&. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? Yes (J No 8b. If yes, explain how project meets FEMA requirements: The sanitary sewer is underground and will have no impact on the flood elevation
8c. What source(s) did you use to make the floodplain determination? FEMA Map No. 371010688200K, Dated March 16, 2009
True Homes, BY: Jeffrey C. Guernier | _— % = as [rue themes ov W/m 210-20 Applicant/Agent’s Printed Name Applicant/Agent's)Signaturé/ Date (Agent's signature is valid only if an authofization
letter from the applicant is provided.)
Page 10 of 10
NORTH CAROLINA4024 North Main Street, High Point NCFORABBOTTS CREEK TOWNSHIP, FORSYTH COUNTYSEAL
C
14984
H
ENG I
SEFO
E NARAO
LI
REEN LA
N
OIS
NROPAHC T
RR BURTLSP YJR.,.TRAILCEDARWOODN
M
A
I
N
S
T
HI
G
H
P
O
I
N
T
R
O
A
D DRIVEBEECHNUTCIRMONTERAY
DELRAY AVENUENC 66 SOUTHS
B
3
1
1
N
B
3
1
1
NC 6
6
S
B
3
1
1
N
B
3
1
1
N
C
6
6
THOMAS ROAD
THOMAS ROAD
N
B
3
1
1
N
C
6
6
NC 6
6
S
B
3
1
1
N
B
3
1
1
S
B
3
1
1
NC 66 SOUTHDELRAY AVENUEMONTERAY CIRBEECHNUTDRIVE
HI
G
H
P
O
I
N
T
R
O
A
D
N
M
A
I
N
S
T
CEDARWOODTRAILSEAL
C
14984
H
ENG I
SEFO
E NARAO
LI
REEN LA
N
OIS
NROPAHC T
RR BURTLSP YJR.,.ABBOTTS CREEK TOWNSHIP, FORSYTH COUNTYFOR4024 North Main Street, High Point NCNORTH CAROLINA
GENERAL SEQUENCE:
1. CONSTRUCT TEMPORARY CONSTRUCTION
ENTRANCE/STREAM CROSSING.
2. STOCKPILE GRAVEL (IF PRESENT) FOR USE AS
STREAM BOTTOM RESTORATION MATERIAL.
3. CONSTRUCT TEMPORARY COFFER DAMS.
4. PROVIDE ADEQUATE PUMP(S) TO DEWATER WORK
AREA. DO NOT REDUCE OR HALT STREAM BASE FLOW.
DISCHARGE PUMP EFFLUENT INTO SILT BAG. DISCHARGE
SILT BAG BEHIND SILT FENCE AT SILT FENCE OUTLET.
5. INSTALL THE 8" SANITARY SEWER LINE ALONG WITH
16" STREEL ENCASEMENT PIPE UNDER STREAM.
6. PROVIDE CONSOLIDATED AGGREGATE BACKFILL PER
CITY OF HIGH POINT STANDARDS. A LICENSED NC
GEOTECHNICAL ENGINEER AND THE CITY OF HIGH POINT
INSPECTIONS DEPARTMENT SHALL APPROVE BACKFILL.
7. PROVIDE ANY REQUIRED SOIL BACKFILL IN SHORT,
WELL COMPACTED LIFTS. TEST FOR PROPER
COMPACTION, CONSULT GEOTECHNICAL ENGINEER.
8. SEED UPLAND AREAS AS SOON AS GRADING ALLOWS.
SEE EROSION CONTROL PLAN FOR SEEDING SCHEDULE
REQUIREMENTS.NORTH CAROLINA4024 North Main Street, High Point NCFORABBOTTS CREEK TOWNSHIP, FORSYTH COUNTYSEAL
C
14984
H
ENG I
SEFO
E NARAO
LI
REEN LA
N
OIS
NROPAHC T
RR BURTLSP YJR.,.
WETLANDS
WETLANDSWETLANDS
WE
T
L
A
ND
S
WETLANDSVULCAN LANDS INC.
PIN: 6882-79-4184
ZONING: RS-20
NC HWY 66 SOUTHFENCE MEANDERS
ALONG PROPERTY LINE
PERPETUAL 30' EASEMENT TO
THE BENEFIT OF KB IRA PER
DEED BOOK 1378, PAGE 89.
SPARKS PROPERTY
PERPETUAL 30' EASEMENT TO THE
BENEFIT OF VULCAN LANDS, INC. PER
DEED BOOK 1338, PAGE 165.
D.B. 3384, PG. 2169 KB IRA, FORMERLY
ITEM 2
SPARKS PROPERTY
KB IRA, FORMERLY
ITEM 2
H.E. DURHAMD.B 2349, PG. 75260' PUBLIC R/W32' ACCESS &
UTILITY EASEMENT
3
2
1
4
6
13
14
15
16 17 18
19
20 21 22 24 25
27
28
29
30 31
32
33
34
35
36
37 38 39
40
41
42
44
45
50
51
52
56
57
58
59
60
61 64
65
67
68
69
70
71
72
73
74
80
88
89
90
91
92 95
96
97
99
100
101
102
103
104
105
106
107
23
108
110
111
113
114
115
116
117
118
119
120
121
123
122
124
125
126
127
7
8
10
11
109
128
129
130
132 131
133
134
112
135
136
137
138
139
140
141
142
143144145146147148149150151152153154
155
156
157
158
159
160
161
162163
164
PIN 6882-77-6093
FORK FORKRICHCHARLES W. LEDFORD, JR. TRUSTEE
PDRIVEBEECHNUT
TRAILCEDARWOODKMBUNKER HOLDINGS LLC
PIN: 6882-69-9041
ZONING: CZ RM-16
D.B. 3294, PG. 2755
EQUITY TRUST COMPANY CUSTODIAN,DENNIS N. BUNKER III
PIN: 6882-78-4954
D.B. 3345, PG. 2038
MAP NO: 684826
DENNIS N. BUNKER III - TRUSTEE
OF DNBIII TRUST
PIN: 6882-68-9756
D.B. 3356, PG. 4441
KATHRYN M. BUNKER - TRUSTEE
OF KMBUNKER TRUST
PIN: 6882-78-1754
D.B. 3356, PG. 4438
H.E. DURHAM
RUTH L. DURHAM
PIN: 6882-78-5793
D.B. 1536, PG. 1164
ZONING: RS-20
D.B. 2349, PG. 752
VULCAN LANDS INC.
PIN: 6882-79-5442
ZONING: GI-S
D.B. 2907, PG. 3441
EQUITY TRUST COMPANY CUSTODIAN,
KATHRYN M. BUNKERPIN: 6882-88-2913
D.B. 3196, PG. 1315
MAP NO: 684826
ZONING: CZ RM-16
RONALD B. MARTIN
SARAH H. MARTIN
PIN: 6882-77-4984
D.B. 2787, PG. 2139
ZONING: RS-20
ALFRED LEE SCOTT
REVOCABLE TRUST
PIN: 6882-77-5047
D.B. 3206, PG. 3373
ZONING: RS-20 ALFRED LEE SCOTT
REVOCABLE TRUST
D.B. 3395, PG. 429
ZONING: RS-20
ALFRED LEE SCOTT
REVOCABLE TRUST
PIN 6882-86-0864
D.B. 3206, PG. 3430
ZONING: RM-12
PIN 6882-96-4523
CHM&S LLC
D.B. 2862, PG. 2238
ZONING: RS-20
PIN 6892-06-1411
HENRY F. LEDFORD, TRUSTEE
DB. 2439 PG. 2896
ZONING: RS-20
HPT INVESTMENT
PIN: 6882-87-3851 PART
D.B. 3511, PG. 1504
HOLDINGS, LLC
ZONING: CZ RM-16
ZONING: CZ RM-16
ZONING: CZ RM-16
ZONING: CZ RM-16
(PUBLIC)CENTERPIECE
CT
(PUBL
IC)PURSUANCE CT(PUBLIC)TRANSITION ST(PUBLIC)TRANSITION ST(PUBLIC)CENTERPIECE DR(PUBLIC)STARDUST CT(PUBLIC)RESOLUTION CT(PUBLIC)M
O
N
T
E
R
A
Y
C
I
R
(P
U
B
L
I
C
)MONTERAY CIR(PUBLIC)DENNIS N. BUNKER III,
PIN: 6882-87-3851 PART
D.B. 3170, PG. 148
KMBUNKER LLC
ZONING: CZ RM-16
PROPERTY LINE D.B
.
