20111099 Ver 1_401 Application_20111211

Stantec Consulting Services Inc
801 Jones Franklin Road Suite 300
Raleigh NC 27606
Tel [phone]
Fax [phone]
staMec
December 13 2011
Ian McMillan
N C Division of Water Quality
1650 Mail Service Center
Raleigh NC 27699 165069
Dear Mr McMillan
20 1 1 10 9 9
Please find the attached Pre construction Notification (PCN) and supporting documentation that was sent to
the USACE Wilmington office to apply for a Nationwide Permit (NWP) No 18 for the Centralized Downtown
Stormwater BMPs in Jacksonville NC A portion of the existing City stormwater pipe and ditch system within
an existing drainage easement will be replaced with a vegetated swale on the south side of Poplar Street
near the intersection of Poplar Street and Ford Street in downtown Jacksonville
The project site consists of an existing drainage easement on the Faith Body of Christ Assembly church
property and adjacent City property A 24 pipe flows from the north side of Poplar Street before emptying into
a small ditch within the drainage easement The ditch then flows into another 24 pipe and empties into a
wetland in the riparian zone of an unnamed tributary that eventually flows to Wilson Bay (New River) At the
downstream most outfall the outfall elevation is lower than the elevation of the ground surface Beyond the
outfall a shallow ditch cuts through the wetland to the UT (see Photo) The unnamed tributary and majority of
the wetland in the project area is contained within the City of Jacksonville property The outer edge of the
wetland occurs within the drainage easement portion of the project area
The wetland area is considered a rivenne swamp forest and contains common wetland plant species
including red maple (Acer rubrum) giant cane (Arund►nana g►gantea) wax myrtle (Morella cenfera) sweetbay
(Magnolia u►rg►n►ana) laurel oak (Quercus launfolia) and the invasive Chinese privet (L►gustrum s►nense) The
wetland limit is the edge of the forested area Within the wetland evidence of surface flow was observed and
soils exhibited reduced conditions in the form of a dark surface and a low chroma subsoil
Grading will be necessary in the wetland in order to connect the swale to the Unnamed Tributary Elevations
on the project site and in the area of the proposed stormwater wetland determine what swale slope is needed
to carry flow and prevent flooding to adjacent properties As such grading in the wetland has been minimized
but cannot be avoided completely Six cubic yards of material will be removed from below the Ordinary High
Water elevation in the wetland
The attachments contain the PCN form photos USGS topoquad vicinity map soil map and design sheets
showing existing and proposed conditions including wetland locations and impact areas This letter and
attachments are for DWQ s record only Please contact me if there are any concerns
Sincejply
C
M lissa Ruiz PWS 4;�Z
Scientist
Tel [phone]
Fax [phone]
melissa ruiz @stantec com
Attachment PCN packet
DEC 6 2011
DENR WATER QUALITY
"ElLANDSAND 3TORIOWATER BRANCH

Stantec
December 1, 2011
Jacksonville Centralized Downtown BMPs— NWP 18
Page 2 of 2
Photo 1. Looking south along the drainage easement. Tree line at end of ditch is wetland limit.
Photo 2. Pipe outfall into wetland; ditch flows toward unnamed tributary.

of wa rF9
o� °c 20 1 1 10 9 9 Office use Only
Corps action ID no
5 < DWQ project no
Form Version 13 Dec 10 2008
Page 1 of 11
PCN Form — Version 1 3 December 10 2008 Version
Pre - Construction Notification PCN Form
A Applicant Information
1
Processing
la
Type(s) of approval sought from the
Corps
®Section 404 Permit El Section 10 Permit
ech
1b Specify Nationwide Permit (NWP) number 18 or General Permit (GP) number
1c
Has the NWP or GP number been verified by the Corps?
® Yes
❑ No
1 d
Type(s) of approval sought from the DWQ (check all that apply)
® 401 Water Quality Certification — Regular ❑ Non404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1e
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification
® Yes ❑ No
For the record only for Corps Permit
❑ 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 or in lieu
fee program
❑ Yes
® No
1g
Is the project located in any of NC s twenty coastal counties If yes answer 1 h
below
N Yes
❑ No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2
Project Information
2a
Name of project
Centralized Downtown Stormwater BMPs
2b
County
Onslow p
2c
Nearest municipality / town
Jacksonville
2d
Subdivision name
NA DE
2e
NCDOT only T I P or state
project no
NA DENR WATER QUALITY
3
Owner Information
MWATERBRMCH
3a
Name(s) on Recorded Deed
City of Jacksonville
3b
Deed Book and Page No
Right of way and drainage easement
3c
Responsible Party (for LLC if
applicable)
Richard Woodruff City Manager City of Jacksonville
3d
Street address
804 New Bndge St
3e
City state zip
Jacksonville NC 28540
3f
Telephone no
910 938 5200
3g
Fax no
NA
3h
Email address
citymanager @ci Jacksonville nc us
Page 1 of 11
PCN Form — Version 1 3 December 10 2008 Version