3
1
9
6
,
P
G
.
1
3
1
5
PROPERTY LINE D.B
.
3
1
7
0
,
P
G
.
1
4
8
APPROX
LOCATION OF
EX POND
CENTERP
I
E
C
E
D
R
VICINITY MAP
N
TRAILCEDARWOODN
M
A
I
N
S
T
HI
G
H
P
O
I
N
T
R
O
A
D DRIVEBEECHNUTCIRCLEMONTERAY
DELRAY AVENUENC 66 SOUTHSB
3
1
1
NB
3
1
1
NC 66
S
B
3
1
1
N
B
3
1
1
N
C
6
6
THOMAS ROAD
SEAL
C
14984
H
ENG I
SEFO
E NARAO
LI
REEN LA
NOISNROP
AHC T
R
R BURTLSP YJR.,.
6$:
86$50<&25362)(1*,1((56
:,/0,1*721',675,&7
$FWLRQ,G6$:&RXQW\)RUV\WK86*64XDG1&:LQVWRQ6DOHP
127,),&$7,212)-85,6',&7,21$/'(7(50,1$7,21
3URSHUW\2ZQHU&DUVRQ&RQVWUXFWLRQ&RPSDQ\//&
&KXFN2YHUE\
$GGUHVV%DOODUG5RDG
&ROID[1&
7HOHSKRQH1XPEHU
(PDLOFKXFN#FDUVRQFRQVWUXFWLRQQFFRP
6L]HDFUHVa 1HDUHVW7RZQ+LJK3RLQW
1HDUHVW:DWHUZD\5LFK)RUN 5LYHU%DVLQ/RZHU<DGNLQ
86*6+8& &RRUGLQDWHV /DWLWXGH
/RQJLWXGH
/RFDWLRQGHVFULSWLRQ7KHUHYLHZDUHDLVORFDWHGZHVWRI1&+LJKZD\DSSUR[LPDWHO\PLOHVHDVWRIWKHLQWHUVHFWLRQRI
0RQWHUD\&RXUWDQG'HOUD\$YHQXH3,1VDQG
5HIHUHQFHUHYLHZDUHDGHVFULSWLRQVKRZQLQ-XULVGLFWLRQDO'HWHUPLQDWLRQ5HTXHVWSDFNDJHHQWLWOHG³)LJXUH6LWH
0DS´DQG3ULQWHG'DWHRI2FWREHU
,QGLFDWH:KLFKRIWKH)ROORZLQJ$SSO\
$.PreliminaryDetermination
7KHUHDSSHDUWREHZDWHUVLQFOXGLQJZHWODQGVRQWKHDERYHGHVFULEHGSURMHFWDUHDSURSHUW\WKDWPD\EHVXEMHFWWR6HFWLRQ
RIWKH&OHDQ:DWHU$FW&:$86&DQGRU6HFWLRQRIWKH5LYHUVDQG+DUERUV$FW5+$86&7KH
ZDWHUVLQFOXGLQJZHWODQGVKDYHEHHQGHOLQHDWHGDQGWKHGHOLQHDWLRQKDVEHHQYHULILHGE\WKH&RUSVWREHVXIILFLHQWO\DFFXUDWH
DQGUHOLDEOH7KHDSSUR[LPDWHERXQGDULHVRIWKHVHZDWHUVDUHVKRZQRQWKHHQFORVHGGHOLQHDWLRQPDSGDWHG7KHUHIRUH
WKLVSUHOLPLQDU\MXULVGLFWLRQGHWHUPLQDWLRQPD\EHXVHGLQWKHSHUPLWHYDOXDWLRQSURFHVVLQFOXGLQJGHWHUPLQLQJFRPSHQVDWRU\
PLWLJDWLRQ)RUSXUSRVHVRIFRPSXWDWLRQRILPSDFWVFRPSHQVDWRU\PLWLJDWLRQUHTXLUHPHQWVDQGRWKHUUHVRXUFHSURWHFWLRQ
PHDVXUHVDSHUPLWGHFLVLRQPDGHRQWKHEDVLVRIDSUHOLPLQDU\-'ZLOOWUHDWDOOZDWHUVDQGZHWODQGVWKDWZRXOGEHDIIHFWHGLQDQ\
ZD\E\WKHSHUPLWWHGDFWLYLW\RQWKHVLWHDVLIWKH\DUHMXULVGLFWLRQDOZDWHUVRIWKH867KLVSUHOLPLQDU\GHWHUPLQDWLRQLVQRWDQ
DSSHDODEOHDFWLRQXQGHUWKH5HJXODWRU\3URJUDP$GPLQLVWUDWLYH$SSHDO3URFHVV5HIHUHQFH&)53DUW+RZHYHU\RXPD\
UHTXHVWDQDSSURYHG-'ZKLFKLVDQDSSHDODEOHDFWLRQE\FRQWDFWLQJWKH&RUSVGLVWULFWIRUIXUWKHULQVWUXFWLRQ
7KHUHDSSHDUWREHZDWHUVLQFOXGLQJZHWODQGVRQWKHDERYHGHVFULEHGSURMHFWDUHDSURSHUW\WKDWPD\EHVXEMHFWWR6HFWLRQ
RIWKH&OHDQ:DWHU$FW&:$86&DQGRU6HFWLRQRIWKH5LYHUVDQG+DUERUV$FW5+$86&
+RZHYHUVLQFHWKHZDWHUVLQFOXGLQJZHWODQGVKDYHQRWEHHQSURSHUO\GHOLQHDWHGWKLVSUHOLPLQDU\MXULVGLFWLRQGHWHUPLQDWLRQ
PD\QRWEHXVHGLQWKHSHUPLWHYDOXDWLRQSURFHVV:LWKRXWDYHULILHGZHWODQGGHOLQHDWLRQWKLVSUHOLPLQDU\GHWHUPLQDWLRQLV
PHUHO\DQHIIHFWLYHSUHVXPSWLRQRI&:$5+$MXULVGLFWLRQRYHUDOORIWKHZDWHUVLQFOXGLQJZHWODQGVDWWKHSURMHFWDUHDZKLFK
LVQRWVXIILFLHQWO\DFFXUDWHDQGUHOLDEOHWRVXSSRUWDQHQIRUFHDEOHSHUPLWGHFLVLRQ:HUHFRPPHQGWKDW\RXKDYHWKHZDWHUV
LQFOXGLQJZHWODQGVRQ\RXUSURMHFWDUHDSURSHUW\GHOLQHDWHG$VWKH&RUSVPD\QRWEHDEOHWRDFFRPSOLVKWKLVZHWODQG
GHOLQHDWLRQLQDWLPHO\PDQQHU\RXPD\ZLVKWRREWDLQDFRQVXOWDQWWRFRQGXFWDGHOLQHDWLRQWKDWFDQEHYHULILHGE\WKH&RUSV
%$SSURYHG'HWHUPLQDWLRQ
7KHUHDUH1DYLJDEOH:DWHUVRIWKH8QLWHG6WDWHVZLWKLQWKHDERYHGHVFULEHGSURMHFWDUHDSURSHUW\VXEMHFWWRWKHSHUPLW
UHTXLUHPHQWVRI6HFWLRQRIWKH5LYHUVDQG+DUERUV$FW5+$86&DQG6HFWLRQRIWKH&OHDQ:DWHU$FW
&:$86&8QOHVVWKHUHLVDFKDQJHLQODZRURXUSXEOLVKHGUHJXODWLRQVWKLVGHWHUPLQDWLRQPD\EHUHOLHGXSRQIRU
DSHULRGQRWWRH[FHHGILYH\HDUVIURPWKHGDWHRIWKLVQRWLILFDWLRQ
7KHUHDUHZDWHUVLQFOXGLQJZHWODQGVRQWKHDERYHGHVFULEHGSURMHFWDUHDSURSHUW\VXEMHFWWRWKHSHUPLWUHTXLUHPHQWVRI6HFWLRQ
RIWKH&OHDQ:DWHU$FW&:$86&8QOHVVWKHUHLVDFKDQJHLQWKHODZRURXUSXEOLVKHGUHJXODWLRQVWKLV
GHWHUPLQDWLRQPD\EHUHOLHGXSRQIRUDSHULRGQRWWRH[FHHGILYH\HDUVIURPWKHGDWHRIWKLVQRWLILFDWLRQ
6$:
:HUHFRPPHQG\RXKDYHWKHZDWHUVLQFOXGLQJZHWODQGVRQ\RXUSURMHFWDUHDSURSHUW\GHOLQHDWHG$VWKH&RUSVPD\QRWEH
DEOHWRDFFRPSOLVKWKLVZHWODQGGHOLQHDWLRQLQDWLPHO\PDQQHU\RXPD\ZLVKWRREWDLQDFRQVXOWDQWWRFRQGXFWDGHOLQHDWLRQWKDW
FDQEHYHULILHGE\WKH&RUSV
7KHZDWHUVLQFOXGLQJZHWODQGVRQ\RXUSURMHFWDUHDSURSHUW\KDYHEHHQGHOLQHDWHGDQGWKHGHOLQHDWLRQKDVEHHQYHULILHGE\
WKH&RUSV7KHDSSUR[LPDWHERXQGDULHVRIWKHVHZDWHUVDUHVKRZQRQWKHHQFORVHGGHOLQHDWLRQPDSGDWHG'$7(:HVWURQJO\
VXJJHVW\RXKDYHWKLVGHOLQHDWLRQVXUYH\HG8SRQFRPSOHWLRQWKLVVXUYH\VKRXOGEHUHYLHZHGDQGYHULILHGE\WKH&RUSV2QFH
YHULILHGWKLVVXUYH\ZLOOSURYLGHDQDFFXUDWHGHSLFWLRQRIDOODUHDVVXEMHFWWR&:$MXULVGLFWLRQRQ\RXUSURSHUW\ZKLFKSURYLGHG
WKHUHLVQRFKDQJHLQWKHODZRURXUSXEOLVKHGUHJXODWLRQVPD\EHUHOLHGXSRQIRUDSHULRGQRWWRH[FHHGILYH\HDUV
7KHZDWHUVLQFOXGLQJZHWODQGVKDYHEHHQGHOLQHDWHGDQGVXUYH\HGDQGDUHDFFXUDWHO\GHSLFWHGRQWKHSODWVLJQHGE\WKH
&RUSV5HJXODWRU\2IILFLDOLGHQWLILHGEHORZRQ'$7(8QOHVVWKHUHLVDFKDQJHLQWKHODZRURXUSXEOLVKHGUHJXODWLRQVWKLV
GHWHUPLQDWLRQPD\EHUHOLHGXSRQIRUDSHULRGQRWWRH[FHHGILYH\HDUVIURPWKHGDWHRIWKLVQRWLILFDWLRQ
7KHUHDUHQRZDWHUVRIWKH86WRLQFOXGHZHWODQGVSUHVHQWRQWKHDERYHGHVFULEHGSURMHFWDUHDSURSHUW\ZKLFKDUHVXEMHFWWRWKH
SHUPLWUHTXLUHPHQWVRI6HFWLRQRIWKH&OHDQ:DWHU$FW86&8QOHVVWKHUHLVDFKDQJHLQWKHODZRURXUSXEOLVKHG
UHJXODWLRQVWKLVGHWHUPLQDWLRQPD\EHUHOLHGXSRQIRUDSHULRGQRWWRH[FHHGILYH\HDUVIURPWKHGDWHRIWKLVQRWLILFDWLRQ
7KHSURSHUW\LVORFDWHGLQRQHRIWKH&RDVWDO&RXQWLHVVXEMHFWWRUHJXODWLRQXQGHUWKH&RDVWDO$UHD0DQDJHPHQW$FW&$0$
<RXVKRXOGFRQWDFWWKH'LYLVLRQRI&RDVWDO0DQDJHPHQWLQ0RUHKHDG&LW\1&DWWRGHWHUPLQHWKHLU
UHTXLUHPHQWV
3ODFHPHQWRIGUHGJHGRUILOOPDWHULDOZLWKLQZDWHUVRIWKH86LQFOXGLQJZHWODQGVZLWKRXWD'HSDUWPHQWRIWKH$UP\SHUPLWPD\
FRQVWLWXWHDYLRODWLRQRI6HFWLRQRIWKH&OHDQ:DWHU$FW86&3ODFHPHQWRIGUHGJHGRUILOOPDWHULDOFRQVWUXFWLRQRU
SODFHPHQWRIVWUXFWXUHVRUZRUNZLWKLQQDYLJDEOHZDWHUVRIWKH8QLWHG6WDWHVZLWKRXWD'HSDUWPHQWRIWKH$UP\SHUPLWPD\
FRQVWLWXWHDYLRODWLRQRI6HFWLRQVDQGRURIWKH5LYHUVDQG+DUERUV$FW86&DQGRU,I\RXKDYHDQ\TXHVWLRQV
UHJDUGLQJWKLVGHWHUPLQDWLRQDQGRUWKH&RUSVUHJXODWRU\SURJUDPSOHDVHFRQWDFW%U\DQ5RGHQ5H\QROGVDWRU
EU\DQURGHQUH\QROGV#XVDFHDUP\PLO
C.%DVLV)RU'HWHUPLQDWLRQ%DVLV)RU'HWHUPLQDWLRQ6HHWKHSUHOLPLQDU\MXULVGLFWLRQDOGHWHUPLQDWLRQ
IRUPGDWHG
'.5HPDUNV 1RQH
($WWHQWLRQ86'$3URJUDP3DUWLFLSDQWV
7KLVGHOLQHDWLRQGHWHUPLQDWLRQKDVEHHQFRQGXFWHGWRLGHQWLI\WKHOLPLWVRI&RUSV¶&OHDQ:DWHU$FWMXULVGLFWLRQIRUWKHSDUWLFXODUVLWH
LGHQWLILHGLQWKLVUHTXHVW7KHGHOLQHDWLRQGHWHUPLQDWLRQPD\QRWEHYDOLGIRUWKHZHWODQGFRQVHUYDWLRQSURYLVLRQVRIWKH)RRG6HFXULW\
$FWRI,I\RXRU\RXUWHQDQWDUH86'$3URJUDPSDUWLFLSDQWVRUDQWLFLSDWHSDUWLFLSDWLRQLQ86'$SURJUDPV\RXVKRXOGUHTXHVW
DFHUWLILHGZHWODQGGHWHUPLQDWLRQIURPWKHORFDORIILFHRIWKH1DWXUDO5HVRXUFHV&RQVHUYDWLRQ6HUYLFHSULRUWRVWDUWLQJZRUN
)$SSHDOV,QIRUPDWLRQ7KLVLQIRUPDWLRQDSSOLHVRQO\WRDSSURYHGMXULVGLFWLRQDOGHWHUPLQDWLRQVDVLQGLFDWHGLQ%
DERYH
7KLVFRUUHVSRQGHQFHFRQVWLWXWHVDQDSSURYHGMXULVGLFWLRQDOGHWHUPLQDWLRQIRUWKHDERYHGHVFULEHGVLWH,I\RXREMHFWWRWKLV
GHWHUPLQDWLRQ\RXPD\UHTXHVWDQDGPLQLVWUDWLYHDSSHDOXQGHU&RUSVUHJXODWLRQVDW&)53DUW(QFORVHG\RXZLOOILQGD