4
Applicant Information (if different from owner)
4a
Applicant is
® Agent ❑ Other specify
4b
Name
4c
Business name
(if applicable)
4d
Street address
4e
City state zip
4f
Telephone no
4g
Fax no
4h
Email address
5
Agent/Consultant Information (if applicable)
5a
Name
Melissa Ruiz
5b
Business name
(if applicable)
Stantec
5c
Street address
801 Jones Franklin Rd Suite 300
5d
City state zip
Raleigh NC 27606
5e
Telephone no
919 851 -6866
5f
Fax no
919 851 7024
5g
Email address
melissa ruiz @stantec com
Page 2 of 11
PCN Form — Version 1 3 December 10 2008 Version

B
Project Information and Prior Project History
1
Property Identification
1 a
Property identification no (tax PIN or parcel ID)
Right of Way and Drainage Easement (easement located
on 437609163335)
1 b
Site coordinates (in decimal degrees)
Latitude 34 746034 Longitude 7743085
(DD DDDDDD) ( DD DDDDDD)
1c
Property size
0191 ac drainage easement and 0 012 ac ROW acres
2
Surface Waters
2a
Name of nearest body of water (stream river etc) to
Unnamed Tributary to Wilson Bay
proposed project
2b
Water Quality Classification of nearest receiving water
SC HQW NSW
2c
River basin
White Oak
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
The project site consists of a drainage easement and right of way The right of way is perpendicular to the drainage
easement It cotains a narrow sparsely forested wetland An unnamed tributary (UT) flows west to east along the edge of
the right of way to another unnamed tributary before entering Wilson Bay The drainage easement is located on a vacant
lot that is used for parking by the church on the adjacent lot Land use in the drainage easement is herbaceous cover
Stormwater from the City s stormwater system enters the drainage easement via a drainage pipe at Poplar St The pipe
empties into a ditch and then back into a pipe The final outfall is located at the edge of the drainage easement The
outfall elevation is lower than the elevation of the ground surface Beyond the outfall a shallow ditch cuts through the
wetland to the UT (see photo in cover letter)
3b
List the total estimated acreage of all existing wetlands on the property
0 015 ac
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
0
3d
Explain the purpose of the proposed project
The purpose of the project is to retrofit portions of the existing stormwater system with stormwater Best Management
Practices The pipe and ditch through the drainage easement will be replaced with a swale for the length of the drainage
easement and through the wetland to the Unnamed Tributary The swale will be sized to handle flows coming from the
north of the project site where a stormwater wetland is planned These two projects will help improve water quality and
reduce stormwater peak flows thereby improving Wilson Bay
3e
Describe the overall project in detail including the type of equipment to be used
The existing pipe and ditch in the drainage easement will be replaced with a vegetated swale The swale begins at Poplar
St and will receive flow from a proposed stormwater wetland to be installed just north of Poplar St The swale will have
31 slopes and will be vegetated with a variety of wetland species Grading of the existing ditch in the wetland will be
necessary in order connect the swale to the Unnamed Tributary Elevations on the project site and in the area of the
proposed stormwater wetland determine what swale slope is needed to carry flow and prevent flooding to adjacent
properties As such grading in the wetland has been minimized but cannot be avoided completely General earthmowng
equipment will be used to grade the swale from Poplar St down to the stream
Page 3 of 11
PCN Form — Version 1 3 December 10 2008 Version