1RWLILFDWLRQRI$SSHDO3URFHVV1$3IDFWVKHHWDQGUHTXHVWIRUDSSHDO5)$IRUP,I\RXUHTXHVWWRDSSHDOWKLVGHWHUPLQDWLRQ\RX
PXVWVXEPLWDFRPSOHWHG5)$IRUPWRWKHIROORZLQJDGGUHVV
86$UP\&RUSVRI(QJLQHHUV
6RXWK$WODQWLF'LYLVLRQ
$WWQ-DVRQ6WHHOH5HYLHZ2IILFHU
)RUV\WK6WUHHW6:5RRP0
$WODQWD*HRUJLD
,QRUGHUIRUDQ5)$WREHDFFHSWHGE\WKH&RUSVWKH&RUSVPXVWGHWHUPLQHWKDWLWLVFRPSOHWHWKDWLWPHHWVWKHFULWHULDIRUDSSHDO
XQGHU&)5SDUWDQGWKDWLWKDVEHHQUHFHLYHGE\WKH'LYLVLRQ2IILFHZLWKLQGD\VRIWKHGDWHRIWKH1$36KRXOG\RX
GHFLGHWRVXEPLWDQ5)$IRUPLWPXVWEHUHFHLYHGDWWKHDERYHDGGUHVVE\1RWDSSOLFDEOH
,WLVQRWQHFHVVDU\WRVXEPLWDQ5)$IRUPWRWKH'LYLVLRQ2IILFHLI\RXGRQRWREMHFWWRWKHGHWHUPLQDWLRQLQWKLVFRUUHVSRQGHQFH
6$:
&RUSV5HJXODWRU\2IILFLDOBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
'DWHRI-' ([SLUDWLRQ'DWHRI-'1RWDSSOLFDEOH
7KH:LOPLQJWRQ'LVWULFWLVFRPPLWWHGWRSURYLGLQJWKHKLJKHVWOHYHORIVXSSRUWWRWKHSXEOLF7RKHOSXVHQVXUHZH
FRQWLQXHWRGRVRSOHDVHFRPSOHWHWKH&XVWRPHU6DWLVIDFWLRQ6XUYH\ORFDWHGDW
KWWSFRUSVPDSXXVDFHDUP\PLOFPBDSH[I"S
&RS\IXUQLVKHG
$JHQW3URJUHVV(QYLURQPHQWDO*URXS,QF
-D\/DZVRQ
$GGUHVV32%R[
:LQVWRQ6DOHP1&
7HOHSKRQH1XPEHU
(PDLOMODZVRQ#SURJUHVVHQYFRP
RODEN
REYNOLDS.BRYAN.KENNETH.126338
5574
Digitally signed by RODEN
REYNOLDS.BRYAN.KENNETH.1263385574
DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USA,
cn=RODEN REYNOLDS.BRYAN.KENNETH.1263385574
Date: 2018.11.08 16:33:02 -05'00'
6$:
127,),&$7,212)$'0,1,675$7,9($33($/237,216$1'352&(66$1'
5(48(67)25$33($/
$SSOLFDQW&DUVRQ&RQVWUXFWLRQ&RPSDQ\//&&KXFN
2YHUE\
)LOH1XPEHU6$:'DWH
$WWDFKHGLV 6HH6HFWLRQEHORZ
,1,7,$/352))(5('3(50,76WDQGDUG3HUPLWRU/HWWHURISHUPLVVLRQ $
352))(5('3(50,76WDQGDUG3HUPLWRU/HWWHURISHUPLVVLRQ %
3(50,7'(1,$/&
$33529('-85,6',&7,21$/'(7(50,1$7,21 '
35(/,0,1$5<-85,6',&7,21$/'(7(50,1$7,21 (
6(&7,21,7KHIROORZLQJLGHQWLILHV\RXUULJKWVDQGRSWLRQVUHJDUGLQJDQDGPLQLVWUDWLYHDSSHDORIWKHDERYHGHFLVLRQ
$GGLWLRQDOLQIRUPDWLRQPD\EHIRXQGDWRUKWWSZZZXVDFHDUP\PLO0LVVLRQV&LYLO:RUNV5HJXODWRU\3URJUDPDQG3HUPLWVDVS[
RUWKH&RUSVUHJXODWLRQVDW&)53DUW
$,1,7,$/352))(5('3(50,7<RXPD\DFFHSWRUREMHFWWRWKHSHUPLW
x$&&(37,I\RXUHFHLYHGD6WDQGDUG3HUPLW\RXPD\VLJQWKHSHUPLWGRFXPHQWDQGUHWXUQLWWRWKHGLVWULFWHQJLQHHUIRUILQDO
DXWKRUL]DWLRQ,I\RXUHFHLYHGD/HWWHURI3HUPLVVLRQ/23\RXPD\DFFHSWWKH/23DQG\RXUZRUNLVDXWKRUL]HG<RXU
VLJQDWXUHRQWKH6WDQGDUG3HUPLWRUDFFHSWDQFHRIWKH/23PHDQVWKDW\RXDFFHSWWKHSHUPLWLQLWVHQWLUHW\DQGZDLYHDOO
ULJKWVWRDSSHDOWKHSHUPLWLQFOXGLQJLWVWHUPVDQGFRQGLWLRQVDQGDSSURYHGMXULVGLFWLRQDOGHWHUPLQDWLRQVDVVRFLDWHGZLWKWKH
SHUPLW
x2%-(&7,I\RXREMHFWWRWKHSHUPLW6WDQGDUGRU/23EHFDXVHRIFHUWDLQWHUPVDQGFRQGLWLRQVWKHUHLQ\RXPD\UHTXHVW
WKDWWKHSHUPLWEHPRGLILHGDFFRUGLQJO\<RXPXVWFRPSOHWH6HFWLRQ,,RIWKLVIRUPDQGUHWXUQWKHIRUPWRWKHGLVWULFW
HQJLQHHU<RXUREMHFWLRQVPXVWEHUHFHLYHGE\WKHGLVWULFWHQJLQHHUZLWKLQGD\VRIWKHGDWHRIWKLVQRWLFHRU\RXZLOO
IRUIHLW\RXUULJKWWRDSSHDOWKHSHUPLWLQWKHIXWXUH8SRQUHFHLSWRI\RXUOHWWHUWKHGLVWULFWHQJLQHHUZLOOHYDOXDWH\RXU
REMHFWLRQVDQGPD\DPRGLI\WKHSHUPLWWRDGGUHVVDOORI\RXUFRQFHUQVEPRGLI\WKHSHUPLWWRDGGUHVVVRPHRI\RXU
REMHFWLRQVRUFQRWPRGLI\WKHSHUPLWKDYLQJGHWHUPLQHGWKDWWKHSHUPLWVKRXOGEHLVVXHGDVSUHYLRXVO\ZULWWHQ$IWHU
HYDOXDWLQJ\RXUREMHFWLRQVWKHGLVWULFWHQJLQHHUZLOOVHQG\RXDSURIIHUHGSHUPLWIRU\RXUUHFRQVLGHUDWLRQDVLQGLFDWHGLQ
6HFWLRQ%EHORZ
%352))(5('3(50,7<RXPD\DFFHSWRUDSSHDOWKHSHUPLW
x$&&(37,I\RXUHFHLYHGD6WDQGDUG3HUPLW\RXPD\VLJQWKHSHUPLWGRFXPHQWDQGUHWXUQLWWRWKHGLVWULFWHQJLQHHUIRUILQDO
DXWKRUL]DWLRQ,I\RXUHFHLYHGD/HWWHURI3HUPLVVLRQ/23\RXPD\DFFHSWWKH/23DQG\RXUZRUNLVDXWKRUL]HG<RXU
VLJQDWXUHRQWKH6WDQGDUG3HUPLWRUDFFHSWDQFHRIWKH/23PHDQVWKDW\RXDFFHSWWKHSHUPLWLQLWVHQWLUHW\DQGZDLYHDOO
ULJKWVWRDSSHDOWKHSHUPLWLQFOXGLQJLWVWHUPVDQGFRQGLWLRQVDQGDSSURYHGMXULVGLFWLRQDOGHWHUPLQDWLRQVDVVRFLDWHGZLWKWKH
SHUPLW
x$33($/,I\RXFKRRVHWRGHFOLQHWKHSURIIHUHGSHUPLW6WDQGDUGRU/23EHFDXVHRIFHUWDLQWHUPVDQGFRQGLWLRQVWKHUHLQ
\RXPD\DSSHDOWKHGHFOLQHGSHUPLWXQGHUWKH&RUSVRI(QJLQHHUV$GPLQLVWUDWLYH$SSHDO3URFHVVE\FRPSOHWLQJ6HFWLRQ,,RI
WKLVIRUPDQGVHQGLQJWKHIRUPWRWKHGLYLVLRQHQJLQHHU7KLVIRUPPXVWEHUHFHLYHGE\WKHGLYLVLRQHQJLQHHUZLWKLQGD\V
RIWKHGDWHRIWKLVQRWLFH
&3(50,7'(1,$/<RXPD\DSSHDOWKHGHQLDORIDSHUPLWXQGHUWKH&RUSVRI(QJLQHHUV$GPLQLVWUDWLYH$SSHDO3URFHVVE\
FRPSOHWLQJ6HFWLRQ,,RIWKLVIRUPDQGVHQGLQJWKHIRUPWRWKHGLYLVLRQHQJLQHHU7KLVIRUPPXVWEHUHFHLYHGE\WKHGLYLVLRQ
HQJLQHHUZLWKLQGD\VRIWKHGDWHRIWKLVQRWLFH
'$33529('-85,6',&7,21$/'(7(50,1$7,21<RXPD\DFFHSWRUDSSHDOWKHDSSURYHG-'RUSURYLGHQHZ
LQIRUPDWLRQ
x$&&(37<RXGRQRWQHHGWRQRWLI\WKH&RUSVWRDFFHSWDQDSSURYHG-')DLOXUHWRQRWLI\WKH&RUSVZLWKLQGD\VRIWKH
GDWHRIWKLVQRWLFHPHDQVWKDW\RXDFFHSWWKHDSSURYHG-'LQLWVHQWLUHW\DQGZDLYHDOOULJKWVWRDSSHDOWKHDSSURYHG-'
x$33($/,I\RXGLVDJUHHZLWKWKHDSSURYHG-'\RXPD\DSSHDOWKHDSSURYHG-'XQGHUWKH&RUSVRI(QJLQHHUV
$GPLQLVWUDWLYH$SSHDO3URFHVVE\FRPSOHWLQJ6HFWLRQ,,RIWKLVIRUPDQGVHQGLQJWKHIRUPWRWKHGLVWULFWHQJLQHHU7KLVIRUP
PXVWEHUHFHLYHGE\WKHGLYLVLRQHQJLQHHUZLWKLQGD\VRIWKHGDWHRIWKLVQRWLFH
6$:
(35(/,0,1$5<-85,6',&7,21$/'(7(50,1$7,21<RXGRQRWQHHGWRUHVSRQGWRWKH&RUSVUHJDUGLQJWKH
SUHOLPLQDU\-'7KH3UHOLPLQDU\-'LVQRWDSSHDODEOH,I\RXZLVK\RXPD\UHTXHVWDQDSSURYHG-'ZKLFKPD\EHDSSHDOHG
E\FRQWDFWLQJWKH&RUSVGLVWULFWIRUIXUWKHULQVWUXFWLRQ$OVR\RXPD\SURYLGHQHZLQIRUPDWLRQIRUIXUWKHUFRQVLGHUDWLRQE\WKH
&RUSVWRUHHYDOXDWHWKH-'
6(&7,21,,5(48(67)25$33($/RU2%-(&7,21672$1,1,7,$/352))(5('3(50,7
5($6216)25$33($/252%-(&7,216'HVFULEH\RXUUHDVRQVIRUDSSHDOLQJWKHGHFLVLRQRU\RXUREMHFWLRQVWRDQLQLWLDO
SURIIHUHGSHUPLWLQFOHDUFRQFLVHVWDWHPHQWV<RXPD\DWWDFKDGGLWLRQDOLQIRUPDWLRQWRWKLVIRUPWRFODULI\ZKHUH\RXUUHDVRQVRU
REMHFWLRQVDUHDGGUHVVHGLQWKHDGPLQLVWUDWLYHUHFRUG
$'',7,21$/,1)250$7,217KHDSSHDOLVOLPLWHGWRDUHYLHZRIWKHDGPLQLVWUDWLYHUHFRUGWKH&RUSVPHPRUDQGXPIRUWKH
UHFRUGRIWKHDSSHDOFRQIHUHQFHRUPHHWLQJDQGDQ\VXSSOHPHQWDOLQIRUPDWLRQWKDWWKHUHYLHZRIILFHUKDVGHWHUPLQHGLVQHHGHGWR
FODULI\WKHDGPLQLVWUDWLYHUHFRUG1HLWKHUWKHDSSHOODQWQRUWKH&RUSVPD\DGGQHZLQIRUPDWLRQRUDQDO\VHVWRWKHUHFRUG
+RZHYHU\RXPD\SURYLGHDGGLWLRQDOLQIRUPDWLRQWRFODULI\WKHORFDWLRQRILQIRUPDWLRQWKDWLVDOUHDG\LQWKHDGPLQLVWUDWLYH
UHFRUG
32,172)&217$&7)2548(67,21625,1)250$7,21
,I\RXKDYHTXHVWLRQVUHJDUGLQJWKLVGHFLVLRQDQGRUWKH
DSSHDOSURFHVV\RXPD\FRQWDFW
'LVWULFW(QJLQHHU:LOPLQJWRQ5HJXODWRU\'LYLVLRQ
$WWQ%U\DQ5RGHQ5H\QROGV
&KDUORWWH5HJXODWRU\2IILFH
86$UP\&RUSVRI(QJLQHHUV
8QLYHUVLW\([HFXWLYH3DUN'ULYH6XLWH
&KDUORWWH1RUWK&DUROLQD
,I\RXRQO\KDYHTXHVWLRQVUHJDUGLQJWKHDSSHDOSURFHVV\RXPD\
DOVRFRQWDFW
0U-DVRQ6WHHOH$GPLQLVWUDWLYH$SSHDO5HYLHZ2IILFHU
&(6$'3'2
86$UP\&RUSVRI(QJLQHHUV6RXWK$WODQWLF'LYLVLRQ
)RUV\WK6WUHHW5RRP0
$WODQWD*HRUJLD
3KRQH
5,*+72)(175<<RXUVLJQDWXUHEHORZJUDQWVWKHULJKWRIHQWU\WR&RUSVRI(QJLQHHUVSHUVRQQHODQGDQ\JRYHUQPHQW
FRQVXOWDQWVWRFRQGXFWLQYHVWLJDWLRQVRIWKHSURMHFWVLWHGXULQJWKHFRXUVHRIWKHDSSHDOSURFHVV<RXZLOOEHSURYLGHGDGD\
QRWLFHRIDQ\VLWHLQYHVWLJDWLRQDQGZLOOKDYHWKHRSSRUWXQLW\WRSDUWLFLSDWHLQDOOVLWHLQYHVWLJDWLRQV