4
Jurisdictional Determinations
4a
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
El Yes ®No El Unknown
project (including all prior phases) in the pasty
Comments Preliminary JD submitted with this application
4b
If the Corps made the jurisdictional determination what type
❑ Preliminary ❑ Final
of determination was made?
4c
If yes who delineated the jurisdictional areas?
Agency /Consultant Company Stantec Consulting
Name (if known) Amber Coleman LSS PWS
Services Inc
Other
4d
If yes list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
Preliminary JD is being submitted with this application
5
Project History
5a
Have permits or certifications been requested or obtained for
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b
If yes explain in detail according to help file instructions
6
Future Project Plans
6a
Is this a phased project?
❑ Yes ® No
6b
If yes explain
Page 4 of 11
PCN Form — Version 13 December 10 2008 Version

C Proposed Impacts Inventory
1 Impacts Summary
la Which sections were completed below for your project (check all that apply)
® Wetlands ❑ 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
2b
2c
2d
2e
2f
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps 404 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404 other)
(acres)
Temporary
W1 ®P ❑ T
excavation
Rivenne Swamp
Forest
® Yes
El No
® Corps
E] DWQ
0 0076
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g Total wetland impacts
00076
2h Comments Impact volume is 6 cubic yards
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
3b
3c
3d
3e
3f
3g
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number
(PER) or
(Corps 404 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ P ❑ T
NA
NA
❑ PER
❑ INT
❑ Corps
❑ DWQ
NA
NA
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h Total stream and tributary impacts
31 Comments NA
Page 5 of 11
PCN Form — Version 1 3 December 10 2008 Version

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 type
Area of impact (acres)
Permanent (P) or
Temporary
01 ❑ P ❑ T
NA
NA
NA
NA
02 ❑P ❑T
03 ❑P FIT
04 ❑P ❑T
417 Total open water Impacts
4g Comments NA
5 Pond or Lake Construction
If pond or lake construction proposed then complete the chart below
5a
5b
5c
5d
5e
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
NA
NA
NA
NA
NA
NA
NA
NA
P2
5f Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes permit ID no
51 Expected pond surface area (acres)
NA
5j Size of pond watershed (acres)
NA
5k Method of construction
NA
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
❑ Neuse El Tar Pamlico ❑Other
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary
impact
required?
B1 ❑ P ❑ T
NA
NA
❑Nos
NA
NA
B2 ❑P ❑T
F1 Yes
❑ No
133 ❑P ❑T
El Yes
❑ No
6h Total buffer impacts
61 Comments NA
Page 6 of 11
PCN Form — Version 1 3 December 10 2008 Version

D Impact Justification and Mitigation
1 Avoidance and Minimization
la Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Grading will be necessary in the wetland in order to connect the swale to the Unnamed Tributary Elevations on the project
site and in the area of the proposed stormwater wetland determine what swale slope is needed to carry flow and prevent
flooding to adjacent properties As such grading in the wetland has been minimized but cannot be avoided completely
lb Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
E &SC measures will be adhered to including protection of the adjacent wetland and vegetation reestablishment in the
impacted wetland after grading Tree removal in the wetland will be avoided to the extent possible
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 ® 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 NA
3b Credits Purchased (attach receipt and letter)
Type NA
Quantity NA
3c Comments NA
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
linear feet
4c If using stream mitigation stream temperature
❑ warm ❑ cool ❑cold
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 7 of 11
PCN Form — Version 1 3 December 10 2008 Version

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 ® 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
NA
NA
3 (2 for Catawba)
NA
Zone 2
15
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 8of11
PCN Form — Version 1 3 December 10 2008 Version

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 ® No
within one of the NC Riparian Buffer Protection Rules?
lb
If yes then is a diffuse flow plan included? If no explain why
❑ Yes ❑ No
Comments NA
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 ® No
2c
If this project DOES NOT require a Stormwater Management Plan explain why This
project will not result in an increase
of impervious surface It involves the construction of a stormwater best management practice
2d
If this project DOES require a Stormwater Management Plan then provide a brief narrative description of the plan
NA
❑ Certified Local Government
2e
Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3
Certified Local Government Stormwater Review
3a
In which local government s jurisdiction is this project?
NA
❑ Phase II
3b
Which of the following locally implemented stormwater management programs
❑ NSW
❑ 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
attached?
❑ Yes ❑ No
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 met?
❑ Yes ❑ No
Page 9 of 11
PCN Form — Version 1 3 December 10 2008 Version