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
6LJQDWXUHRIDSSHOODQWRUDJHQW
'DWH 7HOHSKRQHQXPEHU
For appeals on Initial Proffered Permits send this form to:
'LVWULFW(QJLQHHU:LOPLQJWRQ5HJXODWRU\'LYLVLRQ$WWQ%U\DQ5RGHQ5H\QROGV'DUOLQJWRQ$YHQXH:LOPLQJWRQ1RUWK
&DUROLQD
For Permit denials, Proffered Permits and Approved Jurisdictional Determinations send this form to:
'LYLVLRQ(QJLQHHU&RPPDQGHU86$UP\(QJLQHHU'LYLVLRQ6RXWK$WODQWLF$WWQ0U-DVRQ6WHHOH$GPLQLVWUDWLYH$SSHDO
2IILFHU&(6$'3'2)RUV\WK6WUHHW5RRP0$WODQWD*HRUJLD
3KRQH
35(/,0,1$5< -85,6',&7,21$/ '(7(50,1$7,213-' )250
%$&.*5281',1)250$7,21
$5(3257&203/(7,21'$7()253-'
%1$0($1'$''5(662)3(56215(48(67,1*3-'&DUVRQ&RQVWUXFWLRQ&RPSDQ\//&&KXFN2YHUE\
%DOODUG5RDG&ROID[1&
&',675,&72)),&(),/(1$0($1' 180%(5:LOPLQJWRQ'LVWULFW+RUQH\WRZQ5RDG6$:
'352-(&7/2&$7,216$1'%$&.*5281',1)250$7,217KHUHYLHZDUHDLVORFDWHGZHVWRI1&
+LJKZD\DSSUR[LPDWHO\PLOHVHDVWRIWKHLQWHUVHFWLRQRI0RQWHUD\&RXUWDQG'HOUD\$YHQXH3,1V
DQG5HIHUHQFHUHYLHZDUHD
GHVFULSWLRQVKRZQLQ-XULVGLFWLRQDO'HWHUPLQDWLRQ5HTXHVWSDFNDJHHQWLWOHG³)LJXUH6LWH0DS´DQG3ULQWHG'DWHRI
2FWREHU
86(7+(7$%/(%(/2:72'2&80(17 08/7,3/($48$7,&5(6285&(6$1'25
$48$7,&5(6285&(6$7',))(5(176,7(6
6WDWH1&&RXQW\)RUV\WK&LW\+LJK3RLQW
&HQWHUFRRUGLQDWHVRIVLWHODWORQJLQGHJUHHGHFLPDOIRUPDW/DWLWXGH/RQJLWXGH
8QLYHUVDO7UDQVYHUVH0HUFDWRU
1DPHRIQHDUHVWZDWHUERG\5LFK)RUN
(5(9,(:3(5)250(')256,7((9$/8$7,21&+(&.$//7+$7$33/<
2IILFH'HVN'HWHUPLQDWLRQ'DWH)LHOG'HWHUPLQDWLRQ'DWHVDQG
7$%/(2)$48$7,&5(6285&(6,15(9,(:$5($:+,&+0$<%(68%-(&7725(*8/$725<
-85,6',&7,21
^ŝƚĞEƵŵďĞƌ>ĂƚŝƚƵĚĞ;ĚĞĐŝŵĂů
ĚĞŐƌĞĞƐͿ
>ŽŶŐŝƚƵĚĞ;ĚĞĐŝŵĂů
ĚĞŐƌĞĞƐͿ
ƐƚŝŵĂƚĞĚĂŵŽƵŶƚŽĨ
ĂƋƵĂƚŝĐƌĞƐŽƵƌĐĞƐŝŶ
ƌĞǀŝĞǁĂƌĞĂ;ĂĐƌĞĂŐĞ
ĂŶĚůŝŶĞĂƌĨĞĞƚ͕ŝĨ
ĂƉƉůŝĐĂďůĞ
dLJƉĞŽĨĂƋƵĂƚŝĐ
ƌĞƐŽƵƌĐĞƐ;ŝ͘Ğ͕͘
ǁĞƚůĂŶĚǀƐ͘ŶŽŶͲ
ǁĞƚůĂŶĚǁĂƚĞƌƐͿ
'ĞŽŐƌĂƉŚŝĐĂƵƚŚŽƌŝƚLJƚŽ
ǁŚŝĐŚƚŚĞĂƋƵĂƚŝĐƌĞƐŽƵƌĐĞ
͞ŵĂLJďĞ͟ƐƵďũĞĐƚ;ŝ͘Ğ͕͘
^ĞĐƚŝŽŶϰϬϰŽƌ^ĞĐƚŝŽŶ
ϭϬͬϰϬϰͿ
^ƚƌĞĂŵ ϯϲ͘ϬϮϬϵϲϵ ͲϴϬ͘ϬϱϰϮϳϱ ϴϬϬůŝŶĞĂƌĨĞĞƚ EŽŶͲǁĞƚůĂŶĚ ϰϬϰ
^ƚƌĞĂŵ ϯϲ͘ϬϮϭϵϭϵ ͲϴϬ͘ϬϱϰϮϭϵ ϲϬϬůŝŶĞĂƌĨĞĞƚ EŽŶͲǁĞƚůĂŶĚ ϰϬϰ
^ƚƌĞĂŵ ϯϲ͘ϬϮϭϵϭϭ ͲϴϬ͘Ϭϱϰϭϳϴ ϭϬϬůŝŶĞĂƌĨĞĞƚ EŽŶͲǁĞƚůĂŶĚ ϰϬϰ
^ƚƌĞĂŵ ϯϲ͘ϬϮϭϵ ͲϴϬ͘ϬϱϮϬϲϵ ϭ͕ϲϲϱůŝŶĞĂƌĨĞĞƚ EŽŶͲǁĞƚůĂŶĚ ϰϬϰ
^ƚƌĞĂŵ' ϯϲ͘ϬϭϵϳϳϮ ͲϴϬ͘ϬϱϬϮϭϰ ϵϬůŝŶĞĂƌĨĞĞƚ EŽŶͲǁĞƚůĂŶĚ ϰϬϰ
^ƚƌĞĂŵ: ϯϲ͘ϬϮϭϴϯϭ ͲϴϬ͘ϬϱϮϵϰϳ ϮϬůŝŶĞĂƌĨĞĞƚ EŽŶͲǁĞƚůĂŶĚ ϰϬϰ
tĞƚůĂŶĚ ϯϲ͘ϬϮϭϱϮϴ ͲϴϬ͘Ϭϱϯϯϲϭ Ϭ͘ϳĂĐƌĞ tĞƚůĂŶĚ ϰϬϰ
^ŝƚĞEƵŵďĞƌ>ĂƚŝƚƵĚĞ;ĚĞĐŝŵĂů
ĚĞŐƌĞĞƐͿ
>ŽŶŐŝƚƵĚĞ;ĚĞĐŝŵĂů
ĚĞŐƌĞĞƐͿ
ƐƚŝŵĂƚĞĚĂŵŽƵŶƚŽĨ
ĂƋƵĂƚŝĐƌĞƐŽƵƌĐĞƐŝŶ
ƌĞǀŝĞǁĂƌĞĂ;ĂĐƌĞĂŐĞ
ĂŶĚůŝŶĞĂƌĨĞĞƚ͕ŝĨ
ĂƉƉůŝĐĂďůĞ
dLJƉĞŽĨĂƋƵĂƚŝĐ
ƌĞƐŽƵƌĐĞƐ;ŝ͘Ğ͕͘
ǁĞƚůĂŶĚǀƐ͘ŶŽŶͲ
ǁĞƚůĂŶĚǁĂƚĞƌƐͿ
'ĞŽŐƌĂƉŚŝĐĂƵƚŚŽƌŝƚLJƚŽ
ǁŚŝĐŚƚŚĞĂƋƵĂƚŝĐƌĞƐŽƵƌĐĞ
͞ŵĂLJďĞ͟ƐƵďũĞĐƚ;ŝ͘Ğ͕͘
^ĞĐƚŝŽŶϰϬϰŽƌ^ĞĐƚŝŽŶ
ϭϬͬϰϬϰͿ
tĞƚůĂŶĚ ϯϲ͘Ϭϭϵϳϭϵ ͲϴϬ͘ϬϱϬϲϭϳ ϰ͘ϬĂĐƌĞƐ tĞƚůĂŶĚ ϰϬϰ
tĞƚůĂŶĚ& ϯϲ͘ϬϮϬϮϵϮ ͲϴϬ͘ϬϱϬϲϯϵ Ϭ͘ϬϱĂĐƌĞ tĞƚůĂŶĚ ϰϬϰ
tĞƚůĂŶĚ, ϯϲ͘Ϭϭϴϲϰϳ ͲϴϬ͘ϬϱϱϳϵϮ ϭ͘ϬĂĐƌĞƐ tĞƚůĂŶĚ ϰϬϰ
tĞƚůĂŶĚ/ ϯϲ͘ϬϮϭϴϯϵ ͲϴϬ͘ϬϱϮϯϲϰ Ϭ͘ϬϮĂĐƌĞ tĞƚůĂŶĚ ϰϬϰ
tĞƚůĂŶĚ< ϯϲ͘ϬϮϭϳϲϰ ͲϴϬ͘ϬϱϬϮϭϰ Ϭ͘ϬϭĂĐƌĞ tĞƚůĂŶĚ ϰϬϰ
7KH&RUSVRI(QJLQHHUVEHOLHYHVWKDWWKHUHPD\EHMXULVGLFWLRQDODTXDWLFUHVRXUFHVLQWKHUHYLHZ
DUHDDQGWKHUHTXHVWRURIWKLV3-'LVKHUHE\DGYLVHGRIKLVRUKHURSWLRQWR UHTXHVWDQGREWDLQDQ
DSSURYHG-'$-'IRUWKDWUHYLHZDUHDEDVHGRQDQLQIRUPHGGHFLVLRQDIWHUKDYLQJGLVFXVVHGWKH
YDULRXVW\SHVRI-'VDQGWKHLUFKDUDFWHULVWLFVDQGFLUFXPVWDQFHVZKHQWKH\PD\EHDSSURSULDWH
,QDQ\FLUFXPVWDQFHZKHUHDSHUPLWDSSOLFDQWREWDLQVDQLQGLYLGXDOSHUPLWRUD1DWLRQZLGH*HQHUDO
3HUPLW1:3RURWKHUJHQHUDOSHUPLWYHULILFDWLRQUHTXLULQJSUHFRQVWUXFWLRQQRWLILFDWLRQ3&1RU