F Supplementary Information
1 Environmental Documentation (DWQ Requirement)
la Does the project involve an expenditure of public (federal /state /local) funds or the
® Yes ❑ No
use of public (federal /state) land?
1b 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 ® No
(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)
❑ Yes ❑ No
Comments
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
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b Is this an after the -fact permit application?
❑ Yes ® 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
❑ Yes ® 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 not in conjunction with land development The project is part of a stormwater retrofit intended to improve
water quality
4 Sewage Disposal (DWQ Requirement)
4a Clearly detail the ultimate treatment methods and disposition (non discharge or discharge) of wastewater generated from
the proposed project or available capacity of the subject facility
Page 10 of 11
PCN Form — Version 13 December 10 2008 Version

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 ® No
impacts?
❑ Raleigh
5c If yes Indicate the USFWS Field Office you have contacted
❑ Asheville
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Natural Heritage Program Virtual Workroom
6 Essential Fish Habitat (Corps Requirement)
6a WIII this project occur in or near an area designated as essential fish habitats
❑ Yes ® 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 Habitat and Ecosystem IMS (http / /ocean flondamanne org /efh_ coral /ims /viewer htm)
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
❑ 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?
North Carolina State Historic Preservation Office website (http / /gis ncdcr gov /hpowebn
8 Flood Zone Designation (Corps Requirement)
8a WIII this project occur in a FEMA designated 100 year floodplain?
❑ Yes ® No
8b If yes explain how project meets FEMA requirements
8c What source(s) did you use to make the floodplain determination? NC Floodplain Mapping Program
Melissa Ruiz PWS
12/01/2011
Applicant/Agent s Printed Name
Date
Applicant/Agent s Signature
(Agent s signature is valid only d an authorization letter from the applicant
is provided
Page 11 of 11
PCN Form — Version 1 3 December 10 2008 Version

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Centralized Downtown Project Site
Jacksonville, North Carolina
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Centralized Downtown Project Site
Jacksonville, North Carolina
0 0.3 0.6
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CITY OF JACKSONVILLE
Public Services Department — Stormwater Division
November 29 2011
US Army Corps of Engineers
Wilmington Regulatory Field Office
69 Darlington Avenue
Wilmington North Carolina 28403
ATTN Mr Dave Bailey Regulatory Specialist
Subject Jurisdictional Waters Permitting
Dear Sir
City of Jacksonville Centralized Downtown Stormwater BMP Projects
i
The City of Jacksonville has retained Stantec Consulting Services of Raleigh NC to provide
stormwater services on the Centralized Downtown Stormwater BMPs project saes This letter applies
to all project site parcels and easements within this project All easements are owned by the City of
Jacksonville Stantec has my authorization to act on my behalf and take all actions necessary for the
processing issuance and acceptance of this permit or certification
Thank you for your assistance If you have any questions or need any additional information please
contact me at (910 93 8-5220)
rely
C- do�
Richard oodruff
City Manager
Cc Melissa Ruiz Stantec Consulting Services
Post Office Box 128 * Jacksonville North Carolina 28541 * (910) 938 -5233 TDD# [phone] * Fax [phone]

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)
® Maps plans plots or plat submitted by or on behalf of the
applicant/consultant Stantec Consulting Services Inc
❑ Data sheets prepared /submitted by or on behalf of the
applicant/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 124 000
Jacksonville South (on vicinity map)
® USDA Natural Resources Conservation Service Soil Survey Citation
Onslow County 1992
❑ National wetlands inventory map(s) Cite name
❑ State /Local wetland inventory map(s)
❑ FEMA/FIRM maps
❑ 100 -year Floodplain Elevation is (National Geodectic Vertical Datum
of 1929)
® Photographs ® Aerial (Name & Date) NCCGIA Orthoimagery Server
2010 (shown on soil map)
or ® Other (Name & Date) Photo of wetlands included in cover
letter
❑ Previous determination(s) File no and date of response letter
❑ Other information (please specify)
IMPORTANT NOTE The information recorded on this form has not
necessarily been verified by the Corps and should not be relied upon for
later iurisdictional determinations
Signature and date of
Regulatory Project Manager
(REQUIRED)
3
Signature and date of
person requesting preliminary JD
(REQUIRED unless obtaining
the signature is impracticable)

Site
number
Latitude
Longitude
Cowardin
Class
Estimated
amount of
aquatic
resource in
review area
Class of
aquatic
resource
1
Palustnne
forested
0 015 ac
non - section 10
— wetland

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