UHTXHVWVYHULILFDWLRQIRUDQRQUHSRUWLQJ 1:3RURWKHUJHQHUDOSHUPLWDQGWKHSHUPLWDSSOLFDQWKDV
QRWUHTXHVWHGDQ$-'IRUWKHDFWLYLW\WKHSHUPLWDSSOLFDQWLVKHUHE\PDGHDZDUHWKDWWKHSHUPLW
DSSOLFDQWKDVHOHFWHGWRVHHNDSHUPLWDXWKRUL]DWLRQ EDVHGRQD3-'ZKLFKGRHVQRWPDNHDQRIILFLDO
GHWHUPLQDWLRQRIMXULVGLFWLRQDODTXDWLFUHVRXUFHVWKHDSSOLFDQWKDVWKHRSWLRQWRUHTXHVWDQ$-'
EHIRUHDFFHSWLQJWKHWHUPVDQGFRQGLWLRQVRIWKHSHUPLWDXWKRUL]DWLRQDQGWKDWEDVLQJDSHUPLW
DXWKRUL]DWLRQRQDQ$-'FRXOGSRVVLEO\UHVXOWLQOHVVFRPSHQVDWRU\PLWLJDWLRQEHLQJUHTXLUHGRU
GLIIHUHQWVSHFLDOFRQGLWLRQVWKHDSSOLFDQWKDVWKHULJKWWRUHTXHVWDQLQGLYLGXDOSHUPLWUDWKHUWKDQ
DFFHSWLQJWKHWHUPVDQGFRQGLWLRQVRIWKH1:3RURWKHUJHQHUDOSHUPLWDXWKRUL]DWLRQWKHDSSOLFDQW
FDQDFFHSWDSHUPLWDXWKRUL]DWLRQDQGWKHUHE\DJUHHWRFRPSO\ZLWKDOOWKHWHUPVDQGFRQGLWLRQVRIWKDW
SHUPLWLQFOXGLQJZKDWHYHUPLWLJDWLRQUHTXLUHPHQWVWKH&RUSVKDVGHWHUPLQHGWREHQHFHVVDU\
XQGHUWDNLQJDQ\DFWLYLW\LQUHOLDQFHXSRQWKHVXEMHFWSHUPLWDXWKRUL]DWLRQZLWKRXWUHTXHVWLQJDQ$-'
FRQVWLWXWHVWKHDSSOLFDQW
VDFFHSWDQFHRIWKHXVHRIWKH3-'DFFHSWLQJDSHUPLWDXWKRUL]DWLRQHJ
VLJQLQJDSURIIHUHGLQGLYLGXDOSHUPLWRUXQGHUWDNLQJDQ\DFWLYLW\LQUHOLDQFHRQDQ\IRUPRI&RUSV
SHUPLWDXWKRUL]DWLRQEDVHGRQD3-'FRQVWLWXWHVDJUHHPHQWWKDWDOODTXDWLFUHVRXUFHVLQWKHUHYLHZDUHD
DIIHFWHGLQDQ\ZD\E\WKDWDFWLYLW\ZLOOEHWUHDWHGDVMXULVGLFWLRQDODQGZDLYHVDQ\FKDOOHQJHWRVXFK
MXULVGLFWLRQLQDQ\DGPLQLVWUDWLYHRUMXGLFLDOFRPSOLDQFHRUHQIRUFHPHQWDFWLRQRULQDQ\
DGPLQLVWUDWLYHDSSHDORULQDQ\)HGHUDOFRXUWDQGZKHWKHU WKHDSSOLFDQWHOHFWVWRXVHHLWKHUDQ$-'
RUD3-'WKH-'ZLOOEHSURFHVVHGDVVRRQDVSUDFWLFDEOH)XUWKHUDQ$-'DSURIIHUHGLQGLYLGXDO
SHUPLWDQGDOOWHUPVDQGFRQGLWLRQVFRQWDLQHGWKHUHLQRULQGLYLGXDOSHUPLWGHQLDOFDQEH
DGPLQLVWUDWLYHO\DSSHDOHGSXUVXDQWWR&)53DUW,IGXULQJDQDGPLQLVWUDWLYHDSSHDOLW
EHFRPHVDSSURSULDWHWRPDNHDQRIILFLDOGHWHUPLQDWLRQZKHWKHUJHRJUDSKLFMXULVGLFWLRQH[LVWVRYHU
DTXDWLFUHVRXUFHVLQWKHUHYLHZDUHDRUWRSURYLGHDQRIILFLDOGHOLQHDWLRQRIMXULVGLFWLRQDODTXDWLF
UHVRXUFHVLQWKHUHYLHZDUHDWKH&RUSVZLOOSURYLGHDQ$-'WRDFFRPSOLVKWKDWUHVXOWDVVRRQDVLV
SUDFWLFDEOH7KLV3-'ILQGVWKDWWKHUH"may be" ZDWHUVRIWKH86DQGRUWKDWWKHUH"may be"
QDYLJDEOHZDWHUVRIWKH86RQWKHVXEMHFWUHYLHZDUHDDQGLGHQWLILHVDOODTXDWLFIHDWXUHVLQWKH
UHYLHZDUHDWKDWFRXOGEHDIIHFWHGE\WKHSURSRVHGDFWLYLW\EDVHGRQWKHIROORZLQJLQIRUPDWLRQ
6833257,1*'$7$'DWDUHYLHZHGIRU3-'FKHFNDOOWKDWDSSO\
&KHFNHGLWHPVVKRXOGEHLQFOXGHGLQVXEMHFWILOH$SSURSULDWHO\UHIHUHQFHVRXUFHVEHORZZKHUH
LQGLFDWHGIRUDOOFKHFNHGLWHPV
0DSVSODQVSORWVRUSODWVXEPLWWHGE\RURQEHKDOIRIWKH3-'UHTXHVWRU
0DS)LJXUHV
'DWDVKHHWVSUHSDUHGVXEPLWWHGE\RURQEHKDOIRIWKH3-'UHTXHVWRU
2IILFHFRQFXUVZLWKGDWDVKHHWVGHOLQHDWLRQ UHSRUW
2IILFHGRHVQRWFRQFXUZLWKGDWDVKHHWVGHOLQHDWLRQUHSRUW5DWLRQDOH
'DWDVKHHWVSUHSDUHGE\WKH&RUSV
&RUSVQDYLJDEOHZDWHUV
VWXG\
86*HRORJLFDO6XUYH\+\GURORJLF$WODV
86*61+'GDWD
86*6DQGGLJLW+8&PDSV
86*HRORJLFDO6XUYH\PDSV&LWHVFDOH TXDGQDPH)LJXUH7RSRJUDSKLF6LWH0DS:LQVWRQ
6DOHP'DWHG
1DWXUDO5HVRXUFHV&RQVHUYDWLRQ6HUYLFH6RLO6XUYH\&LWDWLRQ)LJXUH6RLO0DS6RLO6XUYH\RI)RUV\WK&RXQW\
1DWLRQDOZHWODQGVLQYHQWRU\PDSV&LWHQDPH)LJXUH1DWLRQDO:HWODQGV,QYHQWRU\0DS86):61:,
0DSSHU
6WDWHORFDOZHWODQGLQYHQWRU\PDSV
)(0$),50PDSV
\HDU)ORRGSODLQ(OHYDWLRQLV 1DWLRQDO*HRGHWLF9HUWLFDO'DWXPRI
3KRWRJUDSKV$HULDO1DPH 'DWH)LJXUH6LWH0DSDQG)LJXUH3RWHQWLDO-XULVGLFWLRQDO$UHDV0DS'DWHG
2FWREHU
RU2WKHU1DPH 'DWH
3UHYLRXVGHWHUPLQDWLRQV)LOHQRDQGGDWHRIUHVSRQVHOHWWHU
2WKHULQIRUPDWLRQSOHDVHVSHFLI\1&':46WUHDP,GHQWLILFDWLRQ)RUPV9HUVLRQ'DWHGDQG
,03257$17127(7KHLQIRUPDWLRQUHFRUGHGRQWKLVIRUPKDVQRWQHFHVVDULO\EHHQ
YHULILHGE\WKH&RUSVDQGVKRXOGQRWEHUHOLHGXSRQIRUODWHUMXULVGLFWLRQDOGHWHUPLQDWLRQV
6LJQDWXUHDQGGDWHRI5HJXODWRU\
VWDIIPHPEHUFRPSOHWLQJ3-'
6LJQDWXUHDQGGDWHRISHUVRQUHTXHVWLQJ3-'
5(48,5('XQOHVVREWDLQLQJWKHVLJQDWXUHLV
LPSUDFWLFDEOH
'LVWULFWVPD\HVWDEOLVKWLPHIUDPHVIRUUHTXHVWHUWRUHWXUQVLJQHG3-'IRUPV ,IWKHUHTXHVWHUGRHVQRWUHVSRQGZLWKLQWKH
HVWDEOLVKHGWLPHIUDPHWKHGLVWULFWPD\SUHVXPHFRQFXUUHQFH DQGQRDGGLWLRQDOIROORZ XSLVQHFHVVDU\SULRUWRILQDOL]LQJDQ
DFWLRQ
RODEN
REYNOLDS.BRYAN.KENNET
H.1263385574
Digitally signed by RODEN
REYNOLDS.BRYAN.KENNETH.1263385574
DN: c=US, o=U.S. Government, ou=DoD, ou=PKI,
ou=USA, cn=RODEN
REYNOLDS.BRYAN.KENNETH.1263385574
Date: 2018.11.08 16:32:40 -05'00'
P.O. Box 5884 Winston-Salem, NC 27113 Telephone: (336) 722-9999 Fax: (336) 722-9998 www.progressenvironmental.com Potential Jurisdictional Areas Map Monteray Circle/Horneytown Road Site High Point, Forsyth County, NC High Point GIS https://gisweb10.highpointnc.gov/JS/thePoint/ Aerial Photography Date: 2014 Scale: As Shown Project: Monteray Circle/Horneytown Road Site Client: Carson Construction Company, LLC Progress Job #: 1018089.001R Date: November 2018 Potential Non-Wetland Waters of the US G – 90 lf Approximate Total Jurisdictional Tributary: 3,275 Linear Feet Approximate Total Jurisdictional Wetlands: 5.785 Acres Approximate Total Uplands: 67.155 Acres Potential Wetland Waters of the US H – 1 acre Potential Wetland Waters of the US F – 0.05 acre Potential Non-Wetland Waters of the US J – 20 lf Potential Wetland Waters of the US K – 0.014 acre Potential Non-Wetland Waters of the US D – 1,665 lf Potential Non-Wetland Waters of the US C – 600 lf Potential Non-Wetland Waters of the US CE – 100 lf Potential Wetland Waters of the US E – 4 acres Potential Non-Wetland Waters of the US A – 800 lf Potential Wetland Waters of the US B – 0.7 acre Potential Wetland Waters of the US I – 0.021 acre S-1 S-2S-3
THOMAS ROAD
N
B
3
1
1
N
C
6
6
NC 6
6
S
B
3
1
1
N
B
3
1
1
S
B
3
1
1
NC 66 SOUTHDELRAY AVENUEMONTERAY CIRBEECHNUTDRIVE
HI
G
H
P
O
I
N
T
R
O
A
D
N
M
A
I
N
S
T
CEDARWOODTRAILSEAL
C
14984
H
ENG I
SEFO
E NARAO
LI
REEN LA
N
OIS
NROPAHC T
RR BURTLSP YJR.,.ABBOTTS CREEK TOWNSHIP, FORSYTH COUNTYFOR4024 North Main Street, High Point NCNORTH CAROLINA
GENERAL SEQUENCE:
1. CONSTRUCT TEMPORARY COFFER DAMS.
2. PROVIDE ADEQUATE PUMP(S) TO DEWATER WORK
AREA. DO NOT REDUCE OR HALT STREAM BASE FLOW.
DISCHARGE PUMP EFFLUENT INTO SILT BAG. DISCHARGE
SILT BAG BEHIND SILT FENCE AT SILT FENCE OUTLET.
3. INSTALL THE 8" SANITARY SEWER LINE ALONG WITH
16" STREEL ENCASEMENT PIPE UNDER STREAM.
4. PROVIDE CONSOLIDATED AGGREGATE BACKFILL PER
CITY OF HIGH POINT STANDARDS. A LICENSED NC
GEOTECHNICAL ENGINEER AND THE CITY OF HIGH POINT
INSPECTIONS DEPARTMENT SHALL APPROVE BACKFILL.
5. PROVIDE ANY REQUIRED SOIL BACKFILL IN SHORT,
WELL COMPACTED LIFTS. TEST FOR PROPER
COMPACTION, CONSULT GEOTECHNICAL ENGINEER.
6. SEED UPLAND AREAS AS SOON AS GRADING ALLOWS.
SEE EROSION CONTROL PLAN FOR SEEDING SCHEDULE
REQUIREMENTS.NORTH CAROLINA4024 North Main Street, High Point NCFORABBOTTS CREEK TOWNSHIP, FORSYTH COUNTYSEAL
C
14984
H
ENG I
SEFO
E NARAO
LI
REEN LA
NOISNROP
AHC T
RR BURTLSP YJR.,